Predictors of the transition from metabolically healthy obesity to unhealthy obesity

Research output: Contribution to journalArticle

Abstract

Purpose: Evidence that metabolically healthy obesity (MHO) is a stable benign condition is unclear. The aim of this study was to estimate the transition of MHO subjects to unhealthy obesity (occurrence of cardio-metabolic events and/or risk factors) and its predictors. Methods: We conducted an explorative follow-up study in a subset of MHO patients > 40 years without any cardio-metabolic risk factors and with normal LDL cholesterol (LDLc) levels, identified among 1530 obese patients. Due to the low sample size, a bootstrap approach was applied to identify the variables to be included in the final multivariate discrete-time logit model. Results: The prevalence of MHO was 3.7%. During the follow-up (mean 6.1 years, SD 2.0), none of the MHO reported cardiovascular events, diabetes or prediabetes; 26 subjects developed risk factors (53% high LDLc and 50% hypertension). At the 6 and 12-year of follow-up, the cumulative incidence of transition to unhealthy obesity was 44% (95% CI 31–59%) and 62% (95% CI 45–79%), the incidence of high LDLc was 23% (95% CI 13–37%) and 40% (95% CI 25–59%) and that of hypertension was 20% (95% CI 11–33%) and 30% (95% CI 17–48%). LDLc and duration of follow-up were independent predictors of the transition from MHO to unhealthy obesity [OR 1.038 (1.005–1.072) and 1.360 (1.115–1.659)]. Conclusions: Results suggest that (a) MHO individuals do not move over time forward diabetes/prediabetes but develop risk factors, such as hypertension and higher LDL c that worsen the cardiovascular prognosis; (b) LDLc and the flow of time independently predict the transition to unhealthy status. Level of evidence: Level III, cohort study.

Original languageEnglish
Pages (from-to)739-744
Number of pages6
JournalEating and Weight Disorders
Volume23
Issue number6
DOIs
Publication statusPublished - Dec 1 2018

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Obesity
LDL Cholesterol
Prediabetic State
Hypertension
Incidence
Metabolically Benign Obesity
Sample Size
Healthy Volunteers
Cohort Studies
Logistic Models

Keywords

  • Follow-up study
  • Hypertension
  • LDL cholesterol
  • Metabolically healthy obesity

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Predictors of the transition from metabolically healthy obesity to unhealthy obesity. / Gilardini, Luisa; Zambon, Antonella; Soranna, Davide; Croci, Marina; Invitti, Cecilia.

In: Eating and Weight Disorders, Vol. 23, No. 6, 01.12.2018, p. 739-744.

Research output: Contribution to journalArticle

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title = "Predictors of the transition from metabolically healthy obesity to unhealthy obesity",
abstract = "Purpose: Evidence that metabolically healthy obesity (MHO) is a stable benign condition is unclear. The aim of this study was to estimate the transition of MHO subjects to unhealthy obesity (occurrence of cardio-metabolic events and/or risk factors) and its predictors. Methods: We conducted an explorative follow-up study in a subset of MHO patients > 40 years without any cardio-metabolic risk factors and with normal LDL cholesterol (LDLc) levels, identified among 1530 obese patients. Due to the low sample size, a bootstrap approach was applied to identify the variables to be included in the final multivariate discrete-time logit model. Results: The prevalence of MHO was 3.7{\%}. During the follow-up (mean 6.1 years, SD 2.0), none of the MHO reported cardiovascular events, diabetes or prediabetes; 26 subjects developed risk factors (53{\%} high LDLc and 50{\%} hypertension). At the 6 and 12-year of follow-up, the cumulative incidence of transition to unhealthy obesity was 44{\%} (95{\%} CI 31–59{\%}) and 62{\%} (95{\%} CI 45–79{\%}), the incidence of high LDLc was 23{\%} (95{\%} CI 13–37{\%}) and 40{\%} (95{\%} CI 25–59{\%}) and that of hypertension was 20{\%} (95{\%} CI 11–33{\%}) and 30{\%} (95{\%} CI 17–48{\%}). LDLc and duration of follow-up were independent predictors of the transition from MHO to unhealthy obesity [OR 1.038 (1.005–1.072) and 1.360 (1.115–1.659)]. Conclusions: Results suggest that (a) MHO individuals do not move over time forward diabetes/prediabetes but develop risk factors, such as hypertension and higher LDL c that worsen the cardiovascular prognosis; (b) LDLc and the flow of time independently predict the transition to unhealthy status. Level of evidence: Level III, cohort study.",
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T1 - Predictors of the transition from metabolically healthy obesity to unhealthy obesity

AU - Gilardini, Luisa

AU - Zambon, Antonella

AU - Soranna, Davide

AU - Croci, Marina

AU - Invitti, Cecilia

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Purpose: Evidence that metabolically healthy obesity (MHO) is a stable benign condition is unclear. The aim of this study was to estimate the transition of MHO subjects to unhealthy obesity (occurrence of cardio-metabolic events and/or risk factors) and its predictors. Methods: We conducted an explorative follow-up study in a subset of MHO patients > 40 years without any cardio-metabolic risk factors and with normal LDL cholesterol (LDLc) levels, identified among 1530 obese patients. Due to the low sample size, a bootstrap approach was applied to identify the variables to be included in the final multivariate discrete-time logit model. Results: The prevalence of MHO was 3.7%. During the follow-up (mean 6.1 years, SD 2.0), none of the MHO reported cardiovascular events, diabetes or prediabetes; 26 subjects developed risk factors (53% high LDLc and 50% hypertension). At the 6 and 12-year of follow-up, the cumulative incidence of transition to unhealthy obesity was 44% (95% CI 31–59%) and 62% (95% CI 45–79%), the incidence of high LDLc was 23% (95% CI 13–37%) and 40% (95% CI 25–59%) and that of hypertension was 20% (95% CI 11–33%) and 30% (95% CI 17–48%). LDLc and duration of follow-up were independent predictors of the transition from MHO to unhealthy obesity [OR 1.038 (1.005–1.072) and 1.360 (1.115–1.659)]. Conclusions: Results suggest that (a) MHO individuals do not move over time forward diabetes/prediabetes but develop risk factors, such as hypertension and higher LDL c that worsen the cardiovascular prognosis; (b) LDLc and the flow of time independently predict the transition to unhealthy status. Level of evidence: Level III, cohort study.

AB - Purpose: Evidence that metabolically healthy obesity (MHO) is a stable benign condition is unclear. The aim of this study was to estimate the transition of MHO subjects to unhealthy obesity (occurrence of cardio-metabolic events and/or risk factors) and its predictors. Methods: We conducted an explorative follow-up study in a subset of MHO patients > 40 years without any cardio-metabolic risk factors and with normal LDL cholesterol (LDLc) levels, identified among 1530 obese patients. Due to the low sample size, a bootstrap approach was applied to identify the variables to be included in the final multivariate discrete-time logit model. Results: The prevalence of MHO was 3.7%. During the follow-up (mean 6.1 years, SD 2.0), none of the MHO reported cardiovascular events, diabetes or prediabetes; 26 subjects developed risk factors (53% high LDLc and 50% hypertension). At the 6 and 12-year of follow-up, the cumulative incidence of transition to unhealthy obesity was 44% (95% CI 31–59%) and 62% (95% CI 45–79%), the incidence of high LDLc was 23% (95% CI 13–37%) and 40% (95% CI 25–59%) and that of hypertension was 20% (95% CI 11–33%) and 30% (95% CI 17–48%). LDLc and duration of follow-up were independent predictors of the transition from MHO to unhealthy obesity [OR 1.038 (1.005–1.072) and 1.360 (1.115–1.659)]. Conclusions: Results suggest that (a) MHO individuals do not move over time forward diabetes/prediabetes but develop risk factors, such as hypertension and higher LDL c that worsen the cardiovascular prognosis; (b) LDLc and the flow of time independently predict the transition to unhealthy status. Level of evidence: Level III, cohort study.

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KW - LDL cholesterol

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