Abstract 16879: Predictors of “Metabolically Healthy” Obesity in a High Risk Population
Introduction: Some obese individuals are thought to be “metabolically healthy” (MHO) with lower risk for cardiovascular disease. This study was designed to identify healthy obesity and its associated risk factors in asymptomatic obese African Americans (AA) and European Americans (EA) from high risk families.
Methods: Obese (BMI > 30) family members of index patients with early-onset coronary disease < 60 years of age underwent standard risk factor and fitness evaluation on a standard maximal treadmill test. MHO was defined as having <3 of the following: fasting plasma glucose ≥ 100 mg/dL, waist circumference > 102 cm (men) or > 88 cm (women), blood pressure ≥ 130 mm Hg systolic and 85 mmHg diastolic, HDL < 40 mg/dL (men) or < 50 mg/dL (women), or triglycerides ≥ 150 mg/dL.
Results: The sample (N=631) was 58% AA and 67% female, with 49.8% meeting criteria for MHO. Metabolically healthy individuals were more fit compared to unhealthy (76.3 ± 41.99 versus 70.48 ± 35.64 MET-minutes, p=0.06). In multivariable regression analysis predicting MHO versus unhealthy obesity, female sex (OR 2.05, 95% CI 1.37-3.09), AA race (OR 2.00, 95% CI 1.41-2.85), lower LDL (beta= -0.008, p<.0001), and higher total levels of fitness (beta=0.01, p= 0.0006) were independently associated with greater likelihood of being classified as MHO. Neither BMI nor age was associated with MHO status (p= 0.19 and p=0.15 respectively).
Conclusions: Among obese individuals from high risk families, age and BMI were not significantly associated with metabolically healthy status, as has been found in other studies. Among mutable risk factors, importantly, the association between better fitness levels and metabolic health suggest that improving fitness may hold promise in moving obese persons to a more metabolically healthy status independent of body weight.
- © 2011 by American Heart Association, Inc.