The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis

Huang, Ming-Yuan; Wang, Mu-Yi; Lin, Yu‐Sheng; Lin, Chien-Ju; Lo, Kai; Chang, I-Jen; Cheng, Ting-Yao; Tsai, Szu-Ying; Chen, Hsin-Hao; Lin, Chien‐Yu; Liu, Shu-Jung; Chien, Kuo‐Liong; Yeh, Tzu-Lin

doi:10.3390/ijerph17041320

Cited by 27 publications

(30 citation statements)

References 31 publications

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“…However, in some studies, there was no increased risk for total mortality between participants with MHO and MHNO. [33][34][35] Our included studies also exhibited inconsistent results for cancer risk. The most likely explanation is that the definition of MHO varied widely among studies.…”

Section: Discussionmentioning

confidence: 95%

“…To the best of our knowledge, this is the first systematic review and meta-analysis to investigate the relationship between MHO and The health implications of MHO are still debated. The study by Caleyachetty et al 32 with 3.5 million individuals and some metaanalyses 15,17,33 demonstrated that participant with MHO had a higher risk of cardiovascular disease (CVD) than participants with MHNW. However, in some studies, there was no increased risk for total mortality between participants with MHO and MHNO.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis yielded inconsistent results of all-cause mortality from MHO using different comparison references (MHNO or MHNW). 33 In our analysis, two studies only divided participants into obesity and non-obesity groups. 24,26 The possibility exists that the MHOW included in the MHNO group could have influenced the effect.…”

Section: Discussionmentioning

confidence: 99%

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The association between metabolically healthy obesity and risk of cancer: A systematic review and meta‐analysis of prospective cohort studies

et al. 2020

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Summary The risk of cancer among adults with metabolically healthy obesity (MHO) has not yet been established. We systematically searched from inception to 15 March 2020. We included prospective cohort studies that compared participants with MHO and participants with metabolically healthy non‐obesity (MHNO) for incidence of any type of cancer. Benign tumors, cancer mortality or cancer prognosis were not in the scope of our analysis. The Newcastle–Ottawa Scale was used for quality assessment. Ultimately, eight studies with a total of 12 542 390 participants were included. The pooled meta‐analysis using random effect model showed participants with MHO demonstrated a significantly increased risk of developing cancer (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.05 to 1.23; and I2 = 39%) than those with MHNO. The subgroup analysis revealed a higher pooled estimate (OR, 1.17; 95% CI, 1.01–1.35; and I2 = 56%) in comparison with metabolically healthy normal weight. No evidence of effect modification by age, sex, ethnicity, smoking, sample size or length of follow‐up was found. In conclusion, the present study reports a positive association between MHO and cancer incidence. All individuals with obesity, even in the absence of metabolic dysfunction, should be encouraged to lose weight.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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The association between metabolically healthy obesity and risk of cancer: A systematic review and meta‐analysis of prospective cohort studies

et al. 2020

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“…The third paper, "The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis", by Huang et al [3], investigates the association among metabolically healthy obesity (MHO), cardiovascular disease (CVD) risk, and all-cause mortality in the Asian population. Participants with MHO had a significantly lower risk of all-cause mortality than MHNO (non-obese, including overweight and underweight) participants, but a borderline significantly higher risk of all-cause mortality than MHNW (without overweight or underweight) participants.…”

Section: Preventive Medicine and Risk Assessmentmentioning

confidence: 99%

Big Data, Decision Models, and Public Health

Chan

Chang

2020

IJERPH

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Unlike most daily decisions, medical decision making often has substantial consequences and trade-offs. Recently, big data analytics techniques such as statistical analysis, data mining, machine learning and deep learning can be applied to construct innovative decision models. With complex decision making, it can be difficult to comprehend and compare the benefits and risks of all available options to make a decision. For these reasons, this Special Issue focuses on the use of big data analytics and forms of public health decision making based on the decision model, spanning from theory to practice. A total of 64 submissions were carefully blind peer reviewed by at least two referees and, finally, 23 papers were selected for this Special Issue.

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“…These results suggested that abdominal obesity per se is the key role in the progress of subclinical vascular in ammation. Obesity in absence of metabolic risk factors is not entirely benign and MHO population would therefore be expected to have a higher risk of CVD and all-cause mortality than MHNO group (45) The strengths of our study include a twin design, a standard de nition of MetS, adjustment for many available covariates, and various analyses including using strati ed analysis and number of MetS components to test the robustness of the conclusions. However, several potential limitations should be addressed.…”

Section: Within Twin-pair Analysismentioning

confidence: 99%

Associations of Obesity-metabolic Status With Insulin Resistance and Chronic Inflammation Level: Results From the CNTR Study

Liao

Gao²,

Cao³

et al. 2020

Preprint

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Background: Insulin resistance (IR) and inflammation are the potential mechanism linking obesity and cardiometabolic risk. The aim of this work was to examine the joint relations of obesity and metabolic status with IR and chronic inflammation level among Chinese adult twins.Methods: The analyses used data from 1113 adult twins in 4 provinces (Shandong, Zhejiang, Jiangsu and Sichuan) from Chinese National Twin Registry (CNTR) which collected detailed information. Those with 0 or 1 metabolic syndrome (MetS) components excluding waist circumference were considered metabolically healthy, and those with waist circumference≥90 cm in men and ≥85 cm in women as obese. All participants were categorized into four phenotypes: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non- obesity (MUNO), metabolically unhealthy obesity (MUO). High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as surrogate measure of insulin resistance. Results: In observational analyses of 1113 individuals (mean [SD] age, 46.6 [12.9] years; 463 obese [41.6%]). 20.3% obese twins were metabolic healthy. Serum HOMA-IR level was higher in MUNO (β=0.42, 95% CI: 0.21–0.64), MHO (β=0.68, 95% CI: 0.36–1.00) and MUO (β=0.69, 95% CI: 0.46–0.91) twins, compared with their MHNO counterparts. The chronic inflammation level, evaluated by hsCRP was similar between MHO and MUO, which differed significantly to metabolic healthy non-obesity (MHNO). Within twin-pair analysis indicated there might exist common genetic influence between HOMA-IR and MHO/MUO phenotype.Conclusions: Among Chinese adult twins, metabolic status were independently associated with higher IR while development of chronic inflammation might closely relate to central obesity. It is necessary for the different risk assessment based on metabolic status in obese population.

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The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis

Cited by 27 publications

References 31 publications

The association between metabolically healthy obesity and risk of cancer: A systematic review and meta‐analysis of prospective cohort studies

The association between metabolically healthy obesity and risk of cancer: A systematic review and meta‐analysis of prospective cohort studies

Big Data, Decision Models, and Public Health

Associations of Obesity-metabolic Status With Insulin Resistance and Chronic Inflammation Level: Results From the CNTR Study

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