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Metabolically healthy obesity and the risk for subclinical atherosclerosis.
Atherosclerosis 2017; 262:191-197A

Abstract

BACKGROUND AND AIMS

Although obesity and metabolic abnormalities are known risk factors for cardiovascular disease, the risk of cardiovascular disease among obese individuals without obesity-related metabolic abnormalities, referred to as metabolically healthy obese (MHO), remains unclear. We examined the association between body mass index categories and the development of subclinical carotid atherosclerosis in a cohort of metabolically healthy individuals.

METHODS

We conducted a cohort study of 6453 men without subclinical carotid atherosclerosis or metabolic abnormalities at baseline, who underwent repeated health check-up examinations that included carotid ultrasound. A metabolically healthy state was defined as having no metabolic syndrome components and a homeostasis model assessment of insulin resistance <2.5. Subclinical carotid atherosclerosis was assessed using ultrasound.

RESULTS

During the follow-up period of 34,797.9 person-years, subclinical carotid atherosclerosis developed in 1916 participants. Comparing overweight and obese with normal weight participants, the multivariable adjusted hazard ratios (95% confidence intervals) for incident subclinical carotid atherosclerosis were 1.24 (1.12-1.38) and 1.54 (1.38-1.72), respectively. The association persisted after further adjustment for metabolic variables. This association was also evident in MHO men without abdominal obesity (waist circumference > 90 cm) and it did not differ across any clinically relevant subgroups evaluated.

CONCLUSIONS

In a large cohort study of strictly defined metabolically healthy participants, the MHO phenotype was associated with an increased risk of incident subclinical carotid atherosclerosis, providing evidence that the MHO phenotype is not protective from cardiovascular risk.

Authors+Show Affiliations

Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: hjls.son@samsung.com.Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: sh703.yoo@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28385392

Citation

Kim, Tae Jun, et al. "Metabolically Healthy Obesity and the Risk for Subclinical Atherosclerosis." Atherosclerosis, vol. 262, 2017, pp. 191-197.
Kim TJ, Shin HY, Chang Y, et al. Metabolically healthy obesity and the risk for subclinical atherosclerosis. Atherosclerosis. 2017;262:191-197.
Kim, T. J., Shin, H. Y., Chang, Y., Kang, M., Jee, J., Choi, Y. H., ... Ryu, S. (2017). Metabolically healthy obesity and the risk for subclinical atherosclerosis. Atherosclerosis, 262, pp. 191-197. doi:10.1016/j.atherosclerosis.2017.03.035.
Kim TJ, et al. Metabolically Healthy Obesity and the Risk for Subclinical Atherosclerosis. Atherosclerosis. 2017;262:191-197. PubMed PMID: 28385392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolically healthy obesity and the risk for subclinical atherosclerosis. AU - Kim,Tae Jun, AU - Shin,Hee-Young, AU - Chang,Yoosoo, AU - Kang,Mira, AU - Jee,Jaehwan, AU - Choi,Yoon-Ho, AU - Ahn,Hyeon Seon, AU - Ahn,Soo Hyun, AU - Son,Hee Jung, AU - Ryu,Seungho, Y1 - 2017/03/28/ PY - 2016/10/30/received PY - 2017/02/27/revised PY - 2017/03/22/accepted PY - 2017/4/8/pubmed PY - 2018/1/30/medline PY - 2017/4/8/entrez KW - Cohort study KW - Metabolic syndrome KW - Obesity KW - Subclinical atherosclerosis SP - 191 EP - 197 JF - Atherosclerosis JO - Atherosclerosis VL - 262 N2 - BACKGROUND AND AIMS: Although obesity and metabolic abnormalities are known risk factors for cardiovascular disease, the risk of cardiovascular disease among obese individuals without obesity-related metabolic abnormalities, referred to as metabolically healthy obese (MHO), remains unclear. We examined the association between body mass index categories and the development of subclinical carotid atherosclerosis in a cohort of metabolically healthy individuals. METHODS: We conducted a cohort study of 6453 men without subclinical carotid atherosclerosis or metabolic abnormalities at baseline, who underwent repeated health check-up examinations that included carotid ultrasound. A metabolically healthy state was defined as having no metabolic syndrome components and a homeostasis model assessment of insulin resistance <2.5. Subclinical carotid atherosclerosis was assessed using ultrasound. RESULTS: During the follow-up period of 34,797.9 person-years, subclinical carotid atherosclerosis developed in 1916 participants. Comparing overweight and obese with normal weight participants, the multivariable adjusted hazard ratios (95% confidence intervals) for incident subclinical carotid atherosclerosis were 1.24 (1.12-1.38) and 1.54 (1.38-1.72), respectively. The association persisted after further adjustment for metabolic variables. This association was also evident in MHO men without abdominal obesity (waist circumference > 90 cm) and it did not differ across any clinically relevant subgroups evaluated. CONCLUSIONS: In a large cohort study of strictly defined metabolically healthy participants, the MHO phenotype was associated with an increased risk of incident subclinical carotid atherosclerosis, providing evidence that the MHO phenotype is not protective from cardiovascular risk. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/28385392/Metabolically_healthy_obesity_and_the_risk_for_subclinical_atherosclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(17)30138-7 DB - PRIME DP - Unbound Medicine ER -