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

BACKGROUND

Controversial 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).

METHODS

The 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.

RESULTS

Eleven 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/m: [OR, 0.84; 95% CI, 0.73-0.98]; BMI, ≥25 kg/m: [OR, 0.53; 95% CI, 0.52-0.55]).

CONCLUSION

In 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.