The Association Between Metabolic Status and Risk of Cancer Among Patients With Obesity: Metabolically Healthy Obesity vs. Metabolically Unhealthy Obesity

Abstract

BackgroundControversial evidence about the association between cancer risk and metabolic status among individuals with obesity has been reported, but pooled data remain absent. This study aims to present pooled data comparing cancer risk between patients with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO).MethodsThe current study systematically searched pieces of literature on January 4, 2021, of prospective cohorts that compare the incidence of cancer between MHO and MUO. The quality of included studies was assessed using Newcastle–Ottawa scale, and publication bias was evaluated using funnel plots.ResultsEleven high-quality studies were eventually selected. Quantitative analysis indicates that a lower cancer incidence exists for MHO phenotype than that for MUO (odds ratio [OR], 0.71; 95% confidential interval [CI], 0.61–0.84). Consistent outcomes are presented by subgroup analyses, which are grouped by cohort region (western population: [OR, 0.84; 95% CI, 0.75–0.93]; Asian population: [OR, 0.64; 95% CI, 0.54–0.77]); definition of metabolic unhealthiness (≥3 metabolic abnormalities: [OR, 0.62; 95% CI, 0.54–0.71]; ≥1 metabolic abnormality: [OR, 0.76; 95% CI, 0.62–0.94]); and definition of obesity (body mass index (BMI), ≥30 kg/m2: [OR, 0.84; 95% CI, 0.73–0.98]; BMI, ≥25 kg/m2: [OR, 0.53; 95% CI, 0.52–0.55]).ConclusionIn conclusion, this study suggests a reduced cancer risk for MHO compared to MUO regardless of population heterogeneity, or the definitions of obesity and metabolic status.

Metabolic phenotypes and risk of end-stage kidney disease in patients with type 2 diabetes

“…Based on the Asian criteria, the general obesity status was assessed by BMI. Obesity was defined as a BMI of ≥ 25.0 kg/m 2 ( 19 , 20 ). Patients with a BMI of 18.5–<23.0 were considered normal weight; for those with a BMI of 23.0–<25.0 were overweight.…”

Body Composition Indicators Jointly Predict Metabolic Unhealthy Phenotypes in Young and Middle-Aged Obese Individuals: A Cross-Sectional Quantitative Computed Tomography Study

“…Some obese individuals have a significantly lower cardiometabolic risk and are considered to have a "metabolically healthy or insulin-insensitive obesity" phenotype, on the contrary, metabolically unhealthy or insulin-resistant obese individuals present with MS. 5 Therefore, some studies have defined obese patients with or without cardiometabolic risk factors by combining body mass index and metabolic characteristics to categorize individuals into metabolically healthy obese (MHO) phenotypes and metabolically unhealthy obese (MUO) phenotypes. 6 Previous studies have shown that patients with MUO are exposed to more severe adverse outcomes than patients with MHO, including a higher risk of cancer 7 and cardiovascular disease. 8 Studies have shown that the metabolic health phenotype in obese individuals may be a transient state, influenced by age, environmental factors, lifestyle and body composition changes.…”

Rising Trends in Metabolically Healthy Obesity in Cancer Patients and Its Impact on Cardiovascular Events: Insights from a Contemporary Nationwide Analysis in the USA (2016–2020)

“…Additionally, there is conflicting evidence linking MHO with certain types of cancer, such as colorectal cancer, thyroid cancer in men, endometrial cancer, renal cancer, and post-menopausal breast cancer [17][18][19]. In a meta-analysis by Zheng et al, lower cancer incidence (OR = 0.71; 95% CI: 0.61-0.84) was reported in the MHO phenotype compared to metabolically unhealthy obesity, which is obesity with one of the risk factors (T2DM, HTN, or dyslipidemia) [20]. While MHO individuals may have a lower risk of developing cardiovascular diseases, cancer, and type 2 diabetes mellitus compared to those with metabolically unhealthy obesity, their overall risk is still higher than that of normal-weight individuals [14,[21][22][23].…”