Obese Women Remain at Risk For Heart Disease, Even When Metabolically Healthy

MedicalResearch.com Interview with:
Nathalie Eckel, MSc

German Diabetes Center
Düsseldorf, Germany 

MedicalResearch.com: What is the background for this study?

 Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called “metabolically healthy obesity” and “metabolically unhealthy normal-weight”. So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

MedicalResearch.com: What are the main findings?

Response: Our results show that large proportions of women with initial metabolic health convert to an unhealthy phenotype over 20 years, particularly among obese women, but also among overweight and normal-weight women. Metabolically unhealthy women have a particularly high risk for cardiovacular disease, but even women with metabolically healthy obesity who maintain this healthy status over 10 or 20 years were at an increased risk for cardiovascular disease compared to women with metabolically healthy normal weight.

MedicalResearch.com: What should readers take away from your report?

Response: Obesity remains a risk factor for cardiovascular disease even in the absence of metabolic disorders. However, having metabolic disorders, such as diabetes, hypertension or hypercholesterolemia, are even stronger risk factors, also among overweight and normal-weight. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should focus on novel concepts to identify subgroups of obese individuals who are not at an elevated risk. For example cardiorespiratory fitness might be such a concept, which has not been examined enough. Also, key determinants for the transition from metabolically healthy to unhealthy obesity should be identified by future research. 


Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90 257 women (the Nurses’ Health Study): 30 year follow-up from a prospective cohort study

Nathalie Eckel, Yanping Li, Olga Kuxhaus, Norbert Stefan, Frank B Hu, Matthias B Schulze
Eckel, Nathalie et al.
The Lancet Diabetes & Endocrinology , Volume 0 , Issue 0 ,

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Last Updated on June 1, 2018 by Marie Benz MD FAAD