Natural course of metabolically healthy abdominal obese adults after 10 years of follow-up: the Tehran Lipid and Glucose Study

Eshtiaghi, Radina; Keihani, Sorena; Hosseinpanah, Farhad; Barzin, Maryam; Azizi, Fereidoun

doi:10.1038/ijo.2014.176

Cited by 75 publications

(82 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MHO class II without any metabolic abnormality did not significantly increase the risk of CACS progression even after adjusting for possible confounders. By contrast, MHO class I, which has been frequently defined in previous studies [24–27,29,30], showed a 1.7-fold higher risk for CACS progression than non-obese metabolically healthy subjects. A stratified analysis of this MHO class I group according to the number of metabolic abnormality (that is, 0 or 1) showed that there was a significant difference in the risk of CACS progression between MHO subjects with no metabolic abnormality and one metabolic abnormality at the baseline.…”

Section: Discussionmentioning

confidence: 78%

“…Abdominal obesity was defined as WC ≥ 90 cm for men and ≥ 80 cm for women according to the International Obesity Task Force criteria for the Asian-Pacific population [23]. MHO was defined according to the most frequently used definition in recent studies (MHO class I) [24–27]. Briefly, obese participants who met ≤ 1 of the following National Cholesterol Education Program–Adult Treatment Panel III (NCEP–ATP III) criteria for metabolic syndrome [28] were considered to have MHO class I: (a) TG level ≥ 1.7 mmol/L (150 mg/dL); (b) HDL cholesterol level < 1.0 mmol/L (40 mg/dL) in men and < 1.3 mmol/L (50 mg/dL) in women; (c) blood pressure ≥ 130/85 mmHg or intake of antihypertensive medication; and (d) fasting glucose level ≥ 5.6 mmol/L (100 mg/dL) or intake of anti-diabetic medication.…”

Section: Methodsmentioning

confidence: 99%

“…Briefly, obese participants who met ≤ 1 of the following National Cholesterol Education Program–Adult Treatment Panel III (NCEP–ATP III) criteria for metabolic syndrome [28] were considered to have MHO class I: (a) TG level ≥ 1.7 mmol/L (150 mg/dL); (b) HDL cholesterol level < 1.0 mmol/L (40 mg/dL) in men and < 1.3 mmol/L (50 mg/dL) in women; (c) blood pressure ≥ 130/85 mmHg or intake of antihypertensive medication; and (d) fasting glucose level ≥ 5.6 mmol/L (100 mg/dL) or intake of anti-diabetic medication. The WC criterion was not used in the definition of metabolic health as in the previous studies [24–27,29,30], because of collinearity with BMI. Additionally, we defined MHO using stricter criteria following the Healthy Obese Project, which was a population-based cohort study conducted in 7 European countries (MHO class II) [31]: MHO class II was established when subjects with obesity had none of the metabolic syndrome components.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Influence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification

et al. 2017

View full text Add to dashboard Cite

ObjectivesDebates whether metabolically healthy obesity (MHO) increases the cardiovascular risk might be due to the metabolic instability of MHO or the absence of a perfect definition of MHO. Therefore, we aimed to investigate the influence of the MHO phenotype on the coronary artery calcium score (CACS) progression according to definition of MHO.MethodsWe analyzed a retrospective cohort with a CACS of 0 at baseline and available serial CACS measurements taken ≥ 12 months apart (n = 1,218). Obesity was defined as BMI ≥ 25 kg/m2, and MHO was defined as obesity accompanied by ≤ 1 (MHO class I) or 0 (MHO class II) components of metabolic syndrome (MetS).ResultsDuring a median follow-up of 45 months, 32.2% of MHO class I and 10.2% of MHO class II subjects developed MetS. Compared to non-obese/metabolically healthy subjects (reference group), hazard ratios (HR) for development of MetS were 2.174 (95% confidence interval [CI]: 1.513–3.124) and 1.166 (95% CI: 0.434–3.129) for MHO class I and II subjects, respectively. The MHO class I subjects showed a significantly increased risk of CACS progression as compared to the reference group (HR: 1.653; 95% CI: 1.144–2.390), whereas MHO class II subjects did not (HR: 1.195; 95% CI: 0.514–2.778). Among subjects with MHO class I, no significant CACS progression was observed in the subjects who maintained metabolic health during follow-up (HR: 1.448; 95% CI: 0.921–2.278).ConclusionsThe risks of metabolic deterioration and CACS progression were significant in subjects with MHO class I, but not in those with MHO class II.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Influence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Some studies suggest that metabolically healthy individuals may be younger than their metabolically unhealthy counter parts suggesting that over time, they too will develop CVD [25,26]. Additionally, the conversion of MHO to the higher risk MUO over time may explain this effect, as in 2 studies, MHO was seen to convert to MUO in 34.2% [27] and >50% of subjects over prolonged follow-up [28].…”

Section: Is Mho a "Benign" Phenotype?mentioning

confidence: 93%

Metabolically Healthy Obesity and the Fit/Fat Phenotype: Associations with Mortality, Subclinical Cardiovascular Disease and Approach to Treatment

Sorathia¹

2015

J Metabolic Synd

View full text Add to dashboard Cite

Obesity is a global epidemic affecting over a third of the adult population. Within the obese, subgroups have been identified, including the metabolically healthy obese (MHO) and the fit/fat phenotypes. The MHO phenotype was traditionally thought to have lower cardiovascular risk than the 'typically obese', a notion that is being challenged by recent data. Similarly, the emerging fit/fat phenotype is raising questions about the impact of obesity on mortality and cardiovascular risk. The present narrative review provides an overview of these phenotypes and summarizes current evidence and viewpoints regarding the same. The review then incorporates this data into a format that can be utilized by clinicians and researchers to aid clinical decision-making.

show abstract

“…Through use of repeated measures of metabolic and obesity statuses on the same individuals over time, studies have shown that after 6 years of follow-up, about one-third of initially healthy obese adults had become unhealthy obese (30,60); others report that after 7-10 years this proportion is nearly half (58,(61)(62)(63); and after 20 years this figure is just over half (59). The proportion of healthy obese adults who progress to unhealthy obesity appears larger with longer follow-up periods, indicating that the tendency to progress gets stronger with time.…”

Section: Is Healthy Obesity Harmless?mentioning

confidence: 99%

Healthy obesity as an intermediate state of risk: a critical review

Bell

Hamer

2016

Expert Review of Endocrinology & Metabolism

View full text Add to dashboard Cite

Introduction: Obesity is a top public health priority but interventions to reverse the condition have had limited success. About 1-in-3 obese adults are free of metabolic risk factor clustering and are considered 'healthy', and much attention has focused on the implications of this state for obesity management. Areas covered:We searched for individual studies, systematic reviews, and meta-analyses which examined correlates and outcomes of metabolically healthy obesity. We discuss the key roles of fat distribution and physical activity in determining healthy vs. unhealthy obesity and report a greatly increased risk of incident type 2 diabetes associated with healthy obesity vs. healthy normal-weight, among other outcomes. We argue that despite inconsistencies in the definition, patterns across studies clearly show that healthy obesity is a state of intermediate disease risk. Expert commentary:Given the current state of population-level evidence, we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health. We recommend that weight loss through energy restriction be a stand-alone target in addition to increased physical activity for minimising risk of future disease.

show abstract

Natural course of metabolically healthy abdominal obese adults after 10 years of follow-up: the Tehran Lipid and Glucose Study

Abstract: MHAO is a relatively unstable condition and a considerable percentage of these individuals will lose their metabolic health as time passes. Baseline metabolic characteristics may be useful predictors of this change and should be considered in the care of these individuals.

Cited by 75 publications

References 41 publications

Influence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification

Influence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification

Metabolically Healthy Obesity and the Fit/Fat Phenotype: Associations with Mortality, Subclinical Cardiovascular Disease and Approach to Treatment

Healthy obesity as an intermediate state of risk: a critical review

Contact Info

Product

Resources

About