Key result
Obesity phenotypes, including metabolically healthy obesity, were associated with higher odds of prolonged PR, P-wave, and QRS durations compared to metabolically healthy non-obese individuals.
Why the study?
To investigate the association of metabolically healthy obesity and other obesity phenotypes with ECG markers to understand the pathophysiological basis of increased CVD risk.
Are obesity phenotypes, including metabolically healthy obesity, associated with abnormal electrocardiographic markers compared to metabolically healthy individuals without obesity?
Cross-Sectional (n=3,700)
Yes
Are obesity phenotypes, including metabolically healthy obesity, associated with abnormal electrocardiographic markers compared to metabolically healthy individuals without obesity?
Metabolically healthy obesity is associated with abnormal electrocardiographic markers, challenging the concept that it is a benign cardiovascular state.
May indicate subclinical conduction effects even in metabolically healthy obesity; challenges its benign status and leaves causal implications open.
OBJECTIVE: This study aimed to investigate the association of metabolically healthy obesity (MHO) and other obesity phenotypes with electrocardiographic (ECG) markers to understand the pathophysiological basis of increased cardiovascular disease (CVD) risk associated with these phenotypes. METHODS: A total of 3,700 participants (58.7 ± 13.6 years, 52% women) without CVD from the third National Health and Nutrition Examination Survey (NHANES III) were included. Logistic regression was used to examine the cross-sectional association between obesity phenotypes (metabolically healthy without obesity [MHNO; reference], metabolically unhealthy without obesity, MHO, and metabolically unhealthy obesity) with ECG markers (PR interval, P-wave duration, QRS duration, and QT interval). RESULTS: Higher odds of prolonged PR interval, P-wave duration, and QRS duration were observed among all phenotypes compared with MHNO, with the highest in participants with obesity with or without metabolic syndrome. However, for QT interval, the trend of association with obesity phenotypes was as follows, from the strongest to the least strong: metabolically unhealthy obesity, metabolically healthy without obesity, and then MHO, compared with MHNO. CONCLUSIONS: An association of obesity phenotypes with ECG abnormalities further raises doubt about the concept of MHO as a healthy state. Variations in associations with ECG markers may suggest that metabolic syndrome and obesity have a different relationship with different CVD outcomes and may explain some of the inconsistent CVD estimates for MHO.
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Ahmad et al. (2019) conducted a cross-sectional in Obesity phenotypes (n=3,700). Obesity phenotypes (MHO, metabolically unhealthy without obesity, metabolically unhealthy obesity) vs. Metabolically healthy without obesity (MHNO) was evaluated on Electrocardiographic markers (PR interval, P-wave duration, QRS duration, and QT interval). Obesity phenotypes, including metabolically healthy obesity, were associated with higher odds of prolonged PR, P-wave, and QRS durations compared to metabolically healthy non-obese individuals.
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