Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk
<strong>Background:</strong> Debate over the cardiometabolic risk associated with metabolically healthy obesity (MHO) continues. Many studies have investigated this relationship by examining MHO at baseline with longitudinal follow-up, with inconsistent results. <strong>Objectives:...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
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Elsevier
2018
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| _version_ | 1826257580239880192 |
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| author | Mongraw-Chaffin, M Foster, M Anderson, C Burke, G Haq, N Kalyani, R Ouyang, P Sibley, C Tracy, R Woodward, M Vaidya, D |
| author_facet | Mongraw-Chaffin, M Foster, M Anderson, C Burke, G Haq, N Kalyani, R Ouyang, P Sibley, C Tracy, R Woodward, M Vaidya, D |
| author_sort | Mongraw-Chaffin, M |
| collection | OXFORD |
| description | <strong>Background:</strong> Debate over the cardiometabolic risk associated with metabolically healthy obesity (MHO) continues. Many studies have investigated this relationship by examining MHO at baseline with longitudinal follow-up, with inconsistent results. <strong>Objectives:</strong> The authors hypothesized that MHO at baseline is transient and that transition to metabolic syndrome (MetS) and duration of MetS explains heterogeneity in incident cardiovascular disease (CVD) and all-cause mortality. <strong>Methods:</strong> Among 6,809 participants of the MESA (Multi-Ethnic Study of Atherosclerosis) the authors used Cox proportional hazards and logistic regression models to investigate the joint association of obesity (≥30 kg/m2) and MetS (International Diabetes Federation consensus definition) with CVD and mortality across a median of 12.2 years. We tested for interaction and conducted sensitivity analyses for a number of conditions. <strong>Results:</strong> Compared with metabolically healthy normal weight, baseline MHO was not significantly associated with incident CVD; however, almost one-half of those participants developed MetS during follow-up (unstable MHO). Those who had unstable MHO had increased odds of CVD (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.14 to 2.25), compared with those with stable MHO or healthy normal weight. Dose response for duration of MetS was significantly and linearly associated with CVD (1 visit with MetS OR: 1.62; 95% CI: 1.27 to 2.07; 2 visits, OR: 1.92; 95% CI: 1.48 to 2.49; 3+ visits, OR: 2.33; 95% CI: 1.89 to 2.87; p value for trend <0.001) and MetS mediated approximately 62% (44% to 100%) of the relationship between obesity at any point during follow-up and CVD. <strong>Conclusion:</strong> Metabolically healthy obesity is not a stable or reliable indicator of future risk for CVD. Weight loss and lifestyle management for CVD risk factors should be recommended to all individuals with obesity. |
| first_indexed | 2024-03-06T18:20:27Z |
| format | Journal article |
| id | oxford-uuid:0616d0c7-1f61-4707-96b1-6dd3afc75812 |
| institution | University of Oxford |
| last_indexed | 2024-03-06T18:20:27Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:0616d0c7-1f61-4707-96b1-6dd3afc758122022-03-26T09:00:55ZMetabolically healthy obesity, transition to metabolic syndrome, and cardiovascular riskJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0616d0c7-1f61-4707-96b1-6dd3afc75812Symplectic Elements at OxfordElsevier2018Mongraw-Chaffin, MFoster, MAnderson, CBurke, GHaq, NKalyani, ROuyang, PSibley, CTracy, RWoodward, MVaidya, D<strong>Background:</strong> Debate over the cardiometabolic risk associated with metabolically healthy obesity (MHO) continues. Many studies have investigated this relationship by examining MHO at baseline with longitudinal follow-up, with inconsistent results. <strong>Objectives:</strong> The authors hypothesized that MHO at baseline is transient and that transition to metabolic syndrome (MetS) and duration of MetS explains heterogeneity in incident cardiovascular disease (CVD) and all-cause mortality. <strong>Methods:</strong> Among 6,809 participants of the MESA (Multi-Ethnic Study of Atherosclerosis) the authors used Cox proportional hazards and logistic regression models to investigate the joint association of obesity (≥30 kg/m2) and MetS (International Diabetes Federation consensus definition) with CVD and mortality across a median of 12.2 years. We tested for interaction and conducted sensitivity analyses for a number of conditions. <strong>Results:</strong> Compared with metabolically healthy normal weight, baseline MHO was not significantly associated with incident CVD; however, almost one-half of those participants developed MetS during follow-up (unstable MHO). Those who had unstable MHO had increased odds of CVD (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.14 to 2.25), compared with those with stable MHO or healthy normal weight. Dose response for duration of MetS was significantly and linearly associated with CVD (1 visit with MetS OR: 1.62; 95% CI: 1.27 to 2.07; 2 visits, OR: 1.92; 95% CI: 1.48 to 2.49; 3+ visits, OR: 2.33; 95% CI: 1.89 to 2.87; p value for trend <0.001) and MetS mediated approximately 62% (44% to 100%) of the relationship between obesity at any point during follow-up and CVD. <strong>Conclusion:</strong> Metabolically healthy obesity is not a stable or reliable indicator of future risk for CVD. Weight loss and lifestyle management for CVD risk factors should be recommended to all individuals with obesity. |
| spellingShingle | Mongraw-Chaffin, M Foster, M Anderson, C Burke, G Haq, N Kalyani, R Ouyang, P Sibley, C Tracy, R Woodward, M Vaidya, D Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title | Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title_full | Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title_fullStr | Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title_full_unstemmed | Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title_short | Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk |
| title_sort | metabolically healthy obesity transition to metabolic syndrome and cardiovascular risk |
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