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Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women.
Open accessAbstract
Background Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals.Objectives This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population.Methods We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease).Results During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities.Conclusions Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.
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“This subgroup, while sometimes characterized as metabolically healthy due to the lack of prevalent disease, is at elevated risk of developing diabetes and other cardiometabolic conditions compared with individuals without obesity.4,5,6,7”
From Factors Associated With Semaglutide Initiation Among Adults With Obesity (2025) · cites this paper as [4]
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Laubner, K. (2023) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/a-1847-2632
“keine arterielle Hypertonie, Dyslipidämie oder Diabetes mellitus Typ 2 vorlagen [21].”
BackgroundDeng, D., Nie, Z., Wang, J.-B., Chen, C., Wang, W., Zhu, Y., Guan, Q., Ou, Y., & Feng, Y. (2023) · medRxiv · doi:10.1101/2023.09.25.23296122
“7,22,23 Our study also suggested that the risk of HF was at a 75% increase in subjects with MHO, in line with the Health Improvement Network cohort of 3.5 million men and women reporting that those with MHO had a 96% higher risk than MHNW. 24 However, this was inconsistent with another previous article of the Women’s…”
InfluentialChallenges of Sodium-glucose Transporter-2 Inhibitors Use in a low Socioeconomic Setting
Cruz, L. J., Frías-Ureña, K., López, L. A., Torres-Bueno, L., Urraca, J., Díaz-Henríquez, K., & Gutiérrez, A. (2023) · Medical Research Archives · doi:10.18103/mra.v11i12.4830
Folgeerkrankungen der Adipositas
(2024) · Elsevier eBooks · doi:10.1016/b978-3-437-23026-4.00002-2
Mahadevan, A., Adivi, S., Akella, S. A., Doshi, P., Salian, R. B., Kohli, M., Radhareddy, A. R., Krishnakumar, M., Pinnamaneni, M., & Desai, R. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107847
Metabolisch gesunde Adipositas
Blüher, M. (2024) · Springer eBooks · doi:10.1007/978-3-662-58895-6_19
Timofeev, Y. S., Lyubimova, N. V., & Drapkina, O. M. (2024) · Almanac of Clinical Medicine · doi:10.18786/2072-0505-2024-52-019
Jung, D. H., Kim, Y. J., Koh, H. B., Son, N., Park, J. T., Han, S. H., Yoo, T., Kang, S., Huh, C. W., & Yun, H. (2024) · Scientific Reports · doi:10.1038/s41598-024-71057-3
“Although there is sufficient evidence that MHO represents a relatively benign state with an attenuated risk of developing various illnesses, discordant research outcomes have been reported 15–17 .”
BackgroundCardiometabolic Disease and Brain Damage
Kotsis, V., Triantafyllou, Α., Λαζαρίδης, Α., & Mastrogiannis, Κ. (2024) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-031-64928-8_3
Wang, P., Liu, M., Zhang, S., Guo, Y., Xiong, Z., Huang, Y., Cai, X., He, L., Chen, Z., Zhou, Y., et al. (2024) · International Journal of Obesity · doi:10.1038/s41366-024-01587-3
“…metabolic risk factors management might be needed for the elderly to reduce the burden of HF. Previous studies have assessed the relationship between MHO and risk of HF and demonstrated that higher risk of HF was observed in MHO and MUO as compared to metabolically healthy normal weight [17, 18].”
Influential(2024) · Elsevier eBooks · doi:10.1016/b978-0-443-23565-8.09996-8
Lifestyle Factors Affecting Biological Processes and Health
Anisman, H., Hayley, S. P., & Kusnecov, A. W. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-23565-8.00009-0
Bajaj, S., & Basu‐Ray, I. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99645-7.00009-3
Kohsari, M., Rahimi, Z., Najafi, F., & Moradinazar, M. (2024) · Indian Journal of Clinical Biochemistry · doi:10.1007/s12291-024-01286-w
Adipose Tissue Dysfunction: Clinical Implications and Complications
Dronkers, J., Lobeek, M., Meems, L. M. G., & Gorter, T. M. (2024) · Contemporary Endocrinology · doi:10.1007/978-3-031-72570-8_5
Metadata
- Authors
- Caleyachetty, R., Thomas, G. N., Toulis, K. A., Mohammed, N., Gokhale, K. M., Balachandran, K., & Nirantharakumar, K.
- Affiliations
- University of Birmingham (GB)
- 424 General Military Hospital (GR)
- Corresponding author
- Thomas, G. Neil
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 70
- Issue
- 12
- Pages
- 1429-1437
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2755267305
- Cited by
- 574
- References
- 37
- Citations by year
- 2026: 48 · 2025: 65 · 2024: 73 · 2023: 60 · 2022: 71 · 2021: 68 · 2020: 66 · 2019: 51 · 2018: 64 · 2017: 8
- FWCI
- 40.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (publishedVersion, cc-by-nc-nd)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Funders
- Medical Research Council (MC_PC_15079)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metabolically healthy obesity, cardiovascular risk, coronary artery disease, cerebrovascular disease, heart failure, peripheral vascular disease, body mass index, metabolic abnormalities, diabetes mellitus, hypertension, hyperlipidemia, normal-weight individuals
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Obesity, Prospective Studies, Incidence, Risk Assessment
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