Open AccessInfluence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification
Author(s) -
Ji Won Yoon,
Chan Hyeon Jung,
Min Kyung Kim,
Hyo Eun Park,
Kyong Soo Park,
Hak Chul Jang,
Min Kyong Moon,
Su Yeon Choi,
Bo Kyung Koo
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0178741
Subject(s) - medicine , hazard ratio , confidence interval , obesity , metabolic syndrome , cohort , cardiology , agatston score , coronary artery disease , endocrinology , coronary artery calcium
Objectives Debates whether metabolically healthy obesity (MHO) increases the cardiovascular risk might be due to the metabolic instability of MHO or the absence of a perfect definition of MHO. Therefore, we aimed to investigate the influence of the MHO phenotype on the coronary artery calcium score (CACS) progression according to definition of MHO. Methods We analyzed a retrospective cohort with a CACS of 0 at baseline and available serial CACS measurements taken ≥ 12 months apart (n = 1,218). Obesity was defined as BMI ≥ 25 kg/m 2 , and MHO was defined as obesity accompanied by ≤ 1 (MHO class I) or 0 (MHO class II) components of metabolic syndrome (MetS). Results During a median follow-up of 45 months, 32.2% of MHO class I and 10.2% of MHO class II subjects developed MetS. Compared to non-obese/metabolically healthy subjects (reference group), hazard ratios (HR) for development of MetS were 2.174 (95% confidence interval [CI]: 1.513–3.124) and 1.166 (95% CI: 0.434–3.129) for MHO class I and II subjects, respectively. The MHO class I subjects showed a significantly increased risk of CACS progression as compared to the reference group (HR: 1.653; 95% CI: 1.144–2.390), whereas MHO class II subjects did not (HR: 1.195; 95% CI: 0.514–2.778). Among subjects with MHO class I, no significant CACS progression was observed in the subjects who maintained metabolic health during follow-up (HR: 1.448; 95% CI: 0.921–2.278). Conclusions The risks of metabolic deterioration and CACS progression were significant in subjects with MHO class I, but not in those with MHO class II.