Abstract Body (Do not enter title and authors here): Background: The Adiposity-Based Chronic Disease (ABCD) model is designed to assess the diagnosis, and the prevalence of adiposity and health risks associated with it. The aim of the present study is to show the prevalence and the associated risk factors for each ABCD stage.
Methods: In this cross-sectional study, 10,087 participants who attended the outpatient clinic of the Vali-Asr Hospital, in Tehran, Iran, were evaluated from February 2002 to March 2020. ABCD stages were defined as: Stage 0 (no identifiable adiposity-based complications (Cardiometabolic Disease Stage [CMDS] 0)), Stage 1 (mild to moderate adiposity-based complications including micro – macro vascular (CMDS 1)), and Stage 2 (severe adiposity-based complications (CMDS 2 – 4)).
Results: Among all study participants, 34.3% (3,465) were men. The median age was 54.48 and 50.17 years for men and women, respectively. The frequency of individuals with ABCD score of equal and more than one was 95.9% in men and 82.2% in women (P value < 0.001). Stage 0 was found in 17.8% of women and 4.0% of men, Stage 1 in 20.2% of women and 12.8% of men, Stage 2 in 83.1% of men and 62.0% of women. ABCD Stages increased with age (P value < 0.001). Compared to stage 0 of ABCD, all ABCD stages were associated with higher systolic [stage 1 OR= 1.044 (P<0.001), stage 2 OR=1.098, (P<0.001)] and diastolic blood pressure [stage 1 OR=1.041 (P<0.001), stage 2 OR=1.104 (P<0.001)], Higher total Cholesterol [stage 1 OR= 1.008 (P<0.001), stage 2 OR= 1.005 (P<0.001)], higher AST [stage 1 OR=1.042 (P<0.001), stage 2 OR= 1.048 (P<0.001)], and higher ALT [stage 1 OR= 1.059 (P<0.001), stage 2 OR= 1.066 (P<0.001)] .

Conclusion: The ABCD framework enables early detection and risk stratification of the subjects who are at risk, but currently not overweight or obese, and do not have abdominal obesity. In our study, the ABCD stages shared common risk factors with diabetes and cardiovascular diseases.