Higher inflammation is associated with cardiometabolic phenotype and biochemical health in women with obesity.

Introduction Metabolic or inflammatory markers may predict adverse outcomes in women with obesity. We sought to describe metabolic-obesity phenotypes of women using novel staging tools and investigate relationships with inflammation. Methods In a cross-sectional study, we collected fasting blood samples from sixty-four females with body mass index (BMI) ≥28kg/m2. Participants were classified as metabolically healthy (MHO) or unhealthy (MUO) using the Cardiometabolic Disease Staging System (CMDS) and Edmonton Obesity Staging System (EOSS). Data was analyzed using independent sample t-tests, Pearson's correlations, and multiple logistic regression. Results Mean (SD) age was 40.2 (9.3) years with median (IQR) BMI 31.8 (30.3-35.7) kg/m2. The prevalence of MUO was 46.9% and 81.3% using CMDS and EOSS criteria respectively. Women with raised CMDS scores had higher C3 (1.34 (0.20) vs 1.18 (0.15), p =.001) and CRP (2.89 (1.31-7.61) vs. 1.39 (0.74-3.60), p=.034). C3 correlated with insulin (r =0.52), hemoglobin A1c (r=0.37), and C-peptide (r=0.58), all p<.05. C3 above the median (>1.23 g/L) increased odds of raised CMDS score, when controlled for age, BMI, ethnicity, and smoking (β=7.1, 95%CI 1.78, 28.4, p=.005). Conclusion The prevalence of MUO was lower using CMDS than EOSS. C3 and CRP may be useful clinical biomarkers of risk or treatment targets in women with obesity.