Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Metab Syndr Relat Disord. 2020 Aug;18(6):302-307. doi: 10.1089/met.2020.0016. Epub 2020 May 12.
Whether subjects with metabolically healthy obesity (MHO) have an increased risk of cardiovascular disease (CVD) is controversial. Some of this discrepancy could be due to differences in the definition of MHO. Therefore, we investigated how the definition of MHO affected the risk of CVD. In the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort (total = 2122, mean age 50 years), obese ( = 134), overweight ( = 845), and normal weight ( = 1143) individuals were subdivided according to the number of Metabolic Syndrome (MetS) risk factors (excluding waist circumference). During a median follow-up of 28.0 years, 877 individuals experienced a CVD event (defined as fatal or nonfatal myocardial infarction, stroke, or heart failure). All obese groups, except that without any MetS risk factors ( = 3), showed an increased risk compared to the control group of normal weight without any MetS risk factors ( = 235), ranging from a hazard ratio (HR) of 3.0 (95% confidence interval [CI] 1.7-5.3, = 0.0002) in those with one MetS risk factor to HR 5.5 (95% CI 3.0-9.8, < 0.00001) in those with four MetS risk factors. The overweight group without any MetS risk factor ( = 74) showed a similar risk of incident CVD as the normal weight group, whereas all other overweight groups showed an increased risk with increasing number of MetS risk factors. The results suggest that the definition of MHO played a major role on the risk of CVD. No increased risk was seen in overweight/obese individuals with no MetS risk factor, but they were very rare.
代谢健康型肥胖（MHO）患者的心血管疾病（CVD）风险是否增加存在争议。这种差异的部分原因可能是由于 MHO 的定义不同。因此，我们研究了 MHO 的定义如何影响 CVD 风险。在乌普萨拉男性成人纵向研究（ULSAM）队列中（共 2122 人，平均年龄 50 岁），根据代谢综合征（MetS）危险因素（不包括腰围）的数量，将肥胖者（ = 134）、超重者（ = 845）和正常体重者（ = 1143）进行细分。在中位数为 28.0 年的随访期间，877 人发生 CVD 事件（定义为致命或非致命性心肌梗死、中风或心力衰竭）。除了没有任何 MetS 危险因素的肥胖者（ = 3）外，所有肥胖组与没有任何 MetS 危险因素的正常体重对照组（ = 235）相比，风险均增加，范围从具有一个 MetS 危险因素的危险比（HR）为 3.0（95%置信区间 [CI] 1.7-5.3， = 0.0002）到具有四个 MetS 危险因素的 HR 为 5.5（95% CI 3.0-9.8， < 0.00001）。没有任何 MetS 危险因素的超重组（ = 74）发生 CVD 的风险与正常体重组相似，而其他所有超重组随着 MetS 危险因素数量的增加，风险也增加。结果表明，MHO 的定义在 CVD 风险中起主要作用。没有 MetS 危险因素的超重/肥胖个体没有增加的风险，但这种情况非常罕见。
