Fangjian Guo1, W Timothy Garvey2,3. 1. Department of Obstetrics & Gynecology and Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas, USA. 2. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA. 3. Geriatric Research Education and Clinical Center (GRECC), Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.
Abstract
OBJECTIVE: To assess the stability of metabolic status and body mass index (BMI) status and their relative contribution to risk of diabetes, cardiovascular events, and mortality. METHODS: A total of 14,685 participants from the Atherosclerosis Risk in Communities Study and 4,990 from the Coronary Artery Risk Development in Young Adults Study were included. People with healthy obesity (HO) are defined as those meeting all three indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all three criteria. RESULTS: In both healthy and unhealthy subgroups, risks for coronary heart disease (CHD), stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% confidence interval [CI] 4.12-7.48), CHD (5.60, 95% CI 3.14-9.98), stroke (4.84, 95% CI 2.13-10.97), and mortality (2.6, 95% CI 1.88-3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In the Coronary Artery Risk Development in Young Adults Study over 20 years, 17.5% of lean subjects and 67.3% of overweight subjects at baseline developed obesity during follow-up. Despite rising BMI, metabolic status remained relatively stable. CONCLUSIONS: Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se.
OBJECTIVE: To assess the stability of metabolic status and body mass index (BMI) status and their relative contribution to risk of diabetes, cardiovascular events, and mortality. METHODS: A total of 14,685 participants from the Atherosclerosis Risk in Communities Study and 4,990 from the Coronary Artery Risk Development in Young Adults Study were included. People with healthy obesity (HO) are defined as those meeting all three indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all three criteria. RESULTS: In both healthy and unhealthy subgroups, risks for coronary heart disease (CHD), stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% confidence interval [CI] 4.12-7.48), CHD (5.60, 95% CI 3.14-9.98), stroke (4.84, 95% CI 2.13-10.97), and mortality (2.6, 95% CI 1.88-3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In the Coronary Artery Risk Development in Young Adults Study over 20 years, 17.5% of lean subjects and 67.3% of overweight subjects at baseline developed obesity during follow-up. Despite rising BMI, metabolic status remained relatively stable. CONCLUSIONS: Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se.
Authors: Salim Yusuf; Steven Hawken; Stephanie Ounpuu; Leonelo Bautista; Maria Grazia Franzosi; Patrick Commerford; Chim C Lang; Zvonko Rumboldt; Churchill L Onen; Liu Lisheng; Supachai Tanomsup; Paul Wangai; Fahad Razak; Arya M Sharma; Sonia S Anand Journal: Lancet Date: 2005-11-05 Impact factor: 79.321
Authors: Kevin E Kip; Oscar C Marroquin; David E Kelley; B Delia Johnson; Sheryl F Kelsey; Leslee J Shaw; William J Rogers; Steven E Reis Journal: Circulation Date: 2004-02-17 Impact factor: 29.690
Authors: G D Friedman; G R Cutter; R P Donahue; G H Hughes; S B Hulley; D R Jacobs; K Liu; P J Savage Journal: J Clin Epidemiol Date: 1988 Impact factor: 6.437
Authors: Jake E Lowry; Batbayar Tumurbaatar; Claudia D'Agostino; Erika Main; Traver J Wright; Edgar L Dillon; Tais B Saito; Craig Porter; Clark R Andersen; Douglas L Brining; Janice J Endsley; Melinda Sheffield-Moore; Elena Volpi; Rong Fang; Nicola Abate; Demidmaa R Tuvdendorj Journal: Br J Nutr Date: 2019-12-28 Impact factor: 3.718
Authors: Yang Du; Tao Zhang; Dianjianyi Sun; Changwei Li; Lydia Bazzano; Lu Qi; Marie Krousel-Wood; Jiang He; Paul K Whelton; Wei Chen; Shengxu Li Journal: Am J Cardiol Date: 2017-12-12 Impact factor: 2.778
Authors: Kristin K Hoddy; Christopher L Axelrod; Jacob T Mey; Adithya Hari; Robbie A Beyl; Jourdan B Blair; Wagner S Dantas; John P Kirwan Journal: Obesity (Silver Spring) Date: 2021-11-24 Impact factor: 9.298
Authors: Camille Lassale; Ioanna Tzoulaki; Karel G M Moons; Michael Sweeting; Jolanda Boer; Laura Johnson; José María Huerta; Claudia Agnoli; Heinz Freisling; Elisabete Weiderpass; Patrik Wennberg; Daphne L van der A; Larraitz Arriola; Vassiliki Benetou; Heiner Boeing; Fabrice Bonnet; Sandra M Colorado-Yohar; Gunnar Engström; Anne K Eriksen; Pietro Ferrari; Sara Grioni; Matthias Johansson; Rudolf Kaaks; Michail Katsoulis; Verena Katzke; Timothy J Key; Giuseppe Matullo; Olle Melander; Elena Molina-Portillo; Concepción Moreno-Iribas; Margareta Norberg; Kim Overvad; Salvatore Panico; J Ramón Quirós; Calogero Saieva; Guri Skeie; Annika Steffen; Magdalena Stepien; Anne Tjønneland; Antonia Trichopoulou; Rosario Tumino; Yvonne T van der Schouw; W M Monique Verschuren; Claudia Langenberg; Emanuele Di Angelantonio; Elio Riboli; Nicholas J Wareham; John Danesh; Adam S Butterworth Journal: Eur Heart J Date: 2018-02-01 Impact factor: 29.983