Transitioning from metabolically healthy obesity to an unhealthy status increased the 10-year risk of cardiovascular disease compared to healthy non-obese individuals (HR 1.43; 95% CI 1.02-2.01).
Cohort (n=3,042)
Does metabolically healthy obese status and its transition to unhealthy status increase the 10-year incidence of cardiovascular disease compared to metabolically healthy non-obese individuals?
Metabolically healthy obesity is often a transient state, and transitioning to an unhealthy metabolic status significantly increases the 10-year risk of cardiovascular disease.
Hazard Ratio: 1.43 (95% CI 1.02–2.01)
Background/Objectives Metabolically benign obesity remains a scientific field of considerable debate. The aim of the present work was to evaluate whether metabolically healthy obese (MHO) status is a transient condition which propagates 10-year cardiovascular disease (CVD) onset. Methods A prospective longitudinal study was conducted during 2001–2012, the ATTICA study studying 1514 (49.8%) men and 1528 (50.2%) women (aged >18 years old) free of CVD and residing in the greater Athens area, Greece. Follow-up assessment of first combined CVD event (2011−2012) was achieved in n = 2020 participants; of them, 317 (15.7%) incident cases were identified. Obesity was defined as body mass index ≥30 kg/m 2 and healthy metabolic status as absence of all NCEP ATP III (2005) metabolic syndrome components (excluding waist circumference). Results The MHO prevalence was 4.8% ( n = 146) with 28.2% of obese participants presenting metabolically healthy status at baseline. Within this group, 52% developed unhealthy metabolic status during the 10-year follow up. MHO vs. metabolically healthy non-obese participants had a higher likelihood of presenting with 10-year CVD events, yet only the subset of them who lost their baseline status reached the level of significance (Hazard Ratio (HR) = 1.43, 95% Confidence Interval (95% CI) 1.02, 2.01). Sensitivity analyses revealed that MHO status was independently associated with elevated CVD risk in women and participants with low adherence to the Mediterranean diet, low grade inflammation, and insulin resistance. Conclusions MHO status is a transient condition where weight management is demanded to prevent the establishment of unhealthy cardiometabolic features. The existence of obese persons who remain "longitudinally" resilient to metabolic abnormalities is an emerging area of future research.
Kouvari et al. (Fri,) conducted a cohort in Metabolically healthy obesity (n=3,042). Metabolically healthy obesity (MHO) transitioning to unhealthy status vs. Metabolically healthy non-obese participants was evaluated on 10-year cardiovascular disease (CVD) onset (first combined CVD event) (HR 1.43, 95% CI 1.02-2.01). Transitioning from metabolically healthy obesity to an unhealthy status increased the 10-year risk of cardiovascular disease compared to healthy non-obese individuals (HR 1.43; 95% CI 1.02-2.01).