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Metabolically healthy obesity affected diabetes, CVD risk
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The metabolically healthy obese phenotype confers a lower risk for type 2 diabetes than the metabolically unhealthy obese phenotype, but both obesity phenotypes are at increased risk for cardiovascular disease, according to recent findings.
“Metabolically healthy obesity does not appear to be a benign condition, making it important to promote prudent weight loss in overweight/obese individuals and control of modifiable risk factors,” the researchers wrote.
Researchers utilized data from 7,122 participants in the Whitehall II cohort study, an ongoing prospective analysis of health in civil service employees in London. Initiated in 1985, the Whitehall II cohort study subsequently collected health data from 1991-1993, 1997-1999, 2002-2004 and 2007-2009. The patients included for analysis were aged 39 to 63 years, and 69.7% were men. Metabolic health data were first collected from 1991-1993, which represents the baseline of the current study. The study participants were weighed, and BMI was calculated using the WHO classification. Metabolic health was evaluated using the Adult Treatment Panel III (ATP-III) criteria. Based on this information, the investigators formulated six phenotypes: metabolically healthy normal weight (MH-NW), metabolically healthy overweight, metabolically healthy obese (MHO), metabolically unhealthy normal weight, metabolically unhealthy overweight, and metabolically unhealthy obese (MUO). The researchers evaluated the prevalence of CVD and type 2 diabetes every 5 years during the follow-up period, which spanned from 1991-1993 to 2009.
The researchers found that of the study population, 657 participants (9.2%) were obese, and 42.5% of these obese participants were classified as MHO at baseline. During the median 17.4-year follow-up, the researchers documented 828 incident cases of CVD (4.5% in the MHO phenotype and 8% in the MUO phenotype) and 798 incident cases of type 2 diabetes (6% in the MHO phenotype and 16% in the MUO phenotype). Participants classified as MHO had an elevated risk for CVD vs. those in the MH-NW phenotype (HR=1.97; 95% CI, 1.38-2.8) and also were at higher risk for type 2 diabetes vs. the patients classified as MH-NW (HR=3.25; 95% CI, 2.32-4.54). The patients in the MUO phenotype were found to face a higher risk for type 2 diabetes vs. the participants classified as MHO (HR=1.98; 95% CI, 1.39-2.83), but there was no significant disparity between the two obesity phenotypes in terms of CVD risk (HR=1.23; 95% CI, 0.81-1.87).
According to the researchers, these findings suggest that the benefits of the MHO phenotype are inconsistent across different health outcomes. They wrote that further studies are warranted to further understand the health risks of the MHO phenotype.
Disclosure: The researchers report no relevant financial disclosures.
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