Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Yuan, Yue; Mu, Jianjun; Chu, Chao; Zheng, Wenfang; Wang, Yang; Hu, Jiawen; Ma, Qiang; Yu, Yan; Liao, Yue‐Yuan; Chen, Chen

doi:10.1186/s12986-020-00474-8

Cited by 12 publications

(17 citation statements)

References 45 publications

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“…The MESA study [ 35 ] found that the inverse relationship between arterial stiffness and BMI remained in the elderly cohort, suggesting that arteries in elderly individuals with normal weight may be less stiff than they appear by measuring BAPWV. Another study found that regardless of the BMI, females are generally more affected by progression of arterial stiffness [ 47 ], while this is not apparent in males. The latter may lend support to other studies which have found BMI to be a crude measures of total adiposity which may inadequately represent body fat distribution and/or body shape [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population

Zuo

Tang

O’Rourke

et al. 2022

JCDD

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Objectives: Arterial stiffness is widely accepted as an important predictor of cardiovascular disease (CVD) development. While obesity is generally associated with increased CVD risk, there is evidence that overweight patients with existing CVD may have better clinical outcomes than their lean counterparts. Our study sought to observe any potential association between brachial–ankle pulse wave velocity (BAPWV), a marker of arterial stiffness related to CVD risk, and Body Mass Index (BMI), a crude and widely used measure of obesity. Methods: Adult individuals (n = 857) assessed for routine CV risk were included and grouped according to their BMI (<25 kg/m2: normal; 25–30 kg/m2: overweight, ≥30 kg/m2: obese). Their anthropometric parameters, brachial cuff pressures, and BAPWV were measured. Results: Brachial pressure was significantly higher as BMI increased. BAPWV showed a positive linear association with systolic (r = 0.66, p < 0.01), mean (r = 0.60, p < 0.01), diastolic (r = 0.51, p < 0.01), and pulse (r = 0.53, p < 0.01) pressures. However, a linear relationship between BMI and BAPWV was only apparent in males aged <50 years (p = 0.01) and in females aged ≥50 years (p < 0.01). In individuals with similar brachial systolic pressure, BAPWV was higher in normal-weight subjects compared to overweight–obese ones. Conclusions: This conflicting finding is attributed to an overestimation of the degree of arterial stiffness as a measure of CVD risk in individuals with a less ‘healthy’ BMI. This suggests that BMI may not the appropriate obesity indicator to assess CV risk. Our finding emphasizes the importance of establishing a non-linear relationship between CVD risk, age, and BMI, taking into account apparent sex differences, to predict future CV events. While this finding may suggest a lower degree of stiffness in large arteries of overweight–obese subjects compared to their normal-weight counterparts, the potential implications for individuals with higher BMI need be explored further.

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Section: Discussionmentioning

confidence: 99%

Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population

Zuo

Tang

O’Rourke

et al. 2022

JCDD

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“…Another prospective study by Fingeret et al [ 28 ] did not find any difference between MHO and MUO in hypertension incidence after 10.9 years of follow-up (odds ratio (OR): 1.3, CI 95%: 0.8–2.09). Yuan et al [ 29 ] showed that MHO has no association with the development of arterial stiffness (OR: 0.99; CI 95%: 0.61–1.6), while MUO and MUNO phenotypes lead to significantly progressed arterial stiffness (OR: 4.56; CI 95%: 2.60–8) and (OR: 5.05; CI 95%: 3.12–8.19), respectively. On the other hand, some studies by Hashimoto et al [ 30 ] and Gilardini et al [ 31 ] did not see any association between MHO and the risk of renal failure, prediabetes, diabetes and CVDs.…”

Section: Discussionmentioning

confidence: 99%

Metabolically healthy versus unhealthy obese phenotypes in relation to hypertension incidence; a prospective cohort study

Hamzeh

Pasdar

Moradi

et al. 2022

BMC Cardiovasc Disord

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Background Although obesity increases the risk of hypertension, the effect of obesity based on metabolic status on the incidence of hypertension is not known. This study aimed to determine the association between obesity phenotypes including metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO) and the risk of hypertension incidence. Methods We conducted a prospective cohort study on 6747 adults aged 35–65 from Ravansar non-communicable diseases (RaNCD) study. Obesity was defined as body mass index above 30 kg/m2 and metabolically unhealthy was considered at least two metabolic disorders based on the International Diabetes Federation criteria. Obesity phenotypes were categorized into four groups including MUO, MHO, metabolically unhealthy non obesity (MUNO), and metabolically healthy non obesity (MHNO). Cox proportional hazards regression models were applied to analyze associations with hypertension incidence. Results The MHO (HR: 1.37; 95% CI: 1.03–1.86) and MUO phenotypes (HR: 2.44; 95% CI: 1.81–3.29) were associated with higher hypertension risk compared to MHNO. In addition, MUNO phenotype was significantly associated with risk of hypertension incidence (HR: 1.65; 95% CI: 1.29–2.14). Conclusions Both metabolically healthy and unhealthy obesity increased the risk of hypertension incidence. However, the increase in metabolically unhealthy phenotype was higher.

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“…Several studies reported that obese individuals had youthful arteries with lower PWV [24,25]. Moreover, a prospective cohort study found an irrelevant association between them [26]. Obesity often coexists with other risk factors and accelerates arterial stiffness through its associated metabolic abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Risk of arterial stiffness according to metabolically healthy obese phenotype: a combined cross-sectional and longitudinal study in kailuan cohort

Wang

Zuo

et al. 2021

Aging

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BackgroundTo investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population. Materials and methodsThe Kailuan study is an ongoing prospective cohort study, 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study from March 1, 2010, to January 31, 2020. Cross-classi cation of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used to assess the association between BMI-metabolic status phenotypes and baPWV in mono-factor and multi-factor models. ResultsThe results of cross-sectional and longitudinal investigation were basically the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.6-fold, 2.8-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal weight controls in the fully adjusted model. Further strati ed analysis shown that metabolic health status was an interaction factor between BMI and arterial stiffness in either study population (P<0.0001 for cross-sectional study and P=0.0003 for longitudinal study). ConclusionsMetabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants. Moreover, MHO is an intermediate stage between metabolically healthy and unhealthy status.

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Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Cited by 12 publications

References 45 publications

Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population

Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population

Metabolically healthy versus unhealthy obese phenotypes in relation to hypertension incidence; a prospective cohort study

Risk of arterial stiffness according to metabolically healthy obese phenotype: a combined cross-sectional and longitudinal study in kailuan cohort

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