From Metabolic Normality to Cardiometabolic Risk Factors in Subjects With Obesity

Abstract

The aim of the study was to evaluate the 3 years incidence of cardiometabolic risk factors, such as impaired fasting glucose, reduced high‐density lipoprotein (HDL)‐cholesterol, increased plasma triglycerides or blood pressure as well as impaired glucose tolerance in overweight or obese (ow/ob) and normal body weight (nbw) subjects metabolically normal at baseline. Subjects from the Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) study were analyzed. We analyzed 284 nbw and 152 ow/ob subjects who, at baseline, did not show any of the above‐mentioned cardiometabolic risk factors. At 3 years, these parameters were re‐evaluated. Intima‐media thickness (IMT) of the common carotid artery (CCA) was echographically measured. At follow‐up, the incidence of one or more cardiometabolic risk factors was 57.2% in ow/ob vs. 31.7% in nbw (P < 0.0001). After adjustment for age, sex, menopause status, lifestyle parameters, insulin sensitivity, and fasting insulinemia, BMI remained significantly linked to the development of one or more cardiometabolic risk factors (P = 0.02). An increased BMI at follow‐up was significantly associated with the development of cardiometabolic alterations, in both nbw and ow/ob groups (P = 0.04). Ow/ob subjects who, at 3 years follow‐up, remained metabolically normal, showed a less favourable cardiometabolic profile, when compared to nbw counterparts. In ow/ob metabolically normal males and females, intima‐media of the common carotid at follow‐up was thicker than in nbw (P = 0.03 for males, P = 0.04 for females). In conclusion, metabolically normal obese subjects show a higher incidence of cardiometabolic risk factors, in a short follow‐up period. Weight gain is significantly associated with the development of these factors, in both nbw and ow/ob subjects.

Coronary artery disease risk among obese metabolically healthy young men

“…It is possible that middle-aged individuals who were overweight and obese for many years without developing any metabolic abnormalities confer a lower risk for incident CAD as compared to young adults in whom obesity sustained for a shorter interval. In support, Bobbioni-Harsch et al (25) and Bell et al (26) have used similar metabolic definitions to ours and showed that the MH obese are at risk for future metabolic abnormalities even after two decades from initial assessment. Moreover, BMI at late adolescence (27), even independent from that at young adulthood (1), has been shown to affect future adjusted CAD risk, pointing the critical role of obesity at young ages in the development of atherosclerotic plaque.…”

“…To address this question, we studied the incidence of CAD among participants of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. All of the men in the Israel Defense Forces (IDF) aged 25 and older have been metabolically characterized and followed in this large ongoing study. Data from this cohort were analyzed to compare the incidence of CAD among overweight and obese individuals with or without the various components of the metabolic syndrome.…”

Carotid Intima Media Thickness and Parameters Related to Blood Flow in Obese Patients

“…In their study, Bobbioni-Harsch et al also found that weight gain was significantly associated with the development of cardiometabolic risk factors. 24 Similarly; Alpsoy et al and Ozcetin et al established that overweight and obese children were also potentially at risk of early atherosclerosis. 25,26 The INTERHEART study identified obesity as an important risk factor for myocardial infarction which was expressed with four different measurements: BMI, WHR, WC and HC.…”

Blood Pressure in Schoolchildren and Adolescents and its Variation according to Nutritional Status Evaluation: An Early Preventive Key for Obesity Comorbidities

“…In normal weight and obese adults [28] and after euglycemic-hyperinsulinemic clamp there was not greater cardiometabolic risk for them insofar as they showed normal insulin sensitivity. This together with the better known experiences about insulin resistance and its associated risks for CVD in adults [29] or pediatric ages [30] should lead to a more efficient search for fasting insulin levels or better for the whole metabolic syndrome factors in all of the overweight people with elevated blood pressure [31], which would imply an earlier preventive intervention.…”