Natural histories of metabolite BMI phenotypes and their impacts on cardiovascular disease risk over a decade-long follow-up - 25/11/21
Highlights |
• | The study resurveyed subjects every 4–5 years to capture dynamic changes. |
• | The long-term stability of MHO may be an exception, not the norm. |
• | The 4.4-year predicted probability of transition from the MHO to MUO phenotype was 0.19. |
• | One-third of the MHO subjects were unhealthy after 12–15 years. |
• | Metabolic deterioration of the metabolite BMI phenotype conferred an increased risk of CVD. |
Abstract |
Purpose |
The prognostic significance of obesity phenotypes is under debate, and few studies have characterized their transition trajectories. This study examined the natural courses of different phenotypes and their associations with cardiovascular disease risks.
Methods |
A total of 1827 participants were followed for 14 years and re-evaluated every 4–5 years. Four metabolite BMI phenotypes were determined according to overweight or obesity (BMI ≥ 24 kg/m2) and metabolic health status (≤1 Adult Treatment Panel III criteria, excluding waist circumference). Cardiovascular risks were assessed by evaluating baPWV and hypertension, diabetes and chronic kidney disease (CKD) development.
Results |
More than 20% of participants changed their initial phenotypes within 5 years. One-third of healthy overweight/obese (MHO) individuals became unhealthy, and only 10.6% regressed to a healthy normal weight (MHN) at the end of follow-up. Compared with MHN participants, MHO participants had higher odds of increased baPWV (OR: 1.18, 95% CI, 0.42–3.33) and increased risks of incident hypertension (HR: 1.87, 95% CI, 1.18–2.98) and diabetes (HR: 2.61, 95% CI, 1.35–5.03). Metabolic deterioration during follow-up resulted in an increased risk of baPWV and clinical diseases.
Conclusions |
The natural trajectory of metabolite BMI phenotypes is time-varying, and interventions for both healthy and unhealthy overweight/obese individuals should be widely recommended.
Le texte complet de cet article est disponible en PDF.Keywords : Metabolically healthy, Overweight and obese, Natural course, Cardiovascular disease risk
Plan
Vol 15 - N° 6
P. 579-586 - novembre 2021 Retour au numéro
Article précédent
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