Cited by 406Diabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Disease and AdiposityCardiovascular Function and Risk Factors

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Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis.

Eckel, Nathalie, Meidtner, Karina, Kalle-Uhlmann, Tamara, Stefan, Norbert, Schulze, Matthias B·2016·European Journal of Preventive Cardiology

DOI 10.1177/2047487315623884

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Abstract

AIMS: Previous studies have provided inconsistent results about the cardiovascular risks for participants with metabolically healthy obesity (MHO). These uncertainties might partly reflect the lack of a uniform definition of MHO. We conducted a systematic review and meta-analysis to examine whether there is a suitable approach that identifies obese participants who are not at an increased risk of cardiovascular events compared with healthy normal-weight participants. METHODS AND RESULTS: Twenty-two prospective studies were eligible for the meta-analysis. Using random-effect models, pooled relative risks (RRs) were calculated for the combined effects of obesity with the presence or absence of metabolic syndrome, insulin resistance, hypertension, diabetes, hyperlipidaemia and any of these metabolic factors. Participants with MHO defined by the absence of metabolic syndrome were at increased risk for cardiovascular events compared with healthy normal-weight participants (pooled RR 1.45, 95% confidence interval (CI) 1.20-1.70), but had lower risks than unhealthy normal-weight (RR 2.07, 95% CI 1.62-2.65) and obese (RR 2.31, 95% CI 1.99-2.69) participants. The risk associated with participants who had MHO was particularly high over the long term. Similar risk estimates were observed when MHO was defined by other approaches. CONCLUSIONS: None of the approaches clearly identified an obese subgroup not at increased risk of cardiovascular events compared with normal-weight healthy participants. A benign obese phenotype might be defined by strict definitions, but insufficient studies exist to support this. More research is needed to better define MHO.

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Additional file 1 of Obesity, metabolic risk and adherence to healthy lifestyle behaviours: prospective cohort study in the UK Biobank
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Additional file 3 of Obesity, metabolic risk and adherence to healthy lifestyle behaviours: prospective cohort study in the UK Biobank
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Additional file 4 of Galectin-4 levels in hospitalized versus non-hospitalized subjects with obesity: the Malmö Preventive Project
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Additional file 2 of Obesity, metabolic risk and adherence to healthy lifestyle behaviours: prospective cohort study in the UK Biobank
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Authors: Eckel, N., Meidtner, K., Kalle-Uhlmann, T., Stefan, N., & Schulze, M. B.
Affiliations: German Center for Diabetes Research (DE)
German Institute of Human Nutrition (DE)
Helmholtz Munich (DE)
Corresponding author: Schulze, Matthias B
ORCID: Meidtner, Karina
Stefan, Norbert
Schulze, Matthias B
Venue: European Journal of Preventive Cardiology
Publisher: Oxford University Press (OUP)
Published: 2016-06-01
Volume: 23
Issue: 9
Pages: 956-966
ISSN: 2047-4873 (ISSN-L)
2047-4881
DOI: 10.1177/2047487315623884
OpenAlex: W2201485362
Cited by: 405
References: 64
Citations by year: 2026: 26 · 2025: 41 · 2024: 37 · 2023: 48 · 2022: 52 · 2021: 52 · 2020: 44 · 2019: 38 · 2018: 37 · 2017: 24 · 2016: 6
FWCI: 3.35
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: European Journal of Preventive Cardiology (publishedVersion)
PubMed (publishedVersion)
Site cant be reached (submittedVersion)
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 events, cardiovascular risk, metabolic syndrome, insulin resistance, hypertension, diabetes mellitus, hyperlipidemia, obesity phenotypes
MeSH terms: Obesity, Metabolically Benign, Cardiovascular Diseases, Humans, Phenotype, Prognosis, Risk Factors, Odds Ratio, Risk Assessment

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Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis.

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