Metabolically healthy obese phenotype and risk of cardiovascular disease: Results from the China Health and Retirement Longitudinal Study

Haibin Li; Dian He; Deqiang Zheng; Endawoke Amsalu; Anxin Wang; Lixin Tao; Jin Guo; Xia Li; Wei Wang; Xiuhua Guo

doi:10.1016/j.archger.2019.01.004

Metabolically healthy obese phenotype and risk of cardiovascular disease: Results from the China Health and Retirement Longitudinal Study

Arch Gerontol Geriatr. 2019 May-Jun:82:1-7. doi: 10.1016/j.archger.2019.01.004. Epub 2019 Jan 25.

Authors

Haibin Li¹, Dian He¹, Deqiang Zheng¹, Endawoke Amsalu¹, Anxin Wang², Lixin Tao¹, Jin Guo³, Xia Li⁴, Wei Wang⁵, Xiuhua Guo⁶

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Guanghua Group Pty Ltd, Melbourne, Victoria, Australia.
⁴ Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia.
⁵ Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia.
⁶ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China. Electronic address: statguo@ccmu.edu.cn.

PMID: 30710843
DOI: 10.1016/j.archger.2019.01.004

Abstract

Background: Epidemiologic evidence on metabolically healthy obese (MHO) phenotype and cardiovascular diseases (CVD) risk remains controversial.

Aims: We aim to examine the relationship between MHO and risk of CVD among the Chinese population.

Methods: The China Health and Retirement Longitudinal Study is a prospective cohort study of 7849 participants aged ≥45 years without CVD at baseline. Metabolic health status was assessed based on blood pressure, triglycerides, high-density lipoprotein cholesterol, glycated hemoglobin, fasting glucose, and C-reactive protein. A cutoff point of body mass index of 24.0 kg/m² was used to define over-weight/obesity (≥24.0 kg/m²) or normal weight (<24.0 kg/m²). CVD was based on self-reported doctor's diagnosis of heart problems and stroke. Incidence rate ratio (IRR) with 95% confidence interval (CI) was deduced from modified Poisson regression.

Results: During a mean 3.6 years of follow-up, 880 incident CVD events were recorded. 789 (10.05%) were identified MHO among 3321 (42.3%) obese individuals. Compared with metabolically healthy normal weight individuals, the multivariable adjusted IRR of CVD was 1.33 (95%CI: 1.19-1.49) for MHO, 1.29 (95%CI: 1.22-1.38) for metabolically unhealthy normal weight, and 1.61 (95%CI: 1.51-1.75) for metabolically unhealthy obese in the full adjusted model.

Conclusions: MHO individuals are associated with the increased risk of cardiovascular diseases among the Chinese population.

Keywords: Cardiovascular diseases; Metabolically healthy; Obesity.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cardiovascular Diseases / etiology*
Female
Humans
Longitudinal Studies
Male
Middle Aged
Obesity, Metabolically Benign / complications*
Phenotype
Prospective Studies
Retirement
Risk Factors