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Eckel, N.* ; Meidtner, K.* ; Kalle-Uhlmann, T.* ; Stefan, N. ; Schulze, M.B.*

Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis.

Eur. J. Prev. Cardiol. 23, 956-966 (2016)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
AIMS: Previous studies have provided inconsistent results about the cardiovascular risks for participants with metabolically healthy obesity (MHO). These uncertainties might partly reflect the lack of a uniform definition of MHO. We conducted a systematic review and meta-analysis to examine whether there is a suitable approach that identifies obese participants who are not at an increased risk of cardiovascular events compared with healthy normal-weight participants. METHODS AND RESULTS: Twenty-two prospective studies were eligible for the meta-analysis. Using random-effect models, pooled relative risks (RRs) were calculated for the combined effects of obesity with the presence or absence of metabolic syndrome, insulin resistance, hypertension, diabetes, hyperlipidaemia and any of these metabolic factors. Participants with MHO defined by the absence of metabolic syndrome were at increased risk for cardiovascular events compared with healthy normal-weight participants (pooled RR 1.45, 95% confidence interval (CI) 1.20-1.70), but had lower risks than unhealthy normal-weight (RR 2.07, 95% CI 1.62-2.65) and obese (RR 2.31, 95% CI 1.99-2.69) participants. The risk associated with participants who had MHO was particularly high over the long term. Similar risk estimates were observed when MHO was defined by other approaches. CONCLUSIONS: None of the approaches clearly identified an obese subgroup not at increased risk of cardiovascular events compared with normal-weight healthy participants. A benign obese phenotype might be defined by strict definitions, but insufficient studies exist to support this. More research is needed to better define MHO.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Body Mass Index ; Cardiovascular Risk ; Meta-analysis ; Metabolically Healthy Obesity ; Systematic Review; Body-mass Index; Coronary-heart-disease; Population-based Cohort; All-cause Mortality; Middle-aged Men; Normal-weight; Cardiorespiratory Fitness; Abdominal Obesity; Risk-factors; Myocardial-infarction
ISSN (print) / ISBN 2047-4873
e-ISSN 2047-4881
Quellenangaben Volume: 23, Issue: 9, Pages: 956-966 Article Number: , Supplement: ,
Publisher Sage
Publishing Place London
Non-patent literature Publications
Reviewing status Peer reviewed