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Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults

Published on Feb 1, 2016in Obesity3.97
· DOI :10.1002/oby.21344
Fangjian Guo11
Estimated H-index: 11
(UTMB: University of Texas Medical Branch),
W. Garvey54
Estimated H-index: 54
(UAB: University of Alabama at Birmingham)
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Abstract
Objective To assess the stability of metabolic status and body mass index (BMI) status and their relative contribution to risk of diabetes, cardiovascular events, and mortality. Methods A total of 14,685 participants from the Atherosclerosis Risk in Communities Study and 4,990 from the Coronary Artery Risk Development in Young Adults Study were included. People with healthy obesity (HO) are defined as those meeting all three indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all three criteria. Results In both healthy and unhealthy subgroups, risks for coronary heart disease (CHD), stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% confidence interval [CI] 4.12-7.48), CHD (5.60, 95% CI 3.14-9.98), stroke (4.84, 95% CI 2.13-10.97), and mortality (2.6, 95% CI 1.88-3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In the Coronary Artery Risk Development in Young Adults Study over 20 years, 17.5% of lean subjects and 67.3% of overweight subjects at baseline developed obesity during follow-up. Despite rising BMI, metabolic status remained relatively stable. Conclusions Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se.
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  • References (33)
  • Citations (30)
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References33
Newest
Published on Mar 1, 2015in The Journal of Clinical Endocrinology and Metabolism5.61
Chang Hee Jung18
Estimated H-index: 18
(UOU: University of Ulsan),
Min Jung Lee12
Estimated H-index: 12
(UOU: University of Ulsan)
+ 7 AuthorsWoo Je Lee22
Estimated H-index: 22
(UOU: University of Ulsan)
Objective: This study sought to investigate whether the metabolically healthy obese (MHO) phenotype is associated with an increased risk of incident type 2 diabetes in a Korean population and, if so, whether systemic inflammation affects this risk in MHO individuals. Design and Methods: The study population comprised 36 135 Koreans without type 2 diabetes. Participants were stratified by body mass index (cutoff value, 25.0 kg/m2) and metabolic health state (assessed using Adult Treatment Panel-I...
Published on Nov 1, 2014in Diabetes Care15.27
Gilad Twig22
Estimated H-index: 22
(Medical Corps),
Arnon Afek39
Estimated H-index: 39
(TAU: Tel Aviv University)
+ 4 AuthorsAmir Tirosh26
Estimated H-index: 26
(Brigham and Women's Hospital)
OBJECTIVE To determine diabetes incidence over time among obese young adults without metabolic risk factors. RESEARCH DESIGN AND METHODS Incident diabetes during a median follow-up of 6.1 years was assessed among 33,939 young men (mean age 30.9 ± 5.2 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults cohort who were stratified for BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ...
Published on Aug 1, 2014in Obesity3.97
Hyun Suk Jung40
Estimated H-index: 40
(SKKU: Sungkyunkwan University),
Yoosoo Chang26
Estimated H-index: 26
(SKKU: Sungkyunkwan University)
+ 11 AuthorsDong Zhao30
Estimated H-index: 30
(Johns Hopkins University)
Objective The aim of this study was to examine an impact of body mass index (BMI) and weight change on the risk of diabetes according to metabolic health status. Methods Cohort study of 34,999 Korean men and women 30-59 years of age free of diabetes at baseline were followed-up annually or biennially for an average of 5.1 years. Being metabolically healthy was defined as not having any metabolic syndrome component. Results During 176,878.6 person-years of follow-up, 889 participants developed di...
Published on Feb 1, 2014in The Journal of Clinical Endocrinology and Metabolism5.61
KoKo Aung11
Estimated H-index: 11
(University of Texas Health Science Center at San Antonio),
Carlos Lorenzo28
Estimated H-index: 28
(University of Texas Health Science Center at San Antonio)
+ 1 AuthorsSteven M. Haffner115
Estimated H-index: 115
(University of Texas Health Science Center at San Antonio)
Context: The risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (DM) associated with obesity appears to be influenced by the coexistence of other metabolic abnormalities. Objective: We examined the risk of developing CVD and DM in metabolically healthy obese (MHO) and metabolically unhealthy normal weight (MUH-NW) individuals. Design and Setting: We analyzed prospective data of the San Antonio Heart Study, a population-based study among Mexican Americans and non-Hispanic whites (m...
Published on Jan 1, 2014in Obesity3.97
Fangjian Guo11
Estimated H-index: 11
(UAB: University of Alabama at Birmingham),
Douglas R. Moellering28
Estimated H-index: 28
(UAB: University of Alabama at Birmingham),
W. Garvey54
Estimated H-index: 54
(UAB: University of Alabama at Birmingham)
Objective To validate a Cardiometabolic Disease Staging (CMDS) system for assigning risk level for diabetes, and all-cause and cardiovascular disease (CVD) mortality. Design and Methods Two large national cohorts, CARDIA and NHANES III, were used to validate CMDS. CMDS: Stage 0: metabolically healthy; Stage 1: one or two metabolic syndrome risk factors [other than impaired fasting glucose (IFG)]; Stage 2: IFG or impaired glucose tolerance (IGT) or metabolic syndrome (without IFG); Stage 3: two o...
Published on Jan 1, 2014in JAMA Internal Medicine20.77
Mette Thomsen7
Estimated H-index: 7
(UCPH: University of Copenhagen),
Børge G. Nordestgaard115
Estimated H-index: 115
(UCPH: University of Copenhagen)
Importance Overweight and obesity likely cause myocardial infarction (MI) and ischemic heart disease (IHD); however, whether coexisting metabolic syndrome is a necessary condition is unknown. Objective To test the hypothesis that overweight and obesity with and without metabolic syndrome are associated with increased risk of MI and IHD. Design, Setting, and Participants We examined 71 527 individuals from the Copenhagen General Population Study and categorized them according to body mass index (...
Published on Aug 1, 2013in Diabetes Care15.27
Sarah Appleton26
Estimated H-index: 26
(University of Adelaide),
Christopher J. Seaborn1
Estimated H-index: 1
+ 4 AuthorsRobert J. Adams44
Estimated H-index: 44
(University of Adelaide)
OBJECTIVE To determine the correlates of the “metabolically healthy obese” (MHO) phenotype and the longitudinal risks of diabetes and cardiovascular disease (CVD)/stroke associated with this phenotype. RESEARCH DESIGN AND METHODS The North West Adelaide Health Study is a prospective cohort study of 4,056 randomly selected adults aged ≥18 years. Participants free of CVD/stroke and not underweight ( n = 3,743) were stratified by BMI categories and metabolic risk, defined as having two or more Inte...
Published on Sep 1, 2012in International Journal of Obesity4.51
Chang Y1
Estimated H-index: 1
,
Seungho Ryu38
Estimated H-index: 38
+ 3 AuthorsSung-Il Cho42
Estimated H-index: 42
Cited By30
Newest
Published on Sep 16, 2019in Journal of Clinical Investigation12.28
Gordon I. Smith3
Estimated H-index: 3
,
Bettina Mittendorfer47
Estimated H-index: 47
,
Samuel Klein89
Estimated H-index: 89
Published on Aug 14, 2018in International Journal of Obesity4.51
William Johnson16
Estimated H-index: 16
(Lboro: Loughborough University),
Joshua A. Bell14
Estimated H-index: 14
(UoB: University of Bristol)
+ 3 AuthorsMark Hamer68
Estimated H-index: 68
(Lboro: Loughborough University)
To describe 20-year risk factor trajectories according to initial weight/health status and investigate the extent to which baseline differences explain greater mortality among metabolically healthy obese (MHO) individuals than healthy non-obese individuals. The sample comprised 6529 participants in the Whitehall II study who were measured serially between 1991–1994 and 2012–2013. Baseline weight (non-obese or obese; body mass index (BMI) ≥30 kg/m2) and health status (healthy or unhealthy; two or...
Published on May 1, 2019in Metabolism-clinical and Experimental6.51
Yun Kyung Cho5
Estimated H-index: 5
,
Yu Mi Kang10
Estimated H-index: 10
+ 5 AuthorsChang Hee Jung18
Estimated H-index: 18
Abstract Aims We hypothesized that transitions in metabolic health status and obesity affect the cardiovascular (CV) risk and mortality in population with metabolically healthy obesity (MHO). Methods This study enrolled 514,866 participants from the Korean National Health Insurance Service–National Sample Cohort. Changes in metabolic health status and obesity from the baseline examination in 2009–2010 to the next biannual health examination in 2011–2012 were determined. Study participants were c...
Paolo Sbraccia28
Estimated H-index: 28
,
Valeria Guglielmi9
Estimated H-index: 9
Published on Jun 1, 2019in Hypertension Research3.22
Xin Chen (Soochow University (Suzhou)), Guoping Gui + 3 AuthorsHongmei Li (Soochow University (Suzhou))
The purpose of this study was to identify the effects of various obesity phenotypes and metabolic abnormalities on cardio-cerebrovascular disease. We performed a large-scale, cross-sectional study including 10,089 participants aged ≥18 years in the National High-Technology district of Suzhou, China, from March 2016 to April 2016. Cardio-cerebrovascular disease included stroke and coronary heart disease. The prevalence rates of cardio-cerebrovascular disease among people with normal weight, overw...
Deborah Armborst (University of Bonn), Christine Metzner3
Estimated H-index: 3
(RWTH Aachen University)
+ 2 AuthorsRoswitha Siener23
Estimated H-index: 23
(University of Bonn)
AbstractThe objective of this study was to examine the effect of a 3-month weight-loss-stabilization phase (phase 2) following a successful 3-month weight-loss phase (phase 1), including a conventional energy-restricted diet with (MR) or without (C) meal replacement, on the cardiometabolic risk profile in 80 overweight women. In phase 2, both groups continued to significantly reduce weight and sustained the significant decreases in waist circumference and LDL-C. During the study, folic acid conc...
Published on May 15, 2019in Labmedicine
Jelena Janac1
Estimated H-index: 1
(University of Belgrade),
Aleksandra Zeljkovic12
Estimated H-index: 12
(University of Belgrade)
+ 7 AuthorsVesna Spasojevic-Kalimanovska15
Estimated H-index: 15
(University of Belgrade)
Published on Apr 1, 2019in Clinical Nutrition6.40
Banaz Al-khalidi2
Estimated H-index: 2
(York University),
Samantha M. Kimball8
Estimated H-index: 8
+ 1 AuthorsChris I. Ardern26
Estimated H-index: 26
(York University)
Summary Background & Aims Previous studies assessing the prognosis of metabolically healthy obesity (MHO) have been limited by a lack of a harmonized definition of MHO phenotype. Furthermore, obesity is a risk factor for vitamin D deficiency and low vitamin D status has been associated with a higher risk of mortality; however, few studies have evaluated the joint association between vitamin D, metabolic health phenotype, and mortality risk. Using a harmonized definition, we investigated whether ...
Published on Jan 1, 2019
Daniel L. Hurley17
Estimated H-index: 17
(Mayo Clinic),
Farhad Zangeneh6
Estimated H-index: 6
Hyperglycemic disorders are very common in patients with overweight or obesity. With increasing fat mass and the development of adiposopathy comes increasing risk of developing hyperglycemia. However, the prevalence of overweight or obesity is estimated at over 60% of the American population. Yet, type 2 diabetes mellitus affects only 16.4% of people with an extreme body mass index. The progression from lean and healthy to overweight or obesity with type 2 diabetes offers opportunities for diagn...
Published on Dec 1, 2018in Diabetes7.20
Eun Hee Koh2
Estimated H-index: 2
(UOU: University of Ulsan),
Natasha Chernis1
Estimated H-index: 1
(BCM: Baylor College of Medicine)
+ 16 AuthorsDimuthu Perera2
Estimated H-index: 2
(BCM: Baylor College of Medicine)
Chronic inflammation accompanies obesity and limits subcutaneous white adipose tissue (WAT) expandability, accelerating the development of insulin resistance and type 2 diabetes mellitus. MicroRNAs (miRNAs) influence expression of many metabolic genes in fat cells, but physiological roles in WAT remain poorly characterized. Here, we report that expression of the miRNA miR-30a in subcutaneous WAT corresponds with insulin sensitivity in obese mice and humans. To examine the hypothesis that restora...
View next paperMetabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study