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Obesity increases ischemic heart disease risk
The risk for ischemic heart disease is increased in adults with obesity, even among those with no metabolic cardiovascular disease risk factors, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Kristine Færch, MSc, PhD, of the Steno Diabetes Center in Denmark, and colleagues evaluated data from the Inter99 study on 6,238 adults (mean age for men, 46.3 years; mean age for women, 45.7 years) to determine whether obesity is a risk factor for ischemic heart disease development regardless of metabolic health. Follow-up was a mean of 10.6 years.
At baseline, 58 men and 114 women were categorized as having metabolically healthy obesity (systolic blood pressure < 140 mm Hg, diastolic BP < 90 mm Hg, triglycerides < 1.7 mmol/L, fasting plasma glucose < 6.1 mmol/L, and HDL 1 mmol/L for men and 1.2 mmol/L for women).
A first event of ischemic heart disease was experienced by 206 men and 117 women during follow-up. The risk for developing ischemic heart disease was increased threefold in men who had metabolically healthy obesity compared with men who had normal weight (HR = 3.1; 95% CI, 1.1-8.2), according to the researchers. There was no increased risk for ischemic heart disease in men who had metabolically healthy overweight. The risk for ischemic heart disease in women who had metabolically healthy obesity or overweight was only slightly increased and was statistically insignificant.
The risk for ischemic heart disease was increased across all weight groups in men who were metabolically unhealthy, whereas the risk was only borderline increased in women with normal weight and obesity, according to the findings.
After 5 years of follow-up, most participants with obesity who were metabolically healthy became metabolically unhealthy.
“We found that obesity was associated with [ischemic heart disease] irrespective of metabolic status, especially among men,” the researchers wrote. “The combination of obesity and a metabolically healthy profile was only present in less than 3% of the study population, and a large majority of those with a metabolically healthy profile at baseline became metabolically unhealthy after 5 years of follow-up. This finding suggests that metabolically healthy obesity is not a permanent state. In conclusion, our results suggest that the metabolically healthy obese phenotype is not a benign condition, and we question the feasibility of denoting a subgroup of obese individuals as metabolically healthy.” – by Amber Cox
Disclosure: Færch reports being supported by the Novo Nordisk Foundation.