Key result
Metabolically healthy obese individuals had a 1.6-fold increased risk for the new occurrence of arterial stiffness compared to metabolically healthy normal weight controls over a 10-year follow-up.
Why the study?
The risk of incident arterial stiffness according to metabolically healthy obese phenotype in a Chinese population was unknown.
Does the metabolically healthy obese phenotype increase the risk of incident arterial stiffness in a Chinese population?
Cohort (n=37,180)
Does the metabolically healthy obese phenotype increase the risk of incident arterial stiffness in a Chinese population?
Odds Ratio: 1.6
The metabolically healthy obese phenotype is not a benign condition but an intermediate stage that significantly increases the risk of arterial stiffness, emphasizing the need for weight management even in the absence of metabolic syndrome.
MHO phenotype was associated with higher arterial stiffness risk; leaves open whether metabolic health modifies obesity effects on vascular aging in broader populations.
BackgroundTo investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population.Materials and methodsThe Kailuan study is an ongoing prospective cohort study, 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study from March 1, 2010, to January 31, 2020. Cross-classification of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used to assess the association between BMI-metabolic status phenotypes and baPWV in mono-factor and multi-factor models. ResultsThe results of cross-sectional and longitudinal investigation were basically the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.6-fold, 2.8-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal weight controls in the fully adjusted model. Further stratified analysis shown that metabolic health status was an interaction factor between BMI and arterial stiffness in either study population (P<0.0001 for cross-sectional study and P=0.0003 for longitudinal study).ConclusionsMetabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants. Moreover, MHO is an intermediate stage between metabolically healthy and unhealthy status.Trial registration: ChiCTR-TNRC-11001489. Registered 24 August 2011 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050
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Wang et al. (2020) conducted a cohort in Arterial Stiffness (n=37,180). Metabolically healthy obese (MHO) phenotype vs. Metabolically healthy normal weight (MH-NW) was evaluated on New occurrence of arterial stiffness (baPWV ≥ 1400 cm/s) (OR 1.6). Metabolically healthy obese individuals had a 1.6-fold increased risk for the new occurrence of arterial stiffness compared to metabolically healthy normal weight controls over a 10-year follow-up.
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