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

Hamzeh, Behrooz; Pasdar, Yahya; Moradi, Shima; Darbandi, Mitra; Rahmani, Negin; Shakiba, Ebrahim; Najafi, Farid

doi:10.1186/s12872-022-02553-5

Cited by 6 publications

(3 citation statements)

References 42 publications

(41 reference statements)

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“…Moreover, the risk was greater for those with metabolic unhealthiness than in baseline exposure models. Consistent with a previous study, 31 individuals with MHO demonstrated healthier behaviours, were more educated, and were younger. However, among individuals who had MHO at baseline and transitioned to MUO within 2 years, higher baseline levels of triglycerides, HDL cholesterol and glucose were observed.…”

Section: Discussionsupporting

confidence: 90%

Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model

Lee,

Park

2023

Diabetes Obesity Metabolism

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AimTo assess the effect of obesity phenotype on the incidence of diabetes, considering phenotype as a time‐varying exposure.MethodsWe used community‐based cohort data from the Korean Genome and Epidemiology Study, with a 16‐year follow‐up period. Obesity phenotype was determined using body mass index and metabolic syndrome criteria. The influence of obesity phenotype on the occurrence of diabetes was evaluated using a Cox proportional hazard model and a marginal structural model (MSM).ResultsObesity phenotypes were defined in 6265 individuals, with diabetes identified in 903 (14.4%) during the follow‐up period. Individuals with metabolically healthy obesity (MHO) exhibited a higher risk of diabetes compared to those with metabolically healthy normal weight (MHNW), with a hazard ratio (HR) of 1.48 (95% confidence interval [CI] 1.15‐1.90). This association remained significant after applying the MSM (HR 1.49, 95% CI 1.01‐2.20). Moreover, various sensitivity analyses consistently demonstrated a higher risk of diabetes in individuals with MHO compared to those with MHNW.ConclusionsEven when obesity phenotype was treated as a time‐varying exposure, individuals with MHO were still at higher risk for developing diabetes than those with MHNW. Consequently, such individuals should aim to avoid transitioning to a metabolically unfavourable state and strive to reduce their body weight to a normal range.

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Section: Discussionsupporting

confidence: 90%

Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model

Lee,

Park

2023

Diabetes Obesity Metabolism

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“…The association between obesity and IR has already been established [29]. Metabolically unhealthy obesity (MUO) has also been observed to be associated with IR and hypertension [29,30]. Okura et al 's study in the Japanese population showed that BMI ≥ 23 is a risk factor for IR [31].…”

Section: Discussionmentioning

confidence: 99%

Triglyceride glucose-body mass index and hypertension risk in iranian adults: a population-based study

et al. 2023

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Background Insulin resistance (IR) and obesity are risk factors for hypertension; triglyceride-glucose (TyG) is known as a surrogate for IR. The present study investigated the association between the triglyceride-glucose body mass index (TyG-BMI) index and the risk of hypertension in Iranian adults. Methods This study was conducted on a sample of 8,610 participants from the baseline phase of the Ravansar non- communicable diseases (RaNCD) in Iran. A logistic regression model was used to evaluate the relationship between TyG-BMI and hypertension. Receiver operating characteristic (ROC) curve analysis was conducted to estimate the predictive power of TyG-BMI for hypertension. Results A total of 4176 men and 4434 women with an average age of 46.74 years were examined. The anthropometric indices were significantly higher in hypertensive than normotensive subjects (P < 0.001). The level of physical activity was significantly higher in the bottom quartiles (P < 0.001). The odds of hypertension in the highest quartile and 3.10 (95% CI: 2.28, 4.16) times significantly higher than the bottom quartile of the TyG-BMI index. The discriminating ability of TyG-BMI to predict blood pressure was 61% (AUC: 0.61; 95% CI: 0.57, 0.63), and higher than BMI and TyG. Conclusion The TyG-BMI index is associated with an increase in the odds of hypertension. Therefore, the TyG-BMI index can be a new clinical index for early diagnosis of hypertension. Lifestyle modifications such as weight control through physical activity and a healthy diet can help improve IR and prevent hypertension.

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“…Approximately 20% of the entire adult population of the world will be obese by 2030 [1]. Obesity increases glucose levels and worsens lipid profiles, blood pressure, and the incidence of inflammation [2][3][4]. Consequently, this condition is associated with the worsening of almost all cardiovascular risk factors such as hypertension, type 2 diabetes (T2DM), metabolic syndrome, dyslipidemia, and chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Metabolically Abnormal Non-Obese Phenotype Is Significantly Associated with All-Cause Mortality in Hemodialysis Patients

Lee,

Yun,

Kim

et al. 2024

JCM

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The association between obesity and all-cause mortality in patients undergoing kidney failure with replacement therapy (KFRT) has shown conflicting results. This study aimed to evaluate whether metabolic abnormalities (MA) increase the risk of all-cause mortality in these patients. Between 2009 and 2015, 1141 patients undergoing KFRT were recruited from the Clinical Research Center for End-Stage Renal Disease dataset. Patients were divided into four groups according to the presence of obesity and MA. Multivariate Cox proportional hazard analysis was performed to determine the association between the phenotypes and all-cause mortality. During a mean follow-up of 4.2 years, all-cause mortality was observed in 491 (43.0%) patients. Obesity had a 24% decreased risk of all-cause mortality compared with non-obesity. In contrast, the presence of MA showed a 1.53-fold increased risk of all-cause mortality. There was a significant interaction between obesity and MA (p = 0.006). In Cox proportional hazard analyses after adjustment of confounding factors, the metabolically abnormal non-obesity (MANO) phenotype showed a 1.63-fold increased risk of all-cause mortality compared with the metabolically healthy non-obesity phenotype. In subgroup analysis, the risk of all-cause mortality was higher in the MANO phenotype; this phenotype was significantly associated with a higher all-cause mortality in patients undergoing KFRT.

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

Cited by 6 publications

References 42 publications

Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model

Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model

Triglyceride glucose-body mass index and hypertension risk in iranian adults: a population-based study

Metabolically Abnormal Non-Obese Phenotype Is Significantly Associated with All-Cause Mortality in Hemodialysis Patients

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