The association between transition from metabolically healthy obesity to metabolic syndrome, and incidence of cardiovascular disease: Tehran lipid and glucose study

Hosseinpanah, Farhad; Tasdighi, Erfan; Barzin, Maryam; Mahdavi, Maryam; Ghanbarian, Arash; Azizi, Fereidoun

doi:10.1371/journal.pone.0239164

Cited by 27 publications

(26 citation statements)

References 32 publications

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“…MHO/OW incidence in this study was similar previous studies [4,8,30,31]. The recent Hosseinpanah cohort study showed that 26.9% of male and 39.4% of female Iranian people were MHO [31].…”

Section: Discussionsupporting

confidence: 91%

Association of Dietary Total Antioxidant Capacity and MC4R Polymorphisms in Metabolically Healthy and Unhealthy Overweight/Obese Women

Elhamkia

Setayesh

Yarizadeh

et al. 2021

Preprint

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Background: 3-15% of people with obesity display a metabolically healthy phenotype. An inflammatory diet impairs metabolic signaling pathways and eliciting metabolic syndrome. The main purpose of this study was to investigate how the Dietary Total Antioxidant Capacity (DTAC) and the MC4R variants affect the metabolic health status in overweight and obese Iranian women.Methods and results: This cross-sectional study was conducted on 237 overweight-obese Tehrani women with mean age of 36 years.The DTAC was calculated using the following indices: total reactive antioxidant potential (TRAP), Trolox equivalent antioxidant capacity (TEAC), and the ferric-reducing ability of plasma (FRAP). The Metabolic health was evaluated using the Karelis criteria. The MC4R genotypes were determined by the restriction fragment length polymorphism (PCR-RFLP) method. Approximately 43% of participants were identified as Metabolically Unhealthy Obesity (MUO), 6% Metabolically Healthy Obesity (MHO) including 42.5% of the total had T/T genotype ,23.8% had the C/T genotype, and 33.5% had the C/C genotype (P=0.05). In the C/C genotype people 75% were unhealthy whereas it was lower in T/T and T/C genotype people. Further, The C/C genotype with higher DTAC quartile had higher Karlis score than other DTAC quartile. A liner model test supported that the probability of MHO was significantly higher in subjects with the T/C genotype (β=-0.001, 95% CI= -0.001-4.796; P ≤ 0.1). Conclusions: Our results indicated that the C/C genotype with higher DTAC had favorable lipid profile and were metabolically healthier. It is plausible that dietary modification targeting antioxidant intake may attenuate metabolic impairments associated with genetic predisposition.

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“…MHO/OW incidence in this study was similar previous studies [4,8,30,31]. The recent Hosseinpanah cohort study showed that 26.9% of male and 39.4% of female Iranian people were MHO [31].…”

Section: Discussionsupporting

confidence: 91%

Association of Dietary Total Antioxidant Capacity and MC4R Polymorphisms in Metabolically Healthy and Unhealthy Overweight/Obese Women

Elhamkia

Setayesh

Yarizadeh

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In a recent Iranian study, neither women nor men with persistent MHO status had increased HR for CVD incidence compared to the non-obese comparison group (35). However, among women and men who transitioned from MHO to MUO, only men had an increased HR compared to the non-obese comparison group (35). In the study by Izumida et al, the authors adjusted for sex, whereas we found an interaction, but only regarding CVD mortality.…”

Section: Discussioncontrasting

confidence: 79%

“…However, the meta-analysis included few sex-strati ed studies. In a recent Iranian study, neither women nor men with persistent MHO status had increased HR for CVD incidence compared to the non-obese comparison group (35). However, among women and men who transitioned from MHO to MUO, only men had an increased HR compared to the non-obese comparison group (35).…”

Section: Discussionmentioning

confidence: 89%

Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey: a population-based cohort study

Michalsen

Kvaløy

Svartberg

et al. 2021

Preprint

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Background: The mortality of metabolic―obesity phenotypes has been thoroughly studied, but it is not known how the association between continuous measures of body mass index (BMI) or waist circumference differ in strata of cardiometabolic health status. Methods: We linked data on 12,815 men and women aged 36―79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥30 kg/m2 and waist circumference ≥88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) continuous measures of BMI and waist circumference fitted with restricted cubic splines. We adjusted for age, leisure-time physical activity, education, smoking and alcohol consumption, and tested for interactions with sex and metabolic status (only continuous measures). Results: The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO group had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality (p=0.05 for general and p=0.02 for abdominal obesity): relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status.Conclusion: The relationships between continuous measures of BMI/waist circumference and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status.

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“…However, the meta-analysis included few sex-stratified studies. In a recent Iranian study, neither women nor men with persistent MHO status had increased HR for CVD incidence compared to the non-obese comparison group [ 32 ]. However, among women and men who transitioned from MHO to MUO, only men had an increased HR compared to the non-obese comparison group [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent Iranian study, neither women nor men with persistent MHO status had increased HR for CVD incidence compared to the non-obese comparison group [ 32 ]. However, among women and men who transitioned from MHO to MUO, only men had an increased HR compared to the non-obese comparison group [ 32 ]. In the study by Izumida et al, the authors adjusted for sex, whereas we found an interaction, but only regarding CVD mortality.…”

Section: Discussionmentioning

confidence: 99%

Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey: a population-based cohort study

Michalsen

Kvaløy

Svartberg

et al. 2021

BMC Cardiovasc Disord

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Background The mortality of metabolic-obesity phenotypes has been thoroughly studied, but it is not known if or how the association between mortality and body mass index (BMI), waist circumference or a body shape index (ABSI) differ in strata of cardiometabolic health status. Methods We linked data on 12,815 men and women aged 36–79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥ 1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥ 30 kg/m2 and waist circumference ≥ 88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) BMI, waist circumference and ABSI fitted with restricted cubic splines. We adjusted for age and lifestyle, and tested for interactions with sex and metabolic status (only continuous measures). Results The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO groups had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality: relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status. ABSI was linearly and positively associated with all-cause and CVD mortality in men. Conclusion The relationships between BMI, waist circumference or ABSI and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status.

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The association between transition from metabolically healthy obesity to metabolic syndrome, and incidence of cardiovascular disease: Tehran lipid and glucose study

Cited by 27 publications

References 32 publications

Association of Dietary Total Antioxidant Capacity and MC4R Polymorphisms in Metabolically Healthy and Unhealthy Overweight/Obese Women

Association of Dietary Total Antioxidant Capacity and MC4R Polymorphisms in Metabolically Healthy and Unhealthy Overweight/Obese Women

Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey: a population-based cohort study

Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey: a population-based cohort study

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