(28-04-12) Metabolically Healthy Obesity and Risk of All-Cause and Cardiovascular Disease Mortality.

Hamer M, Stamatakis E.
Source
Department of Epidemiology and Public Health, University College London,
London WC1E 6BT, United Kingdom.
Abstract
Context:Previous studies have identified an obese phenotype without the burden
of adiposity-associated cardiometabolic risk factors, although the health
effects remain unclear.Objective:We examined the association between
metabolically healthy obesity and risk of cardiovascular disease (CVD) and all-
cause mortality.Design and Setting:This was an observational study with
prospective linkage to mortality records in community-dwelling adults from the
general population in Scotland and England.Participants:A total of 22,203 men
and women [aged 54.1 (SD 12.7 yr), 45.2% men] without known history of CVD at
baseline.Interventions:Based on blood pressure, high-density lipoprotein-
cholesterol, diabetes diagnosis, waist circumference, and low-grade
inflammation (C-reactive protein ≥ 3 mg/liter), participants were classified as
metabolically healthy (0 or 1 metabolic abnormality) or unhealthy (two or more
metabolic abnormalities). Obesity was defined as a body mass index of 30 kg/m
(2) or greater.Main Outcome Measure:Study members were followed up, on average,
more than 7.0 ? 3.0 yr for cause-specific mortality. Cox proportional hazards
models were used to examine the association of metabolic health/obesity
categories with mortality.Results:There were 604 CVD and 1868 all-cause deaths,
respectively. Compared with the metabolically healthy nonobese participants,
their obese counterparts were not at elevated risk of CVD [hazard ratio (HR)
1.26, 95% confidence interval (CI) 0.74-2.13], although both nonobese (HR 1.59,
95% CI 1.30-1.94) and obese (HR 1.64, 95% CI 1.17-2.30) participants with two
or more metabolic abnormalities were at elevated risk. Metabolically unhealthy
obese participants were at elevated risk of all-cause mortality compared with
their metabolically healthy obese counterparts (HR 1.72, 95% CI 1.23-2.41).
Conclusion:Metabolically healthy obese participants were not at increased risk
of CVD and all-cause mortality over 7 yr.

Source: J Clin Endocrinol Metab. 2012 Apr 16. [Epub ahead of print]

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