“Healthy obesity” is unhealthy – still at high risk of diabetes, heart disease, stroke and respiratory illness

New research published in Diabetes (Journal of the European Diabetes Society [EASD]) Means that obese people are actually healthy (called metabolically healthy obesity), even if their metabolic profile is normal, because of the increased risk of diabetes, heart disease, stroke, and respiratory illness. It is clear that it will not.

This study was conducted by Dr. Frederick Ho and colleagues at the Institute of Health and Welfare. University of Glasgow, Glasgow, UK, investigated whether obese people with a normal metabolic profile are healthy or at high risk of developing obesity-related health problems.

It is estimated that there are more than 300 million obese people in the world, and if current trends continue, this figure could exceed 1 billion by 2030, accounting for 20% of the world’s adult population. there is. An ongoing global epidemic of type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD), and many other serious health problems is associated with obesity.

Obesity usually causes metabolic problems characterized by elevated blood sugar levels, elevated blood pressure (BP), insulin resistance, and other adverse metabolic changes. These effects are not universal, and in some obese patients, blood pressure is normal, blood fat is good, systemic inflammation is little or no, and insulin levels are normal. This is sometimes referred to as “metabolic healthy obesity” (MHO), and its incidence is estimated to be 3% to 22% of the total population.

This study investigated the association between MHO and all-cause mortality, T2D, heart attack and stroke, heart failure (HF), and respiratory illness, including chronic obstructive pulmonary disease (COPD). MHO was defined as having a body mass index (BMI) of 30 kg / m2 or higher and meeting at least 4 of the 6 metabolically healthy criteria. These include blood pressure and five blood-based biomarkers. C-reactive protein (CRP, marker of inflammation), triglyceride (fat), low-density lipoprotein (LDL / “bad” cholesterol), high-density lipoprotein (HDL /’) good cholesterol), and glycated hemoglobin (HbA1c, past) Measured value of average blood glucose for 2-3 months). Based on metabolic and obese status, participants were metabolically healthy non-obesity (MHN), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity. It was classified as (MUO).

The authors analyzed the details of 381,363 individuals (excluding those classified as “underweight”) for a median follow-up of 11.2 years. They were part of the UK Biobank project, a large prospective cohort study that recruited participants from the general population of England, Scotland and Wales from 2007 to 2010.

The authors found that MHO people are generally younger than MUO participants, spend less time watching TV, have more exercise, are more educated, have a lower Hunger Index, and consume more lean and processed meats. Many have found that they are unlikely to be male or non-white.

Compared to non-obese, metabolically healthy participants (MHN), MHO participants are 4.3 times more likely to develop T2D, 18% more likely to develop myocardial infarction or stroke, and are at risk of heart failure. Is 76% more likely to have respiratory illness and is 19% more likely to have COPD. People classified as MHO were 28% more likely to develop heart failure than those who were not obese and were metabolically unhealthy (MUN).

The author states: For these results, people with MHO showed a higher rate than people with MUN. “

They said, “Metabolic healthy obese people are at greater risk of diabetes, heart attack, stroke, heart failure, respiratory illness, and all-cause mortality than those who are not obese and have a healthy metabolic profile. It was high. Of particular note is that people with metabolically healthy obesity are at higher risk of heart failure and respiratory illness than participants without metabolically unhealthy obesity. “

In addition, the team also found that within a subset of participants with follow-up metabolic and obesity data, one-third of participants who were metabolically healthy obesity at the start of the study period were within 3-5 years. I also discovered that I became metabolically unhealthy.

The researchers conclude that: “Metabolic healthy obese people are not” healthy “because they are at higher risk of heart attack, stroke, heart failure, and respiratory illness than non-obese people with a normal metabolic profile. “

They advise: The term “metabolically healthy obesity” can be misleading and should be avoided in clinical medicine, and various strategies for defining risk should be considered.

Reference: “Are Metabolic Healthy Obese People Really Healthy? A Prospective Cohort Study of 381,363 UK Biobank Participants” Ziyi Zhou, John Macpherson, Stuart R. Gray, Jason MR Gill, Paul Welsh, Carlos Celis -Morales, Naveed Sattar, Jill P. Pell, Frederick K. Ho, June 10, 2021, Diabetes..
DOI: 10.1007 / s00125-021-05484-6 “Healthy obesity” is unhealthy – still at high risk of diabetes, heart disease, stroke and respiratory illness

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