Key result
Metabolically healthy obesity linked to ~17% higher stroke risk versus metabolically healthy normal weight.
Why the study?
The association between metabolically healthy obesity and the risk of stroke remains unclear.
Does metabolically healthy obesity increase the risk of incident stroke compared to metabolically healthy normal weight?
Meta-Analysis (n=4,256,888)
Does metabolically healthy obesity increase the risk of incident stroke compared to metabolically healthy normal weight?
Effect estimate: RR 1.17 (95% CI 1.11-1.23)
Metabolically healthy obesity is associated with a 17% increased risk of incident stroke compared to metabolically healthy normal weight, indicating that obesity carries cardiovascular risk even in the absence of metabolic abnormalities.
Even metabolically healthy obesity warrants stroke risk consideration; extends meta-analytic associations but remains hypothesis-generating without causal confirmation.
BACKGROUND: Metabolic healthy obesity (MHO) is a unique subgroup of overweight and obese individuals with normal metabolic characteristics. Its association with the risk of stroke remains unclear. We aimed to examine the risk of stroke in MHO individuals and the further associations between stroke and metabolic abnormalities under different bodyweight conditions. METHODS: We systematically searched PubMed, Embase and Cochrane Library from December 1946 to January 2019, and only included prospective cohort studies. Random effects models were used to evaluate the pooled risk ratios (RR) and 95% confidence intervals (95% CI) of incident stroke. RESULTS: A total of eight studies comprising 4,256,888 participants were included in the meta-analysis. MHO individuals had an increased risk of stroke compared with metabolically healthy normal weight (MH-NW) individuals (RR =1.17, 95% CI: 1.11-1.23). However, the stroke risk of metabolically healthy overweight individuals was the same (RR =1.02, 95% CI: 0.84-1.23). All groups with unhealthy metabolism had a similarly elevated risk: normal weight (RR =1.83, 95% CI: 1.57-2.14), overweight (RR =1.93, 95% CI: 1.44-2.58), and obesity (RR =2.00, 95% CI: 1.40-2.87). CONCLUSIONS: The meta-analysis confirms a positive association between MHO phenotype and the risk of stroke. Individuals with metabolic abnormalities under different bodyweight conditions are at elevated risk.
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Ma et al. (2021) conducted a meta-analysis in Metabolically healthy obesity (n=4,256,888). Metabolically healthy obesity (MHO) vs. Metabolically healthy normal weight (MH-NW) was evaluated on Incident stroke (RR 1.17, 95% CI 1.11-1.23). Metabolically healthy obesity was associated with an increased risk of incident stroke compared with metabolically healthy normal weight individuals (RR 1.17; 95% CI 1.11-1.23).
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