METABOLIC AND CARDIAC AUTONOMIC CORRELATES OF THE CUORE SCORE IN NON DIABETICS WITH STAGE I-II OBESITY IN LATE MIDDLE-AGE

Introduction The CUORE score predicts 10-year of fatal and non-fatal cardiovascular (CV) events Obesity (OB) is a worldwide epidemics: the proportion of OB has increased during the two waves of the CUORE project, with over 1 in 4 Italians in the late middle-age range being now OB. Controversy still exits on the identification of OB phenotypes and their relation with CV risk, particularly in women. Insulin resistance (IR) has been recognized as a common marker linking OB to CV risk. We assessed among non diabetics with stage I-II obesity in late middle-age, the metabolic and autonomic correlates of increased CV risk as assessed by the CUORE score. Methods Non diabetics aged >50 and <=70 years with BMI>= 30 and <40 kg/m2 on a group weight management program at our Nutrition Unit underwent anthropometric measures; assessment of body composition by air displacement pletismography, kidney function, lipid and glucose profile. An ECG was recorded during 1-min deep breathing and lying-to-standing. We calculated CUORE score, HOmeostatic Model Assessment-insulin resistance index (HOMA-IR), QUantitative Insulin sensitivity CHeck Index (QUICKI), Visceral Adiposity Index (VAI), Fatty Liver Index (FLI), expiration-inspiration (EI) ratio and 30:15 ratio. We classified patients in 2 groups based on CUORE gender-specific cut-offs as at low (F<3;M<10) or moderate (F >=3;M>=10) risk. Results Among 60 recruited subjects (31 F 29 M, age 60±5 years), CUORE range was M: 3.5-17.5, F: 1-8.2. Patients at moderate risk (25%) showed significantly larger waist circumference, lower glomerular filtration rate (GFR), higher waist-hip ratio, glucose, insulin, HOMA-IR, VAI and FLI; lower insulin sensitivity (QUICKI) and EI ratio; and a 3-fold higher prevalence of the metabolic syndrome than subjects at low risk (Tab.1)