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Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study

AIM: The metabolically healthy obese (MHO) phenotype refers to obese individuals with a favourable metabolic profile. Its prognostic value is unclear and may depend on the health outcome being examined. We examined the association of MHO phenotype with incident cardiovascular disease (CVD) and type...

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Autores principales: Hinnouho, Guy-Marino, Czernichow, Sébastien, Dugravot, Aline, Nabi, Hermann, Brunner, Eric J., Kivimaki, Mika, Singh-Manoux, Archana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344958/
https://www.ncbi.nlm.nih.gov/pubmed/24670711
http://dx.doi.org/10.1093/eurheartj/ehu123
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author Hinnouho, Guy-Marino
Czernichow, Sébastien
Dugravot, Aline
Nabi, Hermann
Brunner, Eric J.
Kivimaki, Mika
Singh-Manoux, Archana
author_facet Hinnouho, Guy-Marino
Czernichow, Sébastien
Dugravot, Aline
Nabi, Hermann
Brunner, Eric J.
Kivimaki, Mika
Singh-Manoux, Archana
author_sort Hinnouho, Guy-Marino
collection PubMed
description AIM: The metabolically healthy obese (MHO) phenotype refers to obese individuals with a favourable metabolic profile. Its prognostic value is unclear and may depend on the health outcome being examined. We examined the association of MHO phenotype with incident cardiovascular disease (CVD) and type 2 diabetes. METHODS AND RESULTS: Body mass index and metabolic health, assessed using the Adult Treatment Panel-III (ATP-III) criteria, were assessed on 7122 participants (69.7% men) from the Whitehall II study, aged 39–63 years in 1991–93. Incident CVD (coronary heart disease or stroke) and type 2 diabetes were ascertained from medical screenings (every 5 years), hospital data, and registry linkage until 2009. A total of 657 individuals (9.2% of the cohort) were obese and 42.5% of these were classified as MHO in 1991–93. Over the median follow-up of 17.4 years, there were 828 incident cases of CVD and 798 incident cases of type 2 diabetes. Compared with metabolically healthy normal weight individuals, MHO subjects were at increased risk for CVD (HR = 1.97, 95% CI: 1.38–2.80) and type 2 diabetes (3.25, 95% CI: 2.32–4.54). There was excess risk in metabolically unhealthy obese compared with MHO for type 2 diabetes (1.98, 95% CI: 1.39–2.83) but not CVD (1.23, 95% CI: 0.81–1.87). Treating all measures as time varying covariates produced similar findings. CONCLUSION: For type 2 diabetes, the MHO phenotype is associated with lower risk than the metabolically unhealthy obese, but for CVD the risk is as elevated in both obesity phenotypes.
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spelling pubmed-43449582015-03-10 Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study Hinnouho, Guy-Marino Czernichow, Sébastien Dugravot, Aline Nabi, Hermann Brunner, Eric J. Kivimaki, Mika Singh-Manoux, Archana Eur Heart J Clinical Research AIM: The metabolically healthy obese (MHO) phenotype refers to obese individuals with a favourable metabolic profile. Its prognostic value is unclear and may depend on the health outcome being examined. We examined the association of MHO phenotype with incident cardiovascular disease (CVD) and type 2 diabetes. METHODS AND RESULTS: Body mass index and metabolic health, assessed using the Adult Treatment Panel-III (ATP-III) criteria, were assessed on 7122 participants (69.7% men) from the Whitehall II study, aged 39–63 years in 1991–93. Incident CVD (coronary heart disease or stroke) and type 2 diabetes were ascertained from medical screenings (every 5 years), hospital data, and registry linkage until 2009. A total of 657 individuals (9.2% of the cohort) were obese and 42.5% of these were classified as MHO in 1991–93. Over the median follow-up of 17.4 years, there were 828 incident cases of CVD and 798 incident cases of type 2 diabetes. Compared with metabolically healthy normal weight individuals, MHO subjects were at increased risk for CVD (HR = 1.97, 95% CI: 1.38–2.80) and type 2 diabetes (3.25, 95% CI: 2.32–4.54). There was excess risk in metabolically unhealthy obese compared with MHO for type 2 diabetes (1.98, 95% CI: 1.39–2.83) but not CVD (1.23, 95% CI: 0.81–1.87). Treating all measures as time varying covariates produced similar findings. CONCLUSION: For type 2 diabetes, the MHO phenotype is associated with lower risk than the metabolically unhealthy obese, but for CVD the risk is as elevated in both obesity phenotypes. Oxford University Press 2015-03-01 2014-03-26 /pmc/articles/PMC4344958/ /pubmed/24670711 http://dx.doi.org/10.1093/eurheartj/ehu123 Text en © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research
Hinnouho, Guy-Marino
Czernichow, Sébastien
Dugravot, Aline
Nabi, Hermann
Brunner, Eric J.
Kivimaki, Mika
Singh-Manoux, Archana
Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title_full Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title_fullStr Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title_full_unstemmed Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title_short Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study
title_sort metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the whitehall ii cohort study
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344958/
https://www.ncbi.nlm.nih.gov/pubmed/24670711
http://dx.doi.org/10.1093/eurheartj/ehu123
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