Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.
Pubmed ID: 26719125
Pubmed Central ID: PMC4731253
Journal: Obesity (Silver Spring, Md.)
Publication Date: 02/01/2016
Affiliation: Geriatric Research Education and Clinical Center (GRECC), Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.
MeSH Terms: Humans, Male, Adult, Female, Risk Factors, Body Mass Index, Coronary Disease, Proportional Hazards Models, Blood Pressure, Young Adult, Follow-Up Studies, Stroke, Obesity, Overweight, Diabetes Mellitus, Type 2, Blood Glucose, Lipids, Health Status, Obesity, Metabolically Benign
Grants: DK-038765, DK-083562, P30 DK079626, P60 DK079626, P60-DK079626, R01 DK038765, R01 DK083562, T32HD055163, I01 CX000432, T32 HD055163
Authors: Guo F, Garvey WT
Cite As: Guo F, Garvey WT. Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults. Obesity (Silver Spring) 2016 Feb;24(2):516-25. Epub 2015 Dec 31.
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.