Cardiometabolic disease risk in metabolically healthy and unhealthy obesity

Stability of metabolic health status in adults

Fangjian Guo, W. Timothy Garvey

Research output: Contribution to journalArticle

33 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)516-525
Number of pages10
JournalObesity
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2016

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Health Status
Obesity
Body Mass Index
Confidence Intervals
Coronary Disease
Mortality
Stroke
Young Adult
Coronary Vessels
Metabolically Benign Obesity
Blood Glucose
Atherosclerosis
Healthy Volunteers
Blood Pressure
Lipids

ASJC Scopus subject areas

  • Endocrinology
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Cardiometabolic disease risk in metabolically healthy and unhealthy obesity : Stability of metabolic health status in adults. / Guo, Fangjian; Garvey, W. Timothy.

In: Obesity, Vol. 24, No. 2, 01.02.2016, p. 516-525.

Research output: Contribution to journalArticle

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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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