Association between the metabolically healthy obese phenotype and the risk of myocardial infarction: results from the Kailuan study

Xu, Youren; Li, Haibin; Wang, Anxin; Su, Zhaoping; Yang, Guang; Luo, Yanxia; Tao, Lixin; Chen, Shuohua; Wu, Shouling; Wang, Youxin; Guo, Xiuhua

doi:10.1530/eje-18-0356

Cited by 28 publications

(25 citation statements)

References 42 publications

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“…Second, we first verified that MHO or MH-OW did not increase the risk for all-cause mortality in a Chinese population. At this point, the present study supported the concept that “all obesity is not created equally.” However, considering our previous finding that obesity was associated with a higher risk of myocardial infarction, even without measurable metabolic abnormalities ( 21 ), whether participants with the MHO or MH-OW phenotype should reduce their body weight needs further consideration.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, we found that obesity was associated with myocardial infarction in a Chinese population, regardless of whether measurable metabolic abnormalities were present ( 21 ). This finding was consistent with those in several reports that aimed to identify a healthy obesity phenotype related to cardiovascular diseases ( 23 – 25 ).…”

Section: Introductionmentioning

confidence: 96%

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All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity

Tian¹,

Wang²,

Zuo³

et al. 2020

JCI Insight

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BACKGROUND Metabolically healthy obesity (MHO) and metabolically healthy overweight (MH-OW) have been suggested to be important and emerging phenotypes with an increased risk of cardiovascular disease (CVD). However, whether MHO and MH-OW are associated with all-cause mortality remains inconsistent. METHODS The association of MHO and MH-OW and all-cause mortality was determined in a Chinese community-based prospective cohort study (the Kailuan study), including 93,272 adults at baseline. Data were analyzed from 2006 to 2017. Participants were categorized into 6 mutually exclusive groups, according to BMI and metabolic syndrome (MetS) status. The primary outcome was all-cause death, and accidental deaths were excluded. RESULTS During a median follow-up of 11.04 years (interquartile range, 10.74–11.22 years), 8977 deaths occurred. Compared with healthy participants with normal BMI (MH-NW), MH-OW participants had the lowest risk of all-cause mortality (multivariate-adjusted HR [aHR], 0.926; 95% CI, 0.861–0.997), whereas there was no increased or decreased risk for MHO (aHR, 1.009; 95% CI, 0.886–1.148). Stratified analyses and sensitivity analyses further validated that there was a nonsignificant association between MHO and all-cause mortality. CONCLUSIONS Overweight and obesity do not predict increased risk of all-cause mortality in metabolic healthy Chinese individuals. FUNDING National Natural Science Foundation of China (NSFC; 81673247, 81872682 and 81773527), the NSFC Joint Project, and the Australian National Health and Medical Research Council (NHMRC; NSFC 81561128020-NHMRC APP1112767).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity

Tian¹,

Wang²,

Zuo³

et al. 2020

JCI Insight

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“…Напротив, в недавнем проспективном когортном китайском исследовании Kailuan (период наблюдения 8 лет), показано, что группа с МЗФО имела повышенный риск ИМ -ОШ=1,8 (95% ДИ 1,37;2,25), по сравнению с метаболически здоровой группой с нормальным весом, после корректировки по потенциально связанным факторам. Риск ИМ был значительно повышен в метаболически нездоровой группе: у лиц с нормальным весом он составил ОШ=1,6 (95% ДИ 1,28;2,05), у метаболически нездоровых лиц с избыточным весом -ОШ=1,9 (95% ДИ 1,67;2,35) и в группе МНФО -ОШ=2,1 (95% ДИ 1,70;2,49) по сравнению с МЗФО [15]. Таким образом, МЗФО в большинстве исследований показывает меньший риск развития ИМ, чем МНФО.…”

Section: Discussionunclassified

Obesity phenotypes and the risk of myocardial infarction: a prospective cohort study

et al. 2019

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Цель. Оценить динамику фенотипов ожирения и их связь с риском развития инфаркта миокарда (ИМ) за 13-летний период наблюдения. Материал и методы. Исследование выполнено на материале международного проекта HAPIEE (популяционная выборка мужчин и женщин 45-69 лет, n=9360, базовое обследование 2003-2005гг). В анализ включены лица с индексом массы тела (ИМТ) ≥30 кг/м 2 : 3197 человек; 857 мужчин (26,8%) и 2340 женщин (73,2%). Для анализа частоты новых случаев ИМ была сформирована выборка 3008 человек без исходного ИМ в анамнезе (752 мужчины и 2256 женщин). Новые случаи ИМ собраны по данным программы ВОЗ "Регистр острого инфарк та миокарда", проводящейся в НИИТПМ-филиал ИЦиГ СО РАН длительное время; результатам двух повторных обследований (2006-2008гг и 2015-2017гг) и почтовых опросов когорты в среднем за 13,6 лет наблюдения. Анализ проведен у лиц с метаболически здоровым фенотипом ожирения (МЗФО). МЗФО определен в соответствии с различными классификациями: 1. (IDF, 2005)-окружность талии (ОТ) ≥94 см у мужчин и ≥80 см у женщин и любой компонент метаболического синдрома (МС) по IDF или без него; 2. (NCEPATP III, 2001) при наличии 2 или менее компонентов МС и 3. (РКО, 2017) показатель индекса ОТ/окружность бедер (ОБ) ≤0,9 у мужчин и ОТ/ОБ ≤0,85 у женщин. Статистический анализ проведен с помощью пакета программ SPSS V. 13.0. Результат. Частота МЗФО в анализируемой выборке по критериям IDF составила 20%, NCEP ATP III-45%, РКО-31%. По данным проспективного наблюдения от 51 до 59% лиц с МЗФО в течение 13 лет перешли в метаболически нездоровый фенотип ожирения (МНФО). Женщины чаще сохраняли МЗФО по критериям NCEP ATP III и РКО, а также более часто, чем мужчины, переходили за 13 лет в группу МЗФО из МНФО по критериям IDF и РКО. Относительный риск ИМ у лиц c МНФО в среднем в 2,5 раза выше, чем у лиц с МЗФО: по критериям NCEP ATP III-отношение шансов (ОШ) =1,9 (95% доверительный интервал (ДИ) 1,2;2,9), у лиц с МНФО по критериям РКО ОШ=3,2 (95% ДИ 1,7;6,1). По критериям IDF не выявлено достоверных различий в частоте развития новых случаев ИМ. Заключение. МЗФО является нестабильным состоянием, так как более половины мужчин и женщин в течение 13 лет наблюдения переходит в МНФО. Относительный риск ИМ в группе с МНФО выше, чем в группе с МЗФО: по критериям NCEP ATP III-ОШ=1,9 (95% ДИ 1,2;2,9), по критериям РКО ОШ=3,2 (95% ДИ 1,7;6,1).

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“…Body mass index (BMI) is a widely used parameter to de ne overweight and obese status in adults [3]. In China, individuals within a BMI range of 24.0-27.9 kg/m 2 are de ned as overweight and those with BMI≥28.0 kg/m 2 as obese [4].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Companion-Intensive Multi-aspect Weight Management in Chinese Adults with Obesity: A Six-Month Multicenter Randomized Clinical Trial

Jiang

Huang

et al. 2020

Preprint

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Background: Obesity is a globally increasing health epidemic requiring early lifestyle intervention. Our main objective was to examine the effectiveness of companion-intensive multi-aspect weight management (CIMWM) in Chinese adults with obesity.Methods: In this 6-month, prospective, open-label, multicenter, randomized controlled clinical trial, we recruited 272 obese adults aged 18–50 years with a body mass index (BMI) ≥28.0 kg/m2 and capable of using smartphones. CIMWM (n=136) offered both daily online instructions and monthly face-to-face guidance by physicians, dietitians, and health managers along with the provision of meal replacements in the first 3 months. Traditional multi-aspect weight management (TMWM, n=136) provided monthly face-to-face guidance by the same panel of professionals and the same meal replacements as CIMWM group, but required subjects to complete daily self-monitoring instead of offering daily online instructions. Body composition and metabolic parameters were assessed at baseline, 1, 2, 3, and 6 months by physicians. Primary outcomes were the clinically-significant weight loss and changes in BMI and body composition.Results: Participants in both groups showed significantly reduced BMI, body fat mass (BFM), visceral fat area (VFA), and HOMA-IR (P<0.05). CIMWM was shown to be superior to TMWM in the improvement of clinically-significant weight loss, BMI, total cholesterol (TC), the body composition parameters BFM and the skeletal muscle mass-to-visceral fat area ratio (S/V) (P<0.05). The non-alcoholic fatty liver disease score (NFS) was negatively related to S/V at baseline. After weight management, NFS was lowered among individuals with levels in the highest tertile (P<0.05). Metabolic memory in terms of the continuous reduction of BMI, BFM, and TC was retained up to 6 months in spite of participants transferring to self-monitoring assessment in the final 3 months.Conclusions: The CIMWM strategy in obese Chinese adults is proved to be more effective than TMWM in weight loss, and motivates greater adherence to intervention and lifestyle reprogramming.Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017463, Registered July 31, 2018, retrospectively registry. http://www.chictr.org.cn/showproj.aspx?proj=29649

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Association between the metabolically healthy obese phenotype and the risk of myocardial infarction: results from the Kailuan study

Cited by 28 publications

References 42 publications

All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity

All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity

Obesity phenotypes and the risk of myocardial infarction: a prospective cohort study

Effectiveness of Companion-Intensive Multi-aspect Weight Management in Chinese Adults with Obesity: A Six-Month Multicenter Randomized Clinical Trial

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