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Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies.
Int J Cardiol. 2013 Oct 12; 168(5):4761-8.IJ

Abstract

BACKGROUND

Cardiovascular risk is inconsistent in the normal-weight, overweight, and obese individuals due to metabolic abnormality. We aimed to investigate combined effects of obesity and metabolic abnormality on the risk of cardiovascular disease and mortality.

METHODS

The MEDLINE, EMBASE, Cochrane library, and references of relevant original articles prior to May 2013 were searched for prospective studies investigating cardiovascular risk and death associated with combined effects of obesity and metabolic syndrome or insulin resistance. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects or fixed-effect models when appropriate.

RESULTS

Fourteen perspective studies with a total of 299,059 participants and 12,125 cases of incident CVD, 2130 cases of CVD death, and 7071 cases of all-cause death were included in the meta-analysis. Compared with healthy normal-weight individuals, metabolically healthy overweight (MHOW) and obese (MHOB) individuals showed increased risk for CVD events, which appeared much stronger during the long-term follow-up period of >15 years, with pooled RR of 1.47 (95% CI 1.37-1.58) in MHOW and 2.00 (95% CI 1.79-2.24) in MHOB. Normal-weight but metabolically abnormal individuals were at increased risk for CVD (pooled RR 1.81, 95% CI 1.56-2.10), CVD-related death (pooled RR 1.55, 95% CI 1.16-2.08), and all-cause death (pooled RR 1.27, 95% CI 1.10-1.47). Metabolically abnormal obese individuals were at the highest risk for CVD and mortality.

CONCLUSION

Individuals with metabolic abnormality, although at normal-weight, had an increased risk of CVD and mortality. Healthy overweight and obese persons had higher risk, which refuted the notion that metabolically healthy obese phenotype is a benign condition.

Authors+Show Affiliations

State Key Laboratory of Cardiovascular Diseases, Sino-German Laboratory for Molecular Medicine, FuWai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23972953

Citation

Fan, Jingyao, et al. "Combined Effect of Obesity and Cardio-metabolic Abnormality On the Risk of Cardiovascular Disease: a Meta-analysis of Prospective Cohort Studies." International Journal of Cardiology, vol. 168, no. 5, 2013, pp. 4761-8.
Fan J, Song Y, Chen Y, et al. Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies. Int J Cardiol. 2013;168(5):4761-8.
Fan, J., Song, Y., Chen, Y., Hui, R., & Zhang, W. (2013). Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies. International Journal of Cardiology, 168(5), 4761-8. https://doi.org/10.1016/j.ijcard.2013.07.230
Fan J, et al. Combined Effect of Obesity and Cardio-metabolic Abnormality On the Risk of Cardiovascular Disease: a Meta-analysis of Prospective Cohort Studies. Int J Cardiol. 2013 Oct 12;168(5):4761-8. PubMed PMID: 23972953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies. AU - Fan,Jingyao, AU - Song,Yiqing, AU - Chen,Yu, AU - Hui,Rutai, AU - Zhang,Weili, Y1 - 2013/08/01/ PY - 2013/01/09/received PY - 2013/07/02/revised PY - 2013/07/25/accepted PY - 2013/8/27/entrez PY - 2013/8/27/pubmed PY - 2014/8/20/medline KW - Cardiovascular disease KW - Metabolic syndrome KW - Metabolically healthy KW - Mortality KW - Obesity SP - 4761 EP - 8 JF - International journal of cardiology JO - Int J Cardiol VL - 168 IS - 5 N2 - BACKGROUND: Cardiovascular risk is inconsistent in the normal-weight, overweight, and obese individuals due to metabolic abnormality. We aimed to investigate combined effects of obesity and metabolic abnormality on the risk of cardiovascular disease and mortality. METHODS: The MEDLINE, EMBASE, Cochrane library, and references of relevant original articles prior to May 2013 were searched for prospective studies investigating cardiovascular risk and death associated with combined effects of obesity and metabolic syndrome or insulin resistance. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects or fixed-effect models when appropriate. RESULTS: Fourteen perspective studies with a total of 299,059 participants and 12,125 cases of incident CVD, 2130 cases of CVD death, and 7071 cases of all-cause death were included in the meta-analysis. Compared with healthy normal-weight individuals, metabolically healthy overweight (MHOW) and obese (MHOB) individuals showed increased risk for CVD events, which appeared much stronger during the long-term follow-up period of >15 years, with pooled RR of 1.47 (95% CI 1.37-1.58) in MHOW and 2.00 (95% CI 1.79-2.24) in MHOB. Normal-weight but metabolically abnormal individuals were at increased risk for CVD (pooled RR 1.81, 95% CI 1.56-2.10), CVD-related death (pooled RR 1.55, 95% CI 1.16-2.08), and all-cause death (pooled RR 1.27, 95% CI 1.10-1.47). Metabolically abnormal obese individuals were at the highest risk for CVD and mortality. CONCLUSION: Individuals with metabolic abnormality, although at normal-weight, had an increased risk of CVD and mortality. Healthy overweight and obese persons had higher risk, which refuted the notion that metabolically healthy obese phenotype is a benign condition. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/23972953/Combined_effect_of_obesity_and_cardio_metabolic_abnormality_on_the_risk_of_cardiovascular_disease:_a_meta_analysis_of_prospective_cohort_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(13)01455-1 DB - PRIME DP - Unbound Medicine ER -