Transition from metabolically benign to metabolically unhealthy obesity and 10-year cardiovascular disease incidence: The ATTICA cohort study
Key result
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).
Why the study?
Metabolically benign obesity remains an area of debate, prompting evaluation of whether metabolically healthy obese status is a transient condition that propagates 10-year CVD onset.
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?
Population
1514 men and 1528 women aged >18 years free of CVD in Athens, Greece
Comparison
MHO vs metabolically healthy non-obese participants
Design
Prospective longitudinal cohort study
Follow-up
10-year
Authors
Discussion
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Member takes
Implication
MHO transition warrants metabolic monitoring in obese adults; leaves open whether intervention on transitions reduces CVD.
Study Design
Type
Cohort (n=3,042)
Structured PICO
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?
P
Population
3,042 adults aged >18 years free of cardiovascular disease at baseline, followed for 10 years to assess incident cardiovascular events.
E
Exposure
Metabolically healthy obese (MHO) status (defined as BMI ≥30 kg/m2 and absence of all NCEP ATP III metabolic syndrome components excluding waist circumference) and its transition to unhealthy metabolic status.
C
Comparator
Metabolically healthy non-obese participants.
O
Outcome
First combined cardiovascular disease event at 10-year follow-up.composite
Main Result
Hazard Ratio: 1.43 (95% CI 1.02–2.01)
Metabolically healthy obesity is often a transient state, and transitioning to an unhealthy metabolic status significantly increases the 10-year risk of cardiovascular disease.
Cite This Study
Kouvari et al. (2019) 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).