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Different Metabolic Phenotypes of Obesity and Risk of Coronary Artery Calcium Progression and Incident Cardiovascular Disease Events: The CARDIA Study.
- Source :
-
Arteriosclerosis, thrombosis, and vascular biology [Arterioscler Thromb Vasc Biol] 2022 May; Vol. 42 (5), pp. 677-688. Date of Electronic Publication: 2022 Apr 07. - Publication Year :
- 2022
-
Abstract
- Background: To investigate whether obesity with or without metabolic syndrome is prospectively associated with coronary artery calcium (CAC) progression and incident cardiovascular disease events.<br />Methods: A total of 1730 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included (age, 40.1±3.6 years; 38.3% men), who completed computed tomography of CAC at baseline (year 15: 2000-2001) and follow-up (year 20 or 25). Metabolically healthy obesity (MHO) was defined as body mass index≥30 kg/m <superscript>2</superscript> without any metabolic syndrome components in our main analysis. Sensitivity analyses were conducted for several conditions characterizing 4 metabolic phenotypes.<br />Results: During a mean follow-up of 9.1 years, 439 participants had CAC progression. MHO subjects had a significantly higher risk of CAC progression than their metabolically healthy normal weight counterparts (adjusted hazard ratios [95% CIs] from 1.761 [1.369-2.264] to 2.047 [1.380-3.036]) depending on the definition of MHO adopted. Obesity with unhealthy metabolic profile remained the highest significant risk of CAC progression and cardiovascular disease events whatever the definitions adopted for metabolically unhealthy status. Up to 60% of participants with MHO converted to metabolically unhealthy obesity from year 15 to year 20 or year 25. Further sensitivity analysis showed that MHO throughout carried a similar risk of incident cardiovascular disease events compared with metabolically healthy normal weight throughout.<br />Conclusions: Different metabolic phenotypes of obesity beginning at a young age exhibit distinct risks of CAC progression and subsequent cardiovascular disease events in later midlife. MHO represents an intermediate phenotype between metabolically low- to high-risk obese individuals.<br />Registration: URL: https://www.<br />Clinicaltrials: gov; Unique identifier: NCT00005130.
- Subjects :
- Adult
Body Mass Index
Calcium
Female
Humans
Male
Obesity complications
Obesity diagnosis
Obesity epidemiology
Phenotype
Risk Factors
Cardiovascular Diseases complications
Cardiovascular Diseases diagnostic imaging
Cardiovascular Diseases epidemiology
Coronary Artery Disease complications
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease epidemiology
Metabolic Syndrome complications
Metabolic Syndrome diagnosis
Metabolic Syndrome epidemiology
Obesity, Metabolically Benign complications
Obesity, Metabolically Benign diagnosis
Obesity, Metabolically Benign epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4636
- Volume :
- 42
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Arteriosclerosis, thrombosis, and vascular biology
- Publication Type :
- Academic Journal
- Accession number :
- 35387482
- Full Text :
- https://doi.org/10.1161/ATVBAHA.122.317526