Coronary artery disease risk among obese metabolically healthy young men

Abstract

Objective: The aim of this study was to assess coronary artery disease (CAD) risk among obese young men without metabolic risk factors. Design: A longitudinal study in a historical cohort. Methods: Incident CAD during a median follow-up of 6.1 years was assessed among 31 684 young men (mean age 31.2G5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI R30 kg/m 2 in the presence of normal blood pressure (BP) and normal levels of fasting glucose, triglyceride, and HDL-cholesterol (HDL-c) levels (nZ599; 1.9%). Cox proportional hazard models were applied.Results: There were 198 new cases of CAD that were diagnosed during 209 971 person-years of follow-up, of which six cases occurred among MH obese. The incidence of CAD among MH lean, overweight, and obese participants was 0.23, 0.45, and 1.0/1000 person-years respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (hazard ratioZ3.08; 95% CIZ1.10-8.68, PZ0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-c, triglycerides, or BP were added to the model. Similar results were also obtained when a more permissive definition of MH was used. Conclusions: Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.

Metabolically healthy overweight/obesity are associated with increased risk of cardiovascular disease in adults, even in the absence of metabolic risk factors: A systematic review and meta‐analysis of prospective cohort studies

“…25,27,32 Two studies reported data for female participants, 35,36 and three reported data for male subjects only. 15,37,38 Participants were from diverse geographical locations: 11 studies were from Europe, 7,16,[20][21][22]25,[30][31][32][33]38 six from North America, 15,24,28,[34][35][36] three from the Middle East, 23,29,37 two from Asia 26,27 and one from Oceania (Australia). 6 No studies detailed the ethnic origins of their subjects.…”

Adolescent overweight and obesity and the risk for pancreatic cancer among men and women: a nationwide study of 1.79 million Israeli adolescents

“…Between January 1967 to December 31, 2010, in total, 2,454,693 adolescents were evaluated, irrespective of whether they actually served in the military, as recently described. 20 After excluding 64,186 individuals who were missing height or weight data and 82,377 non-Jewish examinees (because of the nonrepresentativeness of their source populations), 2,298,130 participants remained. We then excluded 503,560 individuals who were evaluated after December 2002 and did not have the opportunity for at least 10 years of follow-up.…”

What are the Predictors of Coronary Artery Disease in Young Saudi Arabian Patients

“…This study also revealed that in young patients 30-40 years old, obesity and hyperlipidemia were the major predictors in this group of patients [17]. In a study made to assess the risk of CAD in patients who are obese but free of metabolic risk factors, it was found that although patients are only obese the progression of obesity may contribute to amplified risk for incidental CAD especially in young men [18].…”