Endocrine Abstracts

Obesity is a major public health problem. It is a privileged provider of a constellation of metabolic abnormalities, particularly lipids, increasing the risk of morbidity and mortality and hampering the quality of life of the obese.

Material and methods: We conducted a prospective study on 100 obese patients recruited at the Human Obesity Research Unit at the National Institute of Nutrition in Tunis. Our patients benefited from an assay of fasting insulinemia and a complete lipid profile including the assay of cholesterol, triglycerides, HDL-cholesterol with calculation of LDL-cholesterol and non-HDL-cholesterol.

Results and Statistical Analysis: The average age of our population is 37 ± 10.8 years. The average BMI is 38 ± 6.7 kg/m² with extremes of 30 and 67 kg/m². Mean fasting insulinemia is 24.7 ± 20.1 μU/ml with extremes of 5.3 and 146 μU/ml. One-third of obese people have high fasting insulin levels. Hypertriglyceridaemia is noted in 19% of obese patients. 29% of obese people have hypercholesterolemia. More than a quarter of obese people (27%) have low HDL-cholesterol levels below 1.03 mmol/l (0.4 g/l). On the other hand, 14% of patients have an HDL-cholesterol level greater than or equal to 1.55 mmol/l (0.6 g/l). The average non-HDL cholesterol is 3.35 ± 0.9 mmol/l (1.3 ± 0.36 g/l). The average LDL-cholesterol of 2.81 ± 0.85 mmol/l (1.09 ± 0.33 g/l) with extremes of 1 and 6 mmol/l (0.39 and 2.32 g/l). Hyper LDLemia was discovered in 29.3% of obese patients. The duration of evolution of obesity is positively and significantly correlated with the elevation of cholesterolemia (P = 0.001), LDL-cholesterol (P = 0.002) and non-HDL-cholesterol (P = 0.001). The rise in fasting insulinemia is positively and statistically correlated with the rise in cholesterolemia (P = 0.001), LDL-cholesterol (P < 10−3), non-HDL-cholesterol (P < 10−3). A negative and statistically significant correlation was also noted between fasting insulinemia and HDL-cholesterol (P = 0.02).

Conclusion: The lipid profile of the obese is highly atherogenic. It is distinguished by a variety of lipid abnormalities dominated by elevated LDL-cholesterol, total cholesterol and triglycerides with hypo-HDLemia justifying their early management in order to improve their cardiovascular prognosis.