Key result
Approximately 30% of obese individuals exhibit a healthy cardiometabolic phenotype and do not appear to be at increased risk of incident cardiovascular disease events compared with at-risk obese.
Why the study?
Are individuals with a healthy obese phenotype at increased risk of incident cardiovascular disease events compared with at-risk obese individuals?
Are individuals with a healthy obese phenotype at increased risk of incident cardiovascular disease events compared with at-risk obese individuals?
The healthy obese phenotype, present in about 30% of obese individuals, is not associated with an increased risk of incident CVD events compared to at-risk obese individuals, and standard weight loss recommendations may need reevaluation for this group.
May support phenotype-specific CVD risk assessment in obesity; leaves open whether interventions should differ for metabolically healthy individuals.
PURPOSE OF REVIEW: To introduce the healthy obese phenotype, characterized by favorable cardiometabolic risk factors despite excess adipose tissue. The epidemiology of the healthy obese phenotype is presented, including associated risk of cardiovascular disease (CVD), and potential biologic mechanisms which may give rise to the phenotype are discussed. RECENT FINDINGS: Although it appears that approximately 30% of obese individuals maintain healthy cardiometabolic profiles, little published data exist examining the healthy obese phenotype. The healthy obese do not appear to be at increased risk of incident CVD events compared with at-risk obese, and the location of adipose tissue and the metabolic characteristics of the fat in a given location, including the presence of ectopic fat and associated adipocytokine response, may give rise to the phenotype. Recent data also suggest that weight loss among healthy obese may adversely impact their favorable cardiometabolic profile. SUMMARY: A high prevalence of the healthy obese phenotype has been reported, and these individuals appear to be at no increased risk of CVD. Further research is needed into the mechanisms that allow these individuals to maintain low risk of CVD despite excess adiposity and appropriate weight loss recommendations for this group.
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Rachel P. Wildman (2009) conducted a review in Obesity. Healthy obese phenotype vs. At-risk obese was evaluated on Incident CVD events. Approximately 30% of obese individuals exhibit a healthy cardiometabolic phenotype and do not appear to be at increased risk of incident cardiovascular disease events compared with at-risk obese.
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