Metabolically healthy obesity and risk of mortality Does the definition of metabolic health matter
Guy-Marino Hinnouho,Sébastien Czernichow,Aline Dugravot,G. David Batty,Mika Kivimäki,Archana Singh-Manoux +5 more
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TLDR
For most definitions of metabolic health, both metabolically healthy and unhealthy obese patients carry an elevated risk of mortality.Abstract:
To assess the association of a "metabolically healthy obese" phenotype with mortality using five definitions of metabolic health. Adults (n = 5,269; 71.7% men) aged 39-62 years in 1991 through 1993 provided data on BMI and metabolic health, defined using data from the Adult Treatment Panel-III (ATP-III); criteria from two studies; and the Matsuda and homeostasis model assessment (HOMA) indices. Cross-classification of BMI categories and metabolic status (healthy/unhealthy) created six groups. Cox proportional hazards regression models were used to analyze associations with all-cause and cardiovascular disease (CVD) mortality during a median follow-up of 17.7 years. A total of 638 individuals (12.1% of the cohort) were obese, of whom 9-41% were metabolically healthy, depending on the definition. Regardless of the definition, compared with metabolically healthy, normal-weight individuals, both the metabolically healthy obese (hazard ratios [HRs] ranged from 1.81 [95% CI 1.16-2.84] for ATP-III to 2.30 [1.13-4.70] for the Matsuda index) and the metabolically abnormal obese (HRs ranged from 1.57 [1.08-2.28] for the Matsuda index to 2.05 [1.44-2.92] for criteria defined in a separate study) had an increased risk of mortality. The only exception was the lack of excess risk using the HOMA criterion for the metabolically healthy obese (1.08; 0.67-1.74). Among the obese, the risk of mortality did not vary as a function of metabolic health apart from when using the HOMA criterion (1.93; 1.15-3.22). Similar results were obtained for cardiovascular mortality. For most definitions of metabolic health, both metabolically healthy and unhealthy obese patients carry an elevated risk of mortality.read more
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Changes in Metabolic Health Status Over Time and Risk of Developing Type 2 Diabetes: A Prospective Cohort Study
Seung-Hwan Lee,Hae Kyung Yang,Hee-Sung Ha,Jin-Hee Lee,Hyuk-Sang Kwon,Yong-Moon Park,Hyeon-Woo Yim,Moo-Il Kang,Won-Chul Lee,Ho-Young Son,Kun-Ho Yoon +10 more
TL;DR: Changes in metabolic health status were an independent risk factor for future diabetes in nonobese individuals, whereas general obesity had a greater contribution to the risk of obese individuals developing diabetes.
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Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium
Min Zhao,Abel López-Bermejo,Carmelo Antonio Caserta,Carla Campos Muniz Medeiros,Anastasios Kollias,Judit Bassols,Elisabetta L. Romeo,Thacira Dantas Almeida Ramos,George S. Stergiou,Lili Yang,Silvia Xargay-Torrent,Angela Amante,Tatianne Moura Estrela Gusmão,Evangelos Grammatikos,Yuanyuan Zhang,Anna Prats-Puig,Danielle Franklin de Carvalho,Liu Yang,Gemma Carreras-Badosa,Mônica de Oliveira Simões,Yaping Hou,Berta Mas-Pares,Wang Shui,Teng Guo,Mingming Wang,Hua Chen,Xiaohuan Lou,Qian Zhang,Yanqing Zhang,Pascal Bovet,Costan G. Magnussen,Costan G. Magnussen,Bo Xi +32 more
TL;DR: Among children and adolescents, cIMT was higher for both MHO and metabolicallyhealthy overweight compared with metabolically healthy normal weight, reinforcing the need for weight control in children andolescents irrespective of their metabolic status.
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Natural History of Obesity Subphenotypes: Dynamic Changes Over Two Decades and Prognosis in the Framingham Heart Study.
Justin B. Echouffo-Tcheugui,Meghan I. Short,Vanessa Xanthakis,Patrick Field,Todd R. Sponholtz,Martin G. Larson,Ramachandran S. Vasan +6 more
TL;DR: Over time, most Framingham Offspring Cohort participants developed metabolic abnormalities and clinical disease, and the MHO subphenotype is a harbinger of future risk.
Journal ArticleDOI
Metabolically Healthy Obesity and Ischemic Heart Disease: A 10-Year Follow-Up of the Inter99 Study.
Louise Hansen,Marie K Netterstrøm,Nanna B. Johansen,Pernille Falberg Rønn,Pernille Falberg Rønn,Dorte Vistisen,Lise Lotte N. Husemoen,Marit E. Jørgensen,Marit E. Jørgensen,Naja Hulvej Rod,Kristine Færch +10 more
TL;DR: Being obese is associated with higher incidence of ischemic heart disease irrespective of metabolic status, and the feasibility of denoting a subgroup of obese individuals as metabolically healthy is questioned.
References
More filters
Journal ArticleDOI
Homeostasis model assessment : insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man
TL;DR: The correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Journal ArticleDOI
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
Scott M. Grundy,David W. Bilheimer,Alan Chait,Luther T. Clark,Margo A. Denke,Richard J. Havel,William R. Hazzard,Stephen B. Hulley,Donald B. Hunninghake,Robert A. Kreisberg,Penny M. Kris-Etherton,James M. McKenney,Michael A. Newman,Ernst J. Schaefer,Burton E. Sobel,Carolyn Somelofski,Milton C. Weinstein,H. Bryan Brewer,James I. Cleeman,Karen A. Donato,Nancy D. Ernst,Jeffrey M. Hoeg,Basil M. Rifkind,Jacques E. Rossouw,Christopher T. Sempos,Joanne M. Gallivan,Maureen N. Harris,Laurie Quint-Adler +27 more
TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National
William C. Taylor,Nigel Unwin +1 more
Obesity : Preventing and managing the global epidemic
D. S. Akram,Arne Astrup,T. Atinmo,J. L. Boissin,George A. Bray,K. Carroll,P. Chitson,C. Chunming,William H. Dietz,James O. Hill,Eric Jéquier,C. Komodiki,Yuji Matsuzawa,W. F. Mollentze,K. Moosa,M.I. Noor,K.S. Reddy,Jacob C. Seidell,V. Tanphaichitr,Ricardo Uauy,Paul Zimmet +20 more
Book
Obesity : preventing and managing the global epidemic : report of a WHO Consulation
TL;DR: The fundamental causes of the obesity epidemic are sedentary lifestyles and high-fat energy-dense diets, both resulting from the profound changes taking place in society and the behavioural patterns of communities as a consequence of increased urbanization and industrialization and the disappearance of traditional lifestyles.
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