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Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis.
Nutr Metab Cardiovasc Dis. 2014 Mar; 24(3):256-62.NM

Abstract

BACKGROUNDS AND AIMS

Whether obesity increases risk of cardiovascular disease (CVD) and fatty liver because of the co-existence of other risk factors is uncertain. We investigated odds ratios (ORs) for: a) a measure of pre-clinical atherosclerosis and b) fatty liver, in metabolically healthy obese (MHO) subjects, metabolically abnormal obese (MAO) subjects and metabolically abnormal non obese subjects (MANO), using a metabolically healthy non obese (MHNO) group as the reference.

METHODS AND RESULTS

14,384 South Koreans from an occupational cohort underwent cardiac computed tomography (CT) estimation of CAC score, liver ultrasound determination of fatty liver, and measurement of cardiovascular risk factors. Pre-clinical atherosclerosis was defined by a CAC score >0. We used logistic regression to determine ORs for CAC >0, and fatty liver in MHO, MAO and MANO subjects (reference group MHNO). There was no increase in OR for CAC score >0 (OR = 0.93, [95% CIs 0.67,1.31], p = 0.68), in the MHO group, whereas there was an increase in the ORs for CAC score >0 in the MAO, and MANO groups (OR = 1.64 [95% CI 1.36,1.98], p < 0.001) and (OR = 1.38 [95% CI 1.17,1.64], p < 0.001), respectively. In contrast, for fatty liver, there was an increase in OR in each group (OR = 3.63 [95% CI 3.06, 4.31] p < 0.001); (OR = 5.89 [5.18,6.70] p < 0.001); and (OR = 1.83 [95% CI 1.69,2.08]) in the MHO, MAO group and MANO groups respectively.

CONCLUSION

MHO subjects are at risk of fatty liver but attenuated risk of pre-clinical atherosclerosis. Both MAO and MANO subjects are at risk of fatty liver and pre-clinical atherosclerosis.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea. Electronic address: kcmd.sung@samsung.com.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea.Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea.Nutrition and Metabolism Unit, IDS Building, Southampton General Hospital, University of Southampton, and Southampton National Institute for Health Research Biomedical Research Centre, MP 887 Southampton, UK.

Pub Type(s)

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

Language

eng

PubMed ID

24361070

Citation

Sung, Ki-Chul, et al. "Metabolically Healthy Obese Subjects Are at Risk of Fatty Liver but Not of Pre-clinical Atherosclerosis." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 24, no. 3, 2014, pp. 256-62.
Sung KC, Cha SC, Sung JW, et al. Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis. Nutr Metab Cardiovasc Dis. 2014;24(3):256-62.
Sung, K. C., Cha, S. C., Sung, J. W., So, M. S., & Byrne, C. D. (2014). Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 24(3), 256-62. https://doi.org/10.1016/j.numecd.2013.07.005
Sung KC, et al. Metabolically Healthy Obese Subjects Are at Risk of Fatty Liver but Not of Pre-clinical Atherosclerosis. Nutr Metab Cardiovasc Dis. 2014;24(3):256-62. PubMed PMID: 24361070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis. AU - Sung,Ki-Chul, AU - Cha,Sung-Chul, AU - Sung,Joo-Wook, AU - So,Min-Suk, AU - Byrne,Christopher D, Y1 - 2013/10/09/ PY - 2013/05/20/received PY - 2013/07/18/revised PY - 2013/07/21/accepted PY - 2013/12/24/entrez PY - 2013/12/24/pubmed PY - 2014/11/15/medline KW - Atherosclerosis KW - Cardio-metabolic risk factors KW - Coronary artery calcium (CAC) score KW - Fatty liver KW - Metabolic syndrome (MetS) KW - Metabolically healthy obese KW - Non alcoholic fatty liver disease (NAFLD) SP - 256 EP - 62 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 24 IS - 3 N2 - BACKGROUNDS AND AIMS: Whether obesity increases risk of cardiovascular disease (CVD) and fatty liver because of the co-existence of other risk factors is uncertain. We investigated odds ratios (ORs) for: a) a measure of pre-clinical atherosclerosis and b) fatty liver, in metabolically healthy obese (MHO) subjects, metabolically abnormal obese (MAO) subjects and metabolically abnormal non obese subjects (MANO), using a metabolically healthy non obese (MHNO) group as the reference. METHODS AND RESULTS: 14,384 South Koreans from an occupational cohort underwent cardiac computed tomography (CT) estimation of CAC score, liver ultrasound determination of fatty liver, and measurement of cardiovascular risk factors. Pre-clinical atherosclerosis was defined by a CAC score >0. We used logistic regression to determine ORs for CAC >0, and fatty liver in MHO, MAO and MANO subjects (reference group MHNO). There was no increase in OR for CAC score >0 (OR = 0.93, [95% CIs 0.67,1.31], p = 0.68), in the MHO group, whereas there was an increase in the ORs for CAC score >0 in the MAO, and MANO groups (OR = 1.64 [95% CI 1.36,1.98], p < 0.001) and (OR = 1.38 [95% CI 1.17,1.64], p < 0.001), respectively. In contrast, for fatty liver, there was an increase in OR in each group (OR = 3.63 [95% CI 3.06, 4.31] p < 0.001); (OR = 5.89 [5.18,6.70] p < 0.001); and (OR = 1.83 [95% CI 1.69,2.08]) in the MHO, MAO group and MANO groups respectively. CONCLUSION: MHO subjects are at risk of fatty liver but attenuated risk of pre-clinical atherosclerosis. Both MAO and MANO subjects are at risk of fatty liver and pre-clinical atherosclerosis. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/24361070/Metabolically_healthy_obese_subjects_are_at_risk_of_fatty_liver_but_not_of_pre_clinical_atherosclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(13)00202-0 DB - PRIME DP - Unbound Medicine ER -