Association of Metabolically Healthy Obesity and Risk of Cardiovascular Disease Among Adults in China: A Retrospective Cohort Study

Abstract

Purpose Previous studies have shown that metabolically healthy obesity (MHO) and changes in its status are connected to an increased incidence of cardiovascular disease (CVD). Yet, fewer studies have been conducted in China, especially for the middle-aged and elderly population, a high-risk group. The purpose of the study was to investigate the association between metabolic health status and CVD events. Patients and Methods A total of 46,055 participants were categorized into 6 subgroups with different metabolic states according to the existence of metabolic syndrome and body mass index (BMI). The changes in obesity and metabolic health status were defined from baseline to follow-up outcomes with a combination of overweight and obesity. Cox proportional hazards models estimated the association of CVD events and each BMI–metabolic groups. Results MHO and metabolic abnormality normal weight (MANW) subjects had a higher HR of CVD, 1.62 (95% CI, 1.36–1.92) and 1.24 (95% CI, 1.07–1.44), respectively, than their metabolically healthy normal weight (MHNW) counterparts. Then, more than 50% and 30% of the metabolically healthy overweight or obesity (MHOO) populations maintained their status and converted to a metabolically unhealthy state, respectively. Stable MANW, MHOO and metabolically abnormal obesity (MAO) were associated with a higher risk for CVD, 1.68 (95% CI, 1.37–2.05),1.26 (95% CI, 1.08–1.47) and 1.65 (95% CI, 1.45–1.88), respectively, than stable MHNW. Conclusion Despite being of normal weight, MANW status is in fact a risk factor for CVD, as well as MHO, especially for the Chinese middle-aged and elderly population. Furthermore, metabolic health is a transient state for partial middle-aged and elderly Chinese individuals, and MAO has the highest risk of CVD, including coronary heart disease (CHD) and stroke.

Association between metabolic syndrome and myocardial infarction among patients with excess body weight: a systematic review and meta-analysis

“…The studies were published between 2010 and 2023. Three studies used adult treatment panel III (ATP-III) [ 25 – 27 ], while others used other definitions like Japanese society of internal medicine [ 6 ], American heart association/National heart, lung, and blood institute [ 24 ], harmonized international diabetes federation (IDF) [ 23 ], World Health Organization [ 28 ], joint interim statement [ 29 ], and IDF [ 30 ] (Table 1 ).…”

PM2.5, component cause of severe metabolically abnormal obesity: An in silico, observational and analytical study

“…On the one hand, Yen et al [ 78 ] studied 21 subjects with obesity, and all of them experienced some degree of abnormal metabolism. In contrast, the following authors reported different frequencies of subjects with metabolically normal obesity [ [79] , [80] , [81] , [82] , [83] ]. While metabolically abnormal obesity is reported, there is substantial evidence regarding metabolically normal obesity.…”

“…1 H), the results of body mass and metabolic biomarkers in the mice from Rajagopalan et al [ 33 ] were analyzed. Obesity was defined as a 20–30% increase in body mass compared to controls [ 41 , 42 ], accompanied by ≥ two abnormal metabolic parameters in fasting conditions [ 11 , 43 , 44 ]: insulin resistance [ 11 , 45 ], hypertriglyceridemia [ 11 , [46] , [47] , [48] ], and total hypocholesterolemia [ 41 , 49 ]. The presence of two positive criteria was classified as moderate abnormal metabolism, while three criteria were indicative of severe abnormal metabolism.…”