Publicación

The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness

  • EUROPEAN HEART JOURNAL
  • Autores
    Ortega, FB; Lee, DC; Katzmarzyk, PT; Ruiz, JR; Sui, XM; Church, TS; Blair, SN
  • Año Publicación
    2013
  • Volumen
    34
  • Número
    5
  • Pág. Inicio
    390
  • Pág. Fin
    +
  • Pág. Fin
    390
Referencia Citadas
51
Citas Web of Science
227
Total de veces citado (Z9)
230
Recuento Uso 180 días
1
Recuento Uso 5 años
66

Current knowledge on the prognosis of metabolically healthy but obese phenotype is limited due to the exclusive use of the body mass index to define obesity and the lack of information on cardiorespiratory fitness. We aimed to test the following hypotheses: (i) metabolically healthy but obese individuals have a higher fitness level than their metabolically abnormal and obese peers; (ii) after accounting for fitness, metabolically healthy but obese phenotype is a benign condition, in terms of cardiovascular disease and mortality. Fitness was assessed by a maximal exercise test on a treadmill and body fat per cent (BF) by hydrostatic weighing or skinfolds (obesity BF epsilon 25 or epsilon 30, men or women, respectively) in 43 265 adults (24.3 women). Metabolically healthy was considered if meeting 0 or 1 of the criteria for metabolic syndrome. Metabolically healthy but obese participants (46 of the obese subsample) had a better fitness than metabolically abnormal obese participants (P 0.001). When adjusting for fitness and other confounders, metabolically healthy but obese individuals had lower risk (3050, estimated by hazard ratios) of all-cause mortality, non-fatal and fatal cardiovascular disease, and cancer mortality than their metabolically unhealthy obese peers; while no significant differences were observed between metabolically healthy but obese and metabolically healthy normal-fat participants. (i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.


Web financiada por la Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, Fondo Europeo de Desarrollo Regional (FEDER), proyecto SOMM17/6107/UG

Web financiada por la Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, Fondo Europeo de Desarrollo Regional (FEDER), proyecto SOMM17/6107/UGR