Metabolically healthy obesity was significantly associated with increased risk of gallstones

2021 ◽  
Author(s):  
Sailimai Man ◽  
Yongxiang Gao ◽  
Jun Lv ◽  
Mingkun Tong ◽  
Jianchun Yin ◽  
...  
Keyword(s):  
Normal Weight ◽  
Metabolic Health ◽  
Health Check ◽  
Healthy Individuals ◽  
Metabolically Healthy Obesity ◽  
Increased Risk ◽  
History Of ◽  
Normal Body Weight ◽  
Metabolically Healthy ◽  
Cox Proportional Hazard Regression

Objective The risk of gallstones among metabolically healthy obesity (MHO) individuals is largely unexplored. Therefore, the present study investigated the association between MHO and gallstones in a health check-up cohort of Chinese adults. Design A prospective cohort study. Methods Participants included 58,862 individuals from the MJ health check-up cohort aged ≥ 18 years without history of gallstones at baseline. Gallstones were diagnosed using abdominal B-type ultrasound. Metabolically healthy was defined as not having any one of the components of metabolic syndrome. Obesity was identified by body mass index (BMI) and waist circumference (WC). Participants were cross-classified at baseline by metabolic health and obesity. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of gallstones across BMI categories were estimated with Cox proportional hazard regression models. Results During a median follow-up of 3.0 (interquartile range, 1.6-6.1) years, 1,269 participants developed gallstones. Individuals with MHO (HR: 1.95, 95% CI: 1.23, 3.09 for BMI criteria; HR: 1.74, 95% CI: 1.37, 2.21 for WC criteria) had significantly higher risk of gallstones than those with metabolically healthy normal weight. In metabolically healthy individuals, BMI and WC both displayed linear dose-response relationships with gallstones (P for non-linearity > 0.05). The association between MHO and gallstones remained unchanged when using different criteria for metabolic health and obesity. Conclusions MHO was significantly associated with gallstones, suggesting that obesity can independently contribute to gallstones development, even among metabolically healthy individuals. These findings emphasize that metabolically healthy individuals may still benefit from maintaining normal body weight to prevent gallstones.

scholarly journals Does metabolic health in overweight and obesity persist? – Individual variation and cardiovascular mortality over two decades

2016 ◽  
Vol 175 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Akaal Kaur ◽  
Desmond G Johnston ◽  
Ian F Godsland
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Health Status ◽  
Cardiovascular Mortality ◽  
Normal Weight ◽  
Metabolic Health ◽  
Overweight And Obesity ◽  
Cross Sectional ◽  
Increased Risk ◽  
Metabolically Healthy

Objective Overweight and obese individuals may be metabolically healthy, but attention needs to be given to long-term persistence of this trait and any associated variation in cardiovascular risk. Design Cross-sectional and longitudinal variation in metabolic health and associated cardiovascular mortality were analysed in 1099 white European-origin normal-weight and overweight or obese males followed for 20years. Methods Definitions of metabolic health were based on LDL and HDL cholesterol, triglycerides, blood pressure, fasting glucose and cardiovascular risk. Insulin resistance (e.g. HOMA-IR) and sub-clinical inflammation (ESR and white blood cell count) were explored. Cardiovascular mortality risks and persistence of metabolic health status were evaluated. Results There were 87 cardiovascular deaths. Insulin resistance was increased in metabolically healthy overweight or obese participants (median HOMA-IR 2.63, 95% CI: 1.79–3.65, P<0.001) relative to normal-weight participants (median HOMA-IR 1.67, 95% CI: 1.08–2.67, P<0.001) as was sub-clinical inflammation but metabolically healthy overweight or obese individuals were not at increased risk of cardiovascular mortality compared with the metabolically healthy normal-weight individuals (hazard ratio 1.13, 95% CI: 0.34–3.72, P=0.8). The proportions of initially metabolically healthy overweight or obese who remained metabolically healthy for visits 2, 3 and 4 were 54, 48 and 39% respectively, and for initially normal-weight individuals, 68, 51 and 41%. A lower proportion of metabolically healthy overweight or obese individuals remained metabolically healthy at visit 2 compared with normal-weight individuals (P=0.007), but proportions converged thereafter. Conclusions Despite being insulin resistant and having greater sub-clinical inflammation, and despite instability in metabolic health status, metabolically healthy overweight or obese individuals were at no greater risk of cardiovascular mortality than their normal-weight equivalents.

scholarly journals Determinants of new onset cardiometabolic risk among normal weight children

2019 ◽  
Vol 44 (4) ◽  
pp. 781-789
Author(s):  
Andraea Van Hulst ◽  
Marina Ybarra ◽  
Marie-Eve Mathieu ◽  
Andrea Benedetti ◽  
Gilles Paradis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Screen Time ◽  
Cardiometabolic Risk ◽  
Normal Weight ◽  
Healthy Children ◽  
Parental History ◽  
Increased Risk ◽  
History Of ◽  
Metabolically Healthy ◽  
New Onset

Abstract Objective To identify determinants for the development of “normal weight metabolically unhealthy” (NWMU) profiles among previously metabolically healthy normal weight children. Methods The QUALITY cohort comprises youth 8–10 years of age with a parental history of obesity (n = 630). Of these, normal weight children with no metabolic risk factors were identified and followed up 2 years later (n = 193). Children were classified as NWMU if they remained normal weight but developed at least one cardiometabolic risk factor. They were classified as normal weight metabolically healthy otherwise. Multivariable logistic regression models were used to identify whether adiposity (anthropometrics and DXA), lifestyle habits (physical activity, screen time, vegetables, and fruit- and sugar-sweetened beverages intake), fitness, and family history of cardiometabolic disease were associated with new onset NWMU. Results Of the 193 normal weight and metabolically healthy children at baseline, 45 (23%) became NWMU 2 years later (i.e., 48% had elevated HDL cholesterol, 13% had elevated triglycerides, and 4% had impaired fasting glucose). Changes in adiposity between baseline and follow-up were associated with an increased risk of NWMU for all adiposity measures examined (e.g., for ∆zBMI OR = 3.95; 95% CI: 1.76, 8.83). Similarly, a 2-year change in screen time was associated with incident NWMU status (OR = 1.24; 95% CI 1.04, 1.49). Conclusions Children who increase their adiposity levels as they enter puberty, despite remaining normal weight, are at risk of developing cardiometabolic risk factors. Studies examining long-term consequences of NWMU profiles in pediatrics are needed to determine whether changes in screening practice are warranted.

scholarly journals Metabolic Health Has Greater Impact on Diabetes than Simple Overweight/Obesity in Mexican Americans

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Shenghui Wu ◽  
Susan P. Fisher-Hoch ◽  
Belinda Reninger ◽  
Kristina Vatcheva ◽  
Joseph B. McCormick
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
Normal Weight ◽  
Metabolic Health ◽  
Increased Risk ◽  
Mexico Border ◽  
Control Of Diabetes ◽  
Metabolically Healthy ◽  
Obese Phenotype ◽  
And Control

Purpose. To compare the risk for diabetes in each of 4 categories of metabolic health and BMI.Methods. Participants were drawn from the Cameron County Hispanic Cohort, a randomly selected Mexican American cohort in Texas on the US-Mexico border. Subjects were divided into 4 phenotypes according to metabolic health and BMI: metabolically healthy normal weight, metabolically healthy overweight/obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight/obese. Metabolic health was defined as having less than 2 metabolic abnormalities. Overweight/obese status was assessed by BMI higher than 25 kg/m2. Diabetes was defined by the 2010 ADA definition or by being on a diabetic medication.Results. The odds ratio for diabetes risk was 2.25 in the metabolically healthy overweight/obese phenotype (95% CI 1.34, 3.79), 3.78 (1.57, 9.09) in the metabolically unhealthy normal weight phenotype, and 5.39 (3.16, 9.20) in metabolically unhealthy overweight/obese phenotype after adjusting for confounding factors compared with the metabolically healthy normal weight phenotype.Conclusions. Metabolic health had a greater effect on the increased risk for diabetes than overweight/obesity. Greater focus on metabolic health might be a more effective target for prevention and control of diabetes than emphasis on weight loss alone.

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

2018 ◽  
Vol 179 (6) ◽  
pp. 343-352 ◽  
Author(s):  
Yijie Xu ◽  
Haibin Li ◽  
Anxin Wang ◽  
Zhaoping Su ◽  
Guang Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Model ◽  
Normal Weight ◽  
Metabolically Healthy Obese ◽  
Increased Risk ◽  
Confounding Variables ◽  
History Of ◽  
Healthy Obese ◽  
Metabolically Healthy

Objective This study aimed to determine if the metabolically healthy obese (MHO) is associated with an increased risk of myocardial infarction (MI) in Chinese population. Design The Kailuan study is a community-based prospective cohort study. Methods BMI and metabolic syndrome (MetS) were assessed in 91 866 participants without a history of MI or stroke. Participants were categorised into six mutually exclusive groups according to the BMI-MetS status: normal weight (BMI:  ≤ 18.5to < 24.0 kg/m2) without MetS (MH-NW), normal weight with MetS (MUH-NW), overweight (BMI:  ≤ 24.0to < 28.0 kg/m2) without MetS (MH-OW), overweight with MetS (MUH-OW), obese (BMI ≥ 28.0 kg/m2) without MetS (MHO) and obese with MetS (MUO). The hazard ratio (HR) with 95% CI was calculated for the incidence of MI using a multivariable Cox model. Results A total of 6745 (7.34%) individuals were classified as MHO. During a median 8-year follow-up, 1167 (1.27%) participants developed MI. The MHO group had an increased risk of MI (HR: 1.76, 95% CI: 1.37–2.25) in comparison with the MH-NW group after adjusting for potential confounding variables. After a similar adjustment, the risk of MI was significantly elevated in the MUH-NW (HR: 1.62, 95% CI: 1.28–2.05), MUH-OW (HR: 1.98, 95% CI: 1.67–2.35) and MUO group (HR: 2.06, 95% CI: 1.70–2.49). Conclusions MHO subjects showed a substantially higher risk of MI in comparison with MH-NW subjects. That said, even without measurable metabolic abnormalities, obesity was associated with a higher risk of MI.

Risk of incident ischemic stroke according to the metabolic health and obesity states in the Vascular-Metabolic CUN cohort

2016 ◽  
Vol 12 (2) ◽  
pp. 187-191 ◽  
Author(s):  
Laura Sánchez-Iñigo ◽  
David Navarro-González ◽  
Alejandro Fernández-Montero ◽  
Juan Pastrana-Delgado ◽  
JA Martínez
Keyword(s):  
Ischemic Stroke ◽  
Hazard Analysis ◽  
Normal Weight ◽  
Metabolic Health ◽  
Stroke Incidence ◽  
Metabolically Healthy Obese ◽  
Increased Risk ◽  
Healthy Obese ◽  
Metabolically Healthy

Background Whether obesity is a major risk factor for cardiovascular disease in the absence of metabolic comorbidities remains under debate. Indeed, some obese individuals may be at low risk of metabolic-related complications, while normal-weight individuals may not be “healthy.” Aims To assess the incidence of ischemic stroke according to the metabolic health and obesity states of 5171 participants from the Vascular-Metabolic CUN cohort. Methods A Cox proportional-hazard analysis was conducted to estimate the hazard ratio and their 95% confidence interval of stroke according to the metabolic health and obesity states based on TyG index and Adult Treatment Panel-III criteria, during 9.1 years of follow-up. Results After 50,056.2 person-years of follow-up, 162 subjects developed an ischemic stroke (incidence rate 3.23 per 1000 person-years). Metabolically healthy obese subjects did not show greater risk of stroke, while metabolically unhealthy participants, obese and non-obese, had an increased risk of stroke, compared with healthy non-obese. The hazard ratios for the multivariable adjusted model were 1.55 (95% CI: 1.36–1.77) and 1.86 (95% CI: 1.57–2.21), respectively. Conclusions Metabolically unhealthy individuals exhibited a greater risk of ischemic stroke than metabolically healthy obese individuals.

scholarly journals Relationship of Circulating Fetuin-A Levels with Body Size and Metabolic Phenotypes

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hye Soo Chung ◽  
Hyun Jung Lee ◽  
Soon Young Hwang ◽  
Ju-Hee Choi ◽  
Hye Jin Yoo ◽  
...  
Keyword(s):  
Body Size ◽  
Subclinical Atherosclerosis ◽  
Multiple Logistic Regression Analysis ◽  
Normal Weight ◽  
Metabolic Health ◽  
Fetuin A ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Metabolically Healthy ◽  
Risk Parameters

Background. Previous studies have suggested the existence of distinct body size subgroups according to metabolic health referred to as metabolically healthy obesity (MHO) and metabolically abnormal but normal weight (MANW) patients. Although nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity and metabolic syndrome, the relationship between these phenotypes and fetuin-A, a representative hepatokine, has not been explored. Methods. We examined the association between circulating fetuin-A levels, metabolic health phenotypes, cardiometabolic risk parameters, and subclinical atherosclerosis in 290 subjects who were randomly selected from an ongoing cohort study. Results. Fetuin-A concentrations were significantly associated with detrimental anthropometric and laboratory measurements, including increased waist circumference, blood pressure, alanine aminotransferase, fasting plasma glucose, and triglyceride levels. Furthermore, fetuin-A levels were significantly increased in the metabolically abnormal (MA) group compared to the metabolically healthy (MH) group in subjects without obesity (717.1 [632.1, 769.7] vs. 599.5 [502.0, 709.3], P=0.001) and subjects with obesity (704.1 [595.5-880.9] vs. 612.2 [547.9-802.1], P=0.016). In addition, brachial-ankle pulse wave velocity (baPWV), which reflects arterial stiffness, was higher in MA individuals compared to MH individuals. Multiple logistic regression analysis revealed that both individuals without obesity (P for trend = 0.017) and with obesity (P for trend = 0.028) in the higher tertiles of fetuin-A had an increased risk of MA than those in the lowest tertile. Conclusions. This study demonstrates that fetuin-A levels are significantly associated with metabolic health phenotypes, such as MHO and MANW, in Korean adults.

Natural Course of Metabolically Healthy Phenotype and Risk of Developing Cardiometabolic Diseases: a three years follow-up study

2020 ◽  
Author(s):  
Daniel Elías-López ◽  
Arsenio Vargas-Vázquez ◽  
Roopa Mehta ◽  
Ivette Cruz Bautista ◽  
Fabiola Del Razo Olvera ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Continuous Process ◽  
Incidence Rates ◽  
Metabolic Health ◽  
Metabolically Healthy Obese ◽  
History Of ◽  
Metabolically Healthy ◽  
Cox Proportional Hazard Regression ◽  
Over Time

Abstract Background: Whether the metabolically healthy obese (MHO) phenotype is a single, stable or a transitional, fluctuating state is currently unknown. The Mexican-Mestizo population has a genetic predisposition for the development of type 2 diabetes and other cardiometabolic complications. Little is known about the natural history of metabolic health in this population. The aim of this study was to analyze the transitions over time among individuals with different degrees of metabolic health and body mass index, and evaluate the incidence of cardiometabolic outcomes according to phenotype. Methods: The study population consisted of a metabolic syndrome cohort with at least three years of follow up. Participants were apparently-healthy urban Mexican adults ≥ 20 years with a BMI ≥ 20 kg/m2. Metabolically healthy phenotype was defined using the criteria of the NECP ATP III metabolic syndrome criteria and the subjects were stratified into 4 groups according to their BMI and metabolic health. For cardiometabolic outcomes we estimated the incidence of cardiometabolic outcomes and standardized them per 1, 000 person-years of follow-up. Finally, to evaluate the risk for transition and development of cardiometabolic outcomes, we fitted Cox Proportional Hazard regression models. Results: Amongst the 5,541 subjects, 54.2% were classified as metabolically healthy and 45.8% as unhealthy. The MHO prevalence was 39.3%. Up to a third of the population changed from their initial category to another and the higher transition rate was observed in MHO (42.9%). We also found several novel factors associated to transition to metabolically unhealthy phenotype; socioeconomic status, number of pregnancies, a high carbohydrate intake, history of obesity and consumption of sweetened beverages. Similarly, visceral adipose tissue (VAT) was a main predictor of transition; loss of VAT ≥5% was associated with reversion from metabolically unhealthy to metabolically healthy phenotype (HR 1.545, 95%CI 1.266–1.886). Finally, we observed higher incidence rates and risk of incident T2D and hypertension in the MUHO and MUHL phenotypes compared to MHO. Conclusions Metabolic health is a dynamic and continuous process, at high risk of transition to metabolically unhealthy phenotypes over time. It is imperative to establish effective processes in primary care to prevent such transitions.

Metabolically healthy obesity and metabolically obese normal weight: a review

2021 ◽  
Vol 77 (1) ◽  
pp. 175-189 ◽  
Author(s):  
Saioa Gómez-Zorita ◽  
Maite Queralt ◽  
Maria Angeles Vicente ◽  
Marcela González ◽  
María P. Portillo
Keyword(s):  
Normal Weight ◽  
Metabolically Healthy Obesity ◽  
Metabolically Obese Normal Weight ◽  
Metabolically Healthy

Abstract 13508: Obesity Phenotype and the Risk of Hypertension and Type 2 Diabetes: Does Cardiorespiratory Fitness Matter?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sae Young Jae ◽  
Mercedes Carnethon ◽  
Won Hah Park ◽  
Bo Fernhall
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Cardiorespiratory Fitness ◽  
Normal Weight ◽  
Incident Hypertension ◽  
Metabolically Healthy Obese ◽  
Increased Risk ◽  
Healthy Obese ◽  
Metabolically Healthy

There is conflicting evidence regarding the association between metabolically healthy obese (MHO) and metabolically unhealthy normal weight (MUNW) with incident hypertension and type 2 diabetes. The role of cardiorespiratory fitness on these associations has not been fully explored. We tested the hypothesis that obesity phenotypes predict incident hypertension and type 2 diabetes, but cardiorespiratory fitness modifies these associations in a prospective study of apparently healthy men. 3800 men (mean age 48±6 yrs, range 20-76 yrs) participated in two health examinations during 1998-2009. All subjects were free of hypertension and type 2 diabetes at baseline examination. MHO was defined as obesity (body mass index ≥ 25 kg/m2) with no more than one metabolic abnormality, and MUNW was defined as body mass index < 23 kg/m2) with two or more abnormalities. Cardiorespiratory fitness was directly measured by peak oxygen uptake during a treadmill test. Incident hypertension and type 2 diabetes were defined as blood pressure ≥140/90mmHg and as ≥6.5% of HbA1c or ≥126mg/dl of fasting glucose at second examination, respectively. During an average follow-up of 5 years (1-12 yrs), there were 371 (9.8%) men incident hypertension and 170 (4.5%) men incident type 2 diabetes. MHO and MUNW were present in 844 (22%) and 249 (6.6%) men. Compared with metabolically healthy normal weight men, MHO and MUNW men were at increased risk for hypertension (relative risk (RR) =1.82, 95% Confidence Interval (CI): 1.29-2.56 and 1.75, 1.11-2.74) and type 2 diabetes (RR=3.68, 1.92-7.07 and 5.35, 2.61-10.94), respectively. These risks in MHO and MUNW men were still persisted with adjustment for confounder variables and cardiorespiratory fitness (hypertension=1.57, 1.05-2.34 and 1.59, 1.01-2.51; type 2 diabetes=3.35, 1.63-6.89 and 4.76, 2.32-9.77). Metabolically healthy obese or metabolically unhealthy normal weight men were at increased risk of hypertension and type 2 diabetes compared with metabolically healthy normal weight men. However, these associations were not attenuated by cardiorespiratory fitness or other confounder factors.

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