Letter: Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status (Endocrinol Metab2015;30:185-94, Tae Hoon Lee et al.)

Background: We report the design, protocol and statistical analysis plan for the Arkansas Active Kids (AAK) Study. The study investigates the complex relationships between factors that contribute to metabolic health and obesity status in prepubertal school-age children in the state of Arkansas. Aim: We aim to identify modifiable behavioral and environmental factors and phenotypes related to metabolic health that are associated with obesity status that, if addressed effectively, can aid in designing effective intervention strategies to improve fitness and reduce obesity in children. Methods: We analyzed dietary and physical activity data from two national surveys (National Survey of Children’s Health and Youth Risk Behavior Surveillance System). We then conducted detailed surveys to collect dietary, physical activity, socio-demographic, and environmental data from a sample of 226 prepubertal Arkansas children. In the same sample of prepubertal children, we also collected extensive physiologic data to further study associations between physical activity and metabolic health. Results: All study visits included detailed measures of vital signs, energy expenditure, components of physical fitness, body composition and the collection of biological samples for determination of metabolic analytes. Conclusion: The observational, environmental and physiological results will be used to craft multivariate statistical models to identify which variables define ‘phenotype signatures’ that associate with fitness level and obesity status.

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Obesity and metabolic health status are determinants for the clinical expression of hypertrophic cardiomyopathy

European Journal of Preventive Cardiology ◽

10.1177/2047487319889714 ◽

2019 ◽

Vol 27 (17) ◽

pp. 1849-1857

Author(s):

Jun-Bean Park ◽

Da Hye Kim ◽

Heesun Lee ◽

In-Chang Hwang ◽

Yeonyee E Yoon ◽

...

Keyword(s):

Health Status ◽

Hypertrophic Cardiomyopathy ◽

Population Based ◽

Metabolic Health ◽

Metabolic Abnormalities ◽

Clinical Expression ◽

Obesity Status ◽

Korean National Health Insurance ◽

Study Participants

Aims We sought to investigate the association of obesity and metabolic health status with the incidence of clinical hypertrophic cardiomyopathy (HCM) diagnosis in the general population. Our goal was to identify modifiable risk factors to attenuate clinical expression of HCM, enabling management evolution from a mostly passive strategy of risk stratification to a proactive strategy of modifying disease expression. Methods Using nationwide population-based data from the Korean National Health Insurance Service, 28,679,891 people who were free of prevalent HCM and who underwent health examinations between 2009 and 2015 were followed until 31 December 2016. The primary outcome was clinical HCM that was defined as incident diagnosis of HCM during the follow-up, after a blanking period of 12 months. Results Over a median follow-up of 5.2 years, 0.027% ( n = 7851) of the study participants were diagnosed as incident HCM. The incidence rate per 1000 person-years was 0.059. A significant association was found between body mass index (BMI) and the incidence of clinical HCM after multivariate adjustment, with a hazard ratio per 1 kg/m2 increase in BMI of 1.063 (95% confidence interval 1.051–1.075). Metabolically unhealthy participants had a greater incidence of HCM than metabolically healthy participants, regardless of obesity status. The effect of BMI was more pronounced in several subgroups, including participants with no hypertension, those aged less than 65 years and men. Conclusion We found that individuals with obesity and/or metabolic abnormalities had a significantly higher incidence of clinical HCM diagnosis than their counterparts. Efforts to manage obesity and metabolic abnormalities may be important in modifying clinical expression of HCM.

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Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study

Cardiovascular Diabetology ◽

10.1186/s12933-020-01051-2 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

You-Bin Lee ◽

Da Hye Kim ◽

Seon Mee Kim ◽

Nan Hee Kim ◽

Kyung Mook Choi ◽

...

Keyword(s):

Heart Failure ◽

Population Based ◽

Metabolic Health ◽

Population Based Study ◽

Obesity Status

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Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.625083 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hwi Seung Kim ◽

Jiwoo Lee ◽

Yun Kyung Cho ◽

Joong-Yeol Park ◽

Woo Je Lee ◽

...

Keyword(s):

Heart Failure ◽

National Health ◽

Population Based ◽

Metabolic Health ◽

Metabolically Healthy Obese ◽

Obesity Status ◽

Increased Risk ◽

Metabolically Healthy ◽

Incident Heart Failure

BackgroundMetabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years.MethodsThe Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first.ResultsThe MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20–1.39], 1.37 [1.22–1.53], and 1.63 [1.50–1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status.ConclusionsMetabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.

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Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-01491 ◽

2019 ◽

Vol 104 (7) ◽

pp. 2942-2952 ◽

Cited By ~ 9

Author(s):

Ji-Yeon Lee ◽

Kyungdo Han ◽

Eugene Han ◽

Gyuri Kim ◽

Hanna Cho ◽

...

Keyword(s):

Cohort Study ◽

Late Life ◽

Population Based ◽

Metabolic Health ◽

Incident Dementia ◽

Obesity Status

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Gut microbiome characteristics at the crossroads of metabolic health and lifestyle patterns in an adult population

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004322 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Evdokia K. Mitsou ◽

M. Pilar Francino ◽

Maria Yannakoulia ◽

Smaragdi Antonopoulou ◽

Adamantini Kyriacou

Keyword(s):

Physical Activity ◽

Gut Microbiota ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Gut Microbiome ◽

Dietary Pattern ◽

Adult Population ◽

Metabolic Health ◽

Activity Level ◽

Obesity Status

AbstractIntroductionCumulative findings have recently highlighted the role of gut microbiota as a novel environmental factor in the fight against obesity and related comorbidities. We aimed to investigate (1) the gut microbiome characteristics of a Greek adult population in terms of adiposity prevalence and (2) to further elucidate the potential effect of physical activity level and adherence to a-priori (Mediterranean Diet) and a-posteriori dietary patterns in gut microbiota profiling after accounting for sex, age and obesity status.Materials and MethodsAdult participants (n = 125) underwent clinical, anthropometric, dietary, physical activity and lifestyle evaluation. Obesity status [normal-weight (NW), overweight (OW), obesity (OB)] was defined based on body weight and height measurements, Body Mass Index calculation and the World Health Organization criteria. Levels of physical activity (low/medium/high) were estimated according to International Physical Activity Questionnaire (IPAQ) scoring. Dietary intake was evaluated through a food frequency questionnaire. Adherence to the Mediterranean diet was based on the MedDietScore and Principal Component Analysis (PCA) was applied for dietary patterns analysis. Gut microbial community characteristics (diversity, richness and proportions at phylum level) were calculated based on 16S rRNA gene sequencing.ResultsA total of 122 subjects (58 females; mean age 42.4 ± 13.1 years) completed the study. OB was characterized by lower proportions of Verrucomicrobia compared to NW state (p = 0.034 for univariate), unidentified bacteria (p = 0.014) and the Archaea Euryarchaeota (p = 0.003) compared to OW status, and the phylum Candidatus Saccharibacteria compared to NW (p = 0.027) and OW (p = 0.039) after sex and age adjustments. Regarding lifestyle parameters, our data proposed no significant effect of total physical activity levels on gut microbiome; notably, a ‘fruit and vegetables’ dietary pattern and adherence to Mediterranean diet were both characterized by lower microbial diversity and proportions of Actinobacteria but higher proportions of Cyanobacteria/Chloroplast and Lentisphaerae, respectively. Furthermore, a Western-type dietary pattern (high in full fat dairy products, potatoes, refined cereals, red meat, snacks and junkfood) was characterized by lower gut microbial richness (Chao1 index), whereas a healthy dietary pattern (high in low fat dairy and wholegrain cereals and low in snack and junk food) was characterized by higher proportion of Firmicutes.DiscussionOur data proposed variable connections of metabolic health and dietary patterns with features of gut microbiota; design of gut microbiome studies is advisable to account for host- and lifestyle-related potential confounders.

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Letter to the Editor: Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz081 ◽

2019 ◽

Vol 105 (2) ◽

pp. 571-572

Author(s):

Yu-Mi Lee ◽

Duk-Hee Lee

Keyword(s):

Cohort Study ◽

Late Life ◽

Population Based ◽

Metabolic Health ◽

Letter To The Editor ◽

Incident Dementia ◽

Obesity Status

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The effects of transitions in metabolic health and obesity status on incident cardiovascular disease: Insights from a general Chinese population

European Journal of Preventive Cardiology ◽

10.1177/2047487320935550 ◽

2020 ◽

pp. 204748732093555 ◽

Cited By ~ 1

Author(s):

Xiaofan Guo ◽

Zhao Li ◽

Ying Zhou ◽

Shasha Yu ◽

Hongmei Yang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Confidence Interval ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Metabolic Health ◽

Metabolically Healthy Obesity ◽

Obesity Status ◽

Metabolically Healthy ◽

Incident Cardiovascular Disease

Background Recent studies have investigated the association of transitions in metabolic health and obesity status over time with the risk of cardiovascular disease, focusing on the subgroup demonstrating metabolically healthy obesity. However, these studies have produced inconsistent results. This study evaluates the relation in a general Chinese population. Methods We conducted a prospective cohort study in a general population in Northeast China, with examinations of cardiovascular health from 2012–2015 and follow-up for incident cardiovascular disease until 2018. Cox proportional hazards and logistic regression models were used to investigate the association of baseline metabolic health and obesity status and transitions in those statuses with cardiovascular disease risk. Results A total of 7472 participants aged ≥35 years who were free of cardiovascular disease at baseline were included in this analysis. Over a median follow-up of 4.66 years, a total of 344 cardiovascular disease events occurred. Among the 3380 participants who were obese at baseline, 37.1% were metabolically healthy. Metabolically healthy obesity was associated with a 48% increased risk of cardiovascular disease (hazard ratio: 1.48; 95% confidence interval: 1.07–2.06) compared with the metabolically healthy non-obese group at baseline. Transition from metabolically healthy obesity to metabolically unhealthy obesity was associated with elevated cardiovascular disease risk with an odds ratio of 1.82 (95% confidence interval: 1.06–3.14) compared with metabolically healthy non-obesity throughout after adjustment. Even maintaining metabolically healthy obesity over time was associated with a higher risk of cardiovascular disease (odds ratio: 1.72; 95% confidence interval: 1.00–2.97). Conclusions Weight control and management of existing metabolic disorders should be prioritized in all obese population.

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