Larger Wrist Size May Suggest Unhealthy Metabolic Syndrome Interview with:
Ilaria Cavallari, MD
Department of Cardiovascular Sciences
University Campus Bio-Medico
Roma, Italy What is the background for this study?

Response: Obesity is a well-known risk factor for metabolic and cardiovascular disease (CVD). However, more than the amount of adipose tissue, its function plays important roles in the development of CVD. Distribution of adiposity, evaluated by measuring body circumferences, is related to adipose dysfunction. Wrist circumference has been recently associated with insulin-resistance and diabetes. Therefore, body circumferences, wrist circumference in particular, are candidate easy and fast markers of cardiovascular risk, beyond the classical body mass index (BMI). What are the main findings?

Response: The main finding of this study is that, in overweight-obese subjects undergoing coronary angiography, body circumferences, wrist in particular, represent a useful tool for the identification of metabolic dysfunction. Our data also confirm that metabolic dysfunction, is independently associated with cIMT and with advanced atherosclerosis. However, there was no direct association between anthropometric measurements and atherosclerotic disease. What should readers take away from your report?

Response: Overall our data suggest that wrist circumference can be used as a practical tool for the assessment of metabolic dysfunction in subjects with BMI ≥25Kg/m2. Therefore, by measuring wrist circumference clinicians could estimate the metabolic risk of their overweight-obese patients identifying those who are more likely to be affected by metabolic syndrome. Among overweight-obese subjects, those in each sequentially higher gender-specific tertiles of wrist circumference were 2.57 [96% CI 1.11-5.96] times more likely to be affected by metabolic syndrome. What recommendations do you have for future research as a result of this study?

Response: Because of the cross-sectional design we can associate markers of metabolic dysfunction and atherosclerosis, but cannot indicate whether patterning of adipose deposition predicts disease. Future longitudinal studies have to be conducted to investigate the potential role of body circumferences as predictors. In addition, this study was not designed to investigate the association of body circumferences with the incidence of cardiovascular events (ie, cardiovascular death, myocardial infarction and stroke).

Finally, our results need to be confirmed in normal weight subjects by enrolling a larger population of patients with BMI < 25kg/m2. Is there anything else you would like to add?

Response: Taken together, our study suggests that in everyday clinical practice clinicians might have the possibility to distinguish “metabolically unhealthy” from “metabolically healthy” overweight/obese phenotypes using a measuring tape. Thank you for your contribution to the community.


Relation of Body Circumferences to Cardiometabolic Disease in Overweight-Obese Subjects
Maddaloni, Ernesto et al.
American Journal of Cardiology , Volume 0 , Issue 0 June 28, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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