Metabolically Healthy Obese, Overweight Individuals Still Have High Risk for CHD

Individuals who are overweight or obese still have a higher risk for coronary heart disease (CHD) regardless of their metabolic health compared with healthy individuals within the normal body mass index (BMI) range, according to the findings of a recent study.

In their study, the researchers analyzed data from the European Prospective Investigation into Cancer and Nutrition study, which included 520,000 individuals and documented 7637 CHD cases during the 12.2 years of follow-up.
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BMI was used to classify individuals as overweight or obese, and metabolic dysfunction was defined as 3 or more measurements of elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein-cholesterol, hyperglycemia, and elevated waist circumference. Metabolically healthy normal weight individuals were used as a reference group.

After analyzing the data, the researchers found that participants who were metabolically unhealthy had a higher risk for CHD compared with the reference group, with hazard ratios (HRs) of 2.15 for unhealthy normal weight, 2.33 for unhealthy overweight, and 2.54 for unhealthy obese individuals. Likewise, individuals who were metabolically healthy but were overweight or obese had a higher risk for CHD compared with the reference group, with HRs of 1.26 for those who were overweight and 1.28 for those who were obese.

“Irrespective of BMI, metabolically unhealthy individuals had higher CHD risk than their healthy counterparts,” the researchers concluded. “Conversely, irrespective of metabolic health, overweight and obese people had higher CHD risk than lean people. These findings challenge the concept of ‘metabolically healthy obesity,’ encouraging population-wide strategies to tackle obesity.”

—Melissa Weiss

Reference:

Lassale C, Tzoulaki I, Moons KGM, et al. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis [published online August 14, 2017]. Eur Heart J. https://doi.org/10.1093/eurheartj/ehx448.