Abstract
BACKGROUND: Arterial Hypertension (AH) and Type 2 Diabetes (T2DM) are common in obesity. However, there is no data on the influence of different degrees of obesity on the frequency of the two diseases. PATIENTS AND METHODS: In this cross-sectional study 3,486 patients (867 men and 2,619 women, aged 42.6 ± 11.48 years, minimum BMI 30.0 kg/m(2), mean BMI 41.9 ± 6.62 kg/m(2)), were evaluated at presentation for bariatric surgery (BS). BMI was expressed as a continuous variable, as BMI quartiles (BMIQ), as full obesity class (I-III), as reduced obesity class (II-III), Frequency of AH and T2DM, and of a comorbidity score (CS: AH + T2DM) was recorded, and univariable and multivariable stepwise regression analysis was employed to evaluate the association of BMI indexes with AH, T2DM, and CS. RESULTS: AH, T2DM and CS showed increasing frequency with increasing BMI quartiles (p < 0.001), and with age (p < 0.001). AH and T2DM were frequently associated. At multivariable analysis, age and BMIQ were associated with AH (p < 0.001), T2DM (p < 0.001), and with CS (p < 0.001), more than BMI (NS for CS) full obesity class and reduced obesity class and BMI (NS for T2DM and for CS). The same results were observed at receiver operating curves (ROC), with greater area (AUC) for BMIQ than for BMI and obesity classes. CONCLUSION: The frequency of AH and T2DM increases with increasing BMI levels. BMIQ outperforms BMI and obesity classes in modelling. This finding supports the use of fine stratification of BMI in clinical risk assessment. More specific studies are required to fully understand the impact of different BMI thresholds in determining the health status of obese patients, and to reduce the risks of BS in patients with extreme obesity.