# The Association Between Serum α1‐Acid Glycoprotein and Obesity and Abdominal Obesity in Women: A Cross‐Sectional Study Based on NHANES Data From 2015 to 2018

## TL;DR

This study finds that higher levels of serum α1-acid glycoprotein are linked to increased obesity and abdominal obesity in women, suggesting it could be a useful biomarker.

## Contribution

The study identifies a novel association between serum α1-acid glycoprotein levels and obesity metrics in women, including a threshold effect and modulatory role of education.

## Key findings

- Higher SSAGP levels correlate with increased BMI, waist circumference, and metabolic risk factors in women.
- A threshold effect was observed at SSAGP level K=1.2, with different impacts below and above this point.
- Educational level significantly modulates the SSAGP-obesity relationship.

## Abstract

Obesity and abdominal obesity are major public health issues closely related to metabolic diseases. Serum α1‐acid glycoprotein (SSAGP), an acute‐phase reactant influenced by inflammation and metabolic status, has an unclear relationship with obesity and abdominal obesity. This study investigates this association in women.

Using cross‐sectional data from NHANES (2015–2018), 2219 adult women were divided into three groups based on SSAGP levels (low, medium, and high). Multiple regression analyses assessed the relationship between SSAGP and BMI, waist circumference, obesity (BMI ≥ 30 kg/m2), and abdominal obesity (waist circumference ≥ 90 cm). Threshold and interaction analyses were also conducted.

As SSAGP levels increased, BMI, waist circumference, fasting blood glucose, insulin, and hs‐CRP levels rose significantly (p < 0.001), while HDL levels decreased (p < 0.001). SSAGP was positively correlated with BMI, waist circumference, obesity, and abdominal obesity (p < 0.0001). After adjusting for confounders, a one‐unit increase in SSAGP was associated with a 4.42 increase in BMI (95% CI: 3.08, 5.76), a 12.18 cm increase in waist circumference (95% CI: 9.22, 15.14), a 3.63‐fold increase in obesity risk (95% CI: 1.96, 6.72), and a 10.75‐fold increase in abdominal obesity risk (95% CI: 4.85, 23.85). Threshold effect analysis showed an inflection point (K = 1.2), with SSAGP having a stronger promoting effect below this point and an inhibitory effect above it (p < 0.001). Educational level significantly influenced the SSAGP‐obesity relationship (p = 0.0096).

SSAGP levels are significantly associated with obesity and abdominal obesity in women, with educational level playing a modulatory role. SSAGP may serve as a potential biomarker for obesity risk. Future studies should explore the causal relationships and underlying mechanisms.