Eur J Endocrinol. 2015 Jun 3. pii: EJE-15-0284. [Epub ahead of print]
Coronary Artery Disease Risk among Obese Metabolically Healthy Young Men.
Twig G1, Gerstein H2, Ben-Ami Shor D3, Derazne E4, Tzur D5, Afek A6, Tirosh A7.
The aim of this study was to assess CAD risk among obese young men without metabolic risk factors.
longitudinal study in a historical cohort Methods: Incident CAD during a median follow-up of 6.1 years was assessed among 31,684 young men (mean age 31.2±5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI≥30 kg/m2 in the presence of normal blood pressure and normal levels of fasting glucose, triglyceride and HDL-cholesterol levels (n=599; 1.9%). Cox proportional hazard models were applied.
There were 198 new cases of CAD that were diagnosed during 209,971 person-years of follow-up, of which 6 cases occurred among MH obese. The incidence of CAD among MH lean, overweight and obese participates was 0.23, 0.45 and 1.0 per 1,000 person-years, respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (HR=3.08; 95%CI=1.10-8.68, p=0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-cholesterol, triglycerides or blood pressure were added to the model. Similar results were also obtained when a more permissive definition of metabolic health was used.
Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.
PMID: 26041076 [PubMed – as supplied by publisher]