Association between central obesity and symptoms of autonomic dysfunction: A cross-sectional study

Introduction: Central obesity is associated with diverse complications, including autonomic symptoms; however, there are several diagnostic criteria for defining central obesity. This study aimed to examine the association between central obesity, using two different definitions, and the presence of autonomic dysfunction symptoms in adults. Methods: Secondary data analysis using information from an observational, cross-sectional study conducted in the North of Peru, between 2016 and 2017. Autonomic symptoms were assessed using the Survey of Autonomic Symptoms, whereas central obesity was defined based on waist circumference, using two different criteria (International Diabetes Federation [IDF] and the Adult Treatment Panel III [ATP III]). Crude and adjusted (for age, sex, education level, and socioeconomic status) Poisson regression models were created to evaluate the association of interest. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were reported. Results: A total of 1,609 participants were analyzed, with a mean age of 48.2 years (SD: 10.6) and 810 (50.3%) were women. The prevalence of central obesity was 79.4% (95% CI: 77.3%-81.3%) according to IDF criterion, and 45.5% (95% CI: 43.1%-48.0%) based on ATP III criterion. In multivariable model, central obesity as defined by IDF was significantly associated with urinary leakage (PR = 2.12; 95% CI: 1.22-3.69). A significant but weaker association was observed when applying ATP III criteria (PR = 1.47; 95% CI: 1.10-1.97). Conclusions: Central obesity, as defined by both IDF and ATP III criteria, was significantly associated with autonomic dysfunction symptoms, particularly urinary leakage. Resultados: Se analizaron 1609 participantes, con una edad media de 48,2 años (DE: 10,6), de los cuales 810 (50,3%) eran mujeres. La prevalencia de obesidad central fue del 79,4% (IC del 95%: 77,3%-81,3%) según los criterios de la IDF y del 45,5% (IC del 95%: 43,1%-48,0%) según los criterios del ATP III. En un modelo multivariable, la obesidad central, definida por la IDF, se asoció significativamente con la pérdida urinaria (RP = 2,12; IC del 95%: 1,22-3,69). Se observó una asociación significativa, aunque más débil, al aplicar los criterios del ATP III (RP = 1,47; IC del 95%: 1,10-1,97). Conclusión: La obesidad central, definida tanto por los criterios de la IDF como por los del ATP III, se asoció significativamente con síntomas de disfunción autonómica, en particular con la pérdida urinaria.