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September 18, 2020PLoS ONEOpen Access

Transition from metabolically healthy obesity to metabolic syndrome over 15.9 years increased the risk of cardiovascular disease in males (HR 1.55) but not in females (HR 0.93).

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Why the study?

Data on the cardiovascular risk of the metabolically healthy obesity phenotype and the effect of transitioning to an unhealthy status were inconsistent.

Does transition from metabolically healthy obesity to metabolic syndrome increase the incidence of cardiovascular disease in adults?

Population

6758 participants aged ≥ 20 years (41.6% men)

Comparison

Persistent MHNW, persistent MHO, transitional MHO, and MUO groups

Design

Population-based cohort study

Follow-up

Median follow-up of 15.9 years

Key result

Transition from metabolically healthy obesity to metabolic syndrome over 15.9 years increased the risk of cardiovascular disease in males (HR 1.55) but not in females (HR 0.93).

Authors

FHFarhad HosseinpanahResearch Institute for Endocrine SciencesETErfan TasdighiGeneral / Preventive / LipidsMBMaryam BarzinResearch Institute for Endocrine Sciences

Discussion

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Overview

Persistent MHO showed no excess CVD risk; leaves open whether transition to unhealthy status drives outcomes in observational cohorts.

Study Design

Type

Cohort (n=6,758)

Structured PICO

Does transition from metabolically healthy obesity to metabolic syndrome increase the incidence of cardiovascular disease in adults?

P
Population
6,758 adults aged 20 years and older without baseline cardiovascular disease, followed for a median of 15.9 years to assess the impact of transitioning from metabolically healthy obesity to metabolic syndrome.
E
Exposure
Transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) status during follow-up.
C
Comparator
Persistent metabolically healthy normal weight (MHNW) (reference group) and persistent MHO.
O
Outcome
Incidence of cardiovascular disease (CVD), defined as any coronary heart disease, stroke, or CVD death.hard clinical

Main Result

Hazard Ratio: 1.55 (95% CI 1.02–2.37)

Transition from metabolically healthy obesity to a metabolically unhealthy state increases the risk of cardiovascular disease in men, highlighting the dynamic nature of obesity phenotypes and the need for ongoing metabolic monitoring.

Limitations

  • Information on socioeconomic status and nutrition of subjects was not available
  • Physical activity was recorded using a questionnaire not validated in Iran in the first phase
  • Defining the MHO phenotype as strict as just having 1 or lack of any metabolic criteria was not feasible due to the scarce number of outcomes
  • Low number of events in females in the transitional MHO group

Cite This Study

Hosseinpanah et al. (2020) conducted a cohort in Metabolically healthy obesity (n=6,758). Transition from metabolically healthy obesity to metabolic syndrome vs. Persistent metabolically healthy normal weight was evaluated on Cardiovascular disease incidence (HR 1.55, 95% CI 1.02-2.37). Transition from metabolically healthy obesity to metabolic syndrome over 15.9 years increased the risk of cardiovascular disease in males (HR 1.55) but not in females (HR 0.93).

synapsesocial.com/papers/6a7b717602ab7a73dd0356cahttps://doi.org/10.1371/journal.pone.0239164
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Also Consider

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  1. 1Metabolically healthy obesity is independently associated with 20-year incidence of cardiovascular disease: findings from the ATTICA cohort study (2002–2022)2026 · 2 citations
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  3. 3Risk of Cardiovascular Diseases Among Different Metabolic Obesity Phenotypes: A Prospective Observational Study2023 · 4 citations
  4. 4Impact of the Definition of Metabolically Healthy Obesity on the Association with Incident Cardiovascular Disease2020 · 11 citations
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