Association between metabolically healthy obesity/overweight and cardiovascular disease risk: A representative cohort study in Taiwan
Open Access
- 1 February 2021
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 16 (2), e0246378
- https://doi.org/10.1371/journal.pone.0246378
Abstract
Objectives To investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals. Methods Taiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5–23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis. Results Among 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99). Conclusions Individuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control.This publication has 33 references indexed in Scilit:
- The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studiesBMC Endocrine Disorders, 2014
- Beyond BMI: The “Metabolically healthy obese” phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic reviewBMC Public Health, 2014
- Myocardial Infarction and Ischemic Heart Disease in Overweight and Obesity With and Without Metabolic SyndromeJAMA Internal Medicine, 2014
- Diabetes and Cardiovascular Disease Outcomes in the Metabolically Healthy Obese PhenotypeDiabetes Care, 2013
- The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitnessEuropean Heart Journal, 2012
- Impact of metabolic comorbidity on the association between body mass index and health-related quality of life: a Scotland-wide cross-sectional study of 5,608 participantsBMC Public Health, 2012
- Taiwan’s healthcare report 2010EPMA Journal, 2010
- Prevalence of Obesity and Metabolic Syndrome in TaiwanJournal of the Formosan Medical Association, 2006
- Are there persons who are obese, but metabolically healthy?Metabolism, 2001
- Applied Survival Analysis: Regression Modeling of Time to Event DataJournal of the American Statistical Association, 2000