People with “healthy obesity” are still at high risk of illness

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New research published in Diabetes A normal metabolic profile does not necessarily mean that an obese person is actually healthy because of the increased risk of diabetes, heart disease, stroke, and respiratory illness (called metabolically healthy obesity). ).

The study was conducted by Dr. Frederick Ho and his colleagues at the Institute of Health and Welfare, University of Glasgow, Glasgow, England. obesity And if the normal metabolic profile is healthy or at high risk of developing obesity-related health problems.

It is estimated that there are more than 300 million obese people in the world, and if current trends continue, this figure could exceed 1 billion by 2030, accounting for 20% of the world’s adult population. there is. An ongoing global epidemic of type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD), and many other serious health problems is associated with obesity.

Obesity usually causes metabolic problems. Blood sugar, Elevated blood pressure (BP), insulin resistance, and other adverse metabolic changes. These effects are not universal, and in some obese patients, blood pressure is normal, blood fat is good, systemic inflammation is little or no, and insulin levels are normal.This is “metabolically Healthy obesity‘(MHO), the incidence is estimated to be 3% to 22% of the total population.

This study investigated the association between MHO and all-cause mortality T2D. heart Seizures and strokes, heart failure (HF) Respiratory disease, Includes Chronic Obstructive Pulmonary Disease (COPD). MHO has defined a body mass index (BMI) of 30 kg / m2.2 Or better and meet at least 4 of the 6 metabolically healthy criteria.These are blood pressure And 5 blood-based biomarkers: C-reactive protein (CRP, marker of inflammation), triglyceride (fat), Low density lipoprotein (LDL / “bad” cholesterol) High density lipoprotein (HDL / “good” cholesterol), and glycated hemoglobin (HbA1c, mean blood glucose measurements over the last 2-3 months). Based on metabolic and obese status, participants were metabolically healthy non-obesity (MHN), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity. It was classified as (MUO).

The authors analyzed the details of 381,363 individuals (excluding those classified as “underweight”) for a median follow-up of 11.2 years. They were part of the UK Biobank project, a large prospective cohort study that recruited participants from the general population of England, Scotland and Wales from 2007 to 2010.

The authors found that MHO people are generally younger than MUO participants, have less opportunity to watch TV, are more active, have a higher education level, have a lower Hunger Index, and consume more lean and processed meats. Many found that they were unlikely to be male or non-white.

Compared to non-obese, metabolically healthy participants (MHN), MHO participants are 4.3 times more likely to develop T2D, 18% more likely to develop myocardial infarction or stroke, and are at risk of heart failure. Is 76% more likely to have respiratory illness and is 19% more likely to have COPD. People classified as MHO were 28% more likely to develop heart failure than those who were not obese and were metabolically unhealthy (MUN).

The authors said, “In general, the incidence of cardiovascular and respiratory outcomes was highest in MUO, followed by MUN and MHO, but accidental and fatal heart failure, and accidental. Excluding respiratory diseases. Mun “

They said, “Metabolic healthy obese people are at greater risk of diabetes, heart attack, stroke, heart failure, respiratory illness, and death from any cause than those who are not obese and have a healthy metabolic profile. Of particular value. Note that metabolically healthy obese people are at greater risk of heart failure and respiratory illness than non-obese, metabolically unhealthy participants. “

In addition, the team also found that within a subset of participants with follow-up metabolic and obesity data, one-third of participants who were metabolically healthy obesity at the start of the study period were within 3-5 years. I also discovered that I became metabolically unhealthy.

The researchers conclude that: “A metabolically healthy obese person is not” healthy. ” heart attack And stroke, heart failure, And respiratory illness are compared to non-obese people with a normal metabolic profile. “

They said, “Weight management can be beneficial to all obese patients, regardless of their metabolic profile. The term” metabolically healthy obesity “can be misleading and should be avoided in clinical medicine. It should be and we need to consider different strategies for defining risk. ”

Metabolic Health and Weight Management Keys to Minimize Diabetes Risk

For more information:
Ziyi Zhou et al. Are Metabolic Healthy Obese People Really Healthy? A Prospective Cohort Study of 381,363 UK Biobank Participants, Diabetes (2021). DOI: 10.1007 / s00125-021-05484-6

Quote: People with “healthy obesity” are still at high risk of illness (June 10, 2021) to 2021 6 Search on the 10th of the month

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People with “healthy obesity” are still at high risk of illness

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