Key result
Transitioning from metabolically healthy to unhealthy obesity increased incident cardiovascular disease risk compared to maintaining metabolically healthy non-obesity (OR 1.82; 95% CI 1.06-3.14).
Why the study?
Studies assessing the association between transitions in metabolic health and obesity status over time and cardiovascular disease risk have produced inconsistent results.
Does metabolically healthy obesity and its transition to metabolically unhealthy obesity increase the risk of incident cardiovascular disease in a general Chinese population?
Cohort (n=7,472)
Does metabolically healthy obesity and its transition to metabolically unhealthy obesity increase the risk of incident cardiovascular disease in a general Chinese population?
Odds Ratio: 1.82 (95% CI 1.06–3.14)
Metabolically healthy obesity is not a benign condition and is associated with an increased risk of incident cardiovascular disease, emphasizing the need for weight control in all obese individuals.
Metabolically healthy obesity transition may elevate CVD risk; extends Chinese cohort data but should not yet change practice.
BACKGROUND: Recent studies have investigated the association of transitions in metabolic health and obesity status over time with the risk of cardiovascular disease, focusing on the subgroup demonstrating metabolically healthy obesity. However, these studies have produced inconsistent results. This study evaluates the relation in a general Chinese population. METHODS: We conducted a prospective cohort study in a general population in Northeast China, with examinations of cardiovascular health from 2012-2015 and follow-up for incident cardiovascular disease until 2018. Cox proportional hazards and logistic regression models were used to investigate the association of baseline metabolic health and obesity status and transitions in those statuses with cardiovascular disease risk. RESULTS: A total of 7472 participants aged ≥35 years who were free of cardiovascular disease at baseline were included in this analysis. Over a median follow-up of 4.66 years, a total of 344 cardiovascular disease events occurred. Among the 3380 participants who were obese at baseline, 37.1% were metabolically healthy. Metabolically healthy obesity was associated with a 48% increased risk of cardiovascular disease (hazard ratio: 1.48; 95% confidence interval: 1.07-2.06) compared with the metabolically healthy non-obese group at baseline. Transition from metabolically healthy obesity to metabolically unhealthy obesity was associated with elevated cardiovascular disease risk with an odds ratio of 1.82 (95% confidence interval: 1.06-3.14) compared with metabolically healthy non-obesity throughout after adjustment. Even maintaining metabolically healthy obesity over time was associated with a higher risk of cardiovascular disease (odds ratio: 1.72; 95% confidence interval: 1.00-2.97). CONCLUSIONS: Weight control and management of existing metabolic disorders should be prioritized in all obese population.
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Guo et al. (2020) conducted a cohort in incident cardiovascular disease (n=7,472). Transition from metabolically healthy obesity to metabolically unhealthy obesity vs. Metabolically healthy non-obesity throughout was evaluated on incident cardiovascular disease (OR 1.82, 95% CI 1.06-3.14). Transitioning from metabolically healthy to unhealthy obesity increased incident cardiovascular disease risk compared to maintaining metabolically healthy non-obesity (OR 1.82; 95% CI 1.06-3.14).
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