Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study
Abstract Background A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO a...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-01815-6 |
| _version_ | 1797850248856469504 |
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| author | Dongmei Wei Vannina González-Marrachelli Jesus D Melgarejo Chia-Te Liao Angie Hu Stefan Janssens Peter Verhamme Lucas Van Aelst Thomas Vanassche Josep Redon Maria Tellez-Plaza Juan C Martin-Escudero Daniel Monleon Zhen-Yu Zhang |
| author_facet | Dongmei Wei Vannina González-Marrachelli Jesus D Melgarejo Chia-Te Liao Angie Hu Stefan Janssens Peter Verhamme Lucas Van Aelst Thomas Vanassche Josep Redon Maria Tellez-Plaza Juan C Martin-Escudero Daniel Monleon Zhen-Yu Zhang |
| author_sort | Dongmei Wei |
| collection | DOAJ |
| description | Abstract Background A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern. Methods This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood pressure < 130 mmHg, no antihypertensive drugs, waist-to-hip ratio < 0.95 for women or 1.03 for men, and the absence of diabetes. BMI categories included normal weight, overweight, and obesity (BMI < 25, 25–30, ≥ 30 kg/m2). Participants were classified into six subgroups according to BMI category and metabolic healthy status. Outcomes were fatal and nonfatal composited cardiovascular events. Results Of 2339 participants, the mean age was 51 years, 1161 (49.6%) were women, 434 (18.6%) had obesity, 117 (5.0%) were classified as MHO, and both cohorts had similar characteristics. Over a median of 9.2-year (3.7–13.0) follow-up, 245 cardiovascular events occurred. Compared to those with metabolically healthy normal weight, individuals with metabolic unhealthy status had a higher risk of cardiovascular events, regardless of BMI category (adjusted HR: 3.30 [95% CI: 1.73–6.28] for normal weight, 2.50 [95% CI: 1.34–4.66] for overweight, and 3.42 [95% CI: 1.81–6.44] for obesity), whereas those with MHO were not at increased risk of cardiovascular events (HR: 1.11 [95% CI: 0.36–3.45]). Factor analysis identified a metabolomic factor mainly associated with glucose regulation, which was associated with cardiovascular events (HR: 1.22 [95% CI: 1.10–1.36]). Individuals with MHO tended to present a higher metabolomic factor score than those with metabolically healthy normal weight (0.175 vs. -0.057, P = 0.019), and the score was comparable to metabolically unhealthy obesity (0.175 vs. -0.080, P = 0.91). Conclusions Individuals with MHO may not present higher short-term cardiovascular risk but tend to have a metabolomic pattern associated with higher cardiovascular risk, emphasizing a need for early intervention. |
| first_indexed | 2024-04-09T18:57:20Z |
| format | Article |
| id | doaj.art-a43bc145f2974a0c816d0f5d50f5fc4b |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-09T18:57:20Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-a43bc145f2974a0c816d0f5d50f5fc4b2023-04-09T11:07:16ZengBMCCardiovascular Diabetology1475-28402023-04-0122111110.1186/s12933-023-01815-6Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic studyDongmei Wei0Vannina González-Marrachelli1Jesus D Melgarejo2Chia-Te Liao3Angie Hu4Stefan Janssens5Peter Verhamme6Lucas Van Aelst7Thomas Vanassche8Josep Redon9Maria Tellez-Plaza10Juan C Martin-Escudero11Daniel Monleon12Zhen-Yu Zhang13Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, University of LeuvenDepartment of Physiology, Faculty of Medicine, University of ValenciaStudies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, University of LeuvenStudies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, University of LeuvenStudies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, University of LeuvenDivision of Cardiology, University Hospitals LeuvenDepartment of Cardiovascular Sciences, University of LeuvenDivision of Cardiology, University Hospitals LeuvenDivision of Cardiology, University Hospitals LeuvenInstitute for Biomedical Research, Hospital Clinic of Valencia (INCLIVA)Institute for Biomedical Research, Hospital Clinic of Valencia (INCLIVA)Department of Internal Medicine, Hospital Universitario Rio Hortega, University of ValladolidInstitute for Biomedical Research, Hospital Clinic of Valencia (INCLIVA)Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, University of LeuvenAbstract Background A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern. Methods This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood pressure < 130 mmHg, no antihypertensive drugs, waist-to-hip ratio < 0.95 for women or 1.03 for men, and the absence of diabetes. BMI categories included normal weight, overweight, and obesity (BMI < 25, 25–30, ≥ 30 kg/m2). Participants were classified into six subgroups according to BMI category and metabolic healthy status. Outcomes were fatal and nonfatal composited cardiovascular events. Results Of 2339 participants, the mean age was 51 years, 1161 (49.6%) were women, 434 (18.6%) had obesity, 117 (5.0%) were classified as MHO, and both cohorts had similar characteristics. Over a median of 9.2-year (3.7–13.0) follow-up, 245 cardiovascular events occurred. Compared to those with metabolically healthy normal weight, individuals with metabolic unhealthy status had a higher risk of cardiovascular events, regardless of BMI category (adjusted HR: 3.30 [95% CI: 1.73–6.28] for normal weight, 2.50 [95% CI: 1.34–4.66] for overweight, and 3.42 [95% CI: 1.81–6.44] for obesity), whereas those with MHO were not at increased risk of cardiovascular events (HR: 1.11 [95% CI: 0.36–3.45]). Factor analysis identified a metabolomic factor mainly associated with glucose regulation, which was associated with cardiovascular events (HR: 1.22 [95% CI: 1.10–1.36]). Individuals with MHO tended to present a higher metabolomic factor score than those with metabolically healthy normal weight (0.175 vs. -0.057, P = 0.019), and the score was comparable to metabolically unhealthy obesity (0.175 vs. -0.080, P = 0.91). Conclusions Individuals with MHO may not present higher short-term cardiovascular risk but tend to have a metabolomic pattern associated with higher cardiovascular risk, emphasizing a need for early intervention.https://doi.org/10.1186/s12933-023-01815-6Cardiovascular riskDiabetesObesityMetabolically healthy obesityMetabolomics |
| spellingShingle | Dongmei Wei Vannina González-Marrachelli Jesus D Melgarejo Chia-Te Liao Angie Hu Stefan Janssens Peter Verhamme Lucas Van Aelst Thomas Vanassche Josep Redon Maria Tellez-Plaza Juan C Martin-Escudero Daniel Monleon Zhen-Yu Zhang Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study Cardiovascular Diabetology Cardiovascular risk Diabetes Obesity Metabolically healthy obesity Metabolomics |
| title | Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study |
| title_full | Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study |
| title_fullStr | Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study |
| title_full_unstemmed | Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study |
| title_short | Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study |
| title_sort | cardiovascular risk of metabolically healthy obesity in two european populations prevention potential from a metabolomic study |
| topic | Cardiovascular risk Diabetes Obesity Metabolically healthy obesity Metabolomics |
| url | https://doi.org/10.1186/s12933-023-01815-6 |
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