Metabolically Healthy Obesity May Still Carry Hidden Cardiovascular Risk

Prof Bhupinder Singh, Head, Department of Cardiology, AIIMS, Bathinda

People with metabolically healthy obesity (MHO) did not show higher short-term cardiovascular risk, but showed possible future cardiovascular risk.

Obesity does not affect all people in the same way. Some people with obesity may have normal blood pressure, no diabetes, and fewer metabolic abnormalities. This condition is known as metabolically healthy obesity (MHO). Researchers wanted to understand whether MHO is truly linked to lower cardiovascular risk and how its metabolic profile compares with other obesity groups.

This prospective study included participants from two European population-based studies, the FLEMENGHO and Hortega studies. A total of 2,339 adults were followed, including 2,218 who underwent metabolomic profiling. Individuals were grouped based on their body mass index (BMI) and metabolic health status into six categories, ranging from healthy normal weight to metabolically unhealthy obesity.

The average age of participants was 51 years, and nearly half were women. Among the study population, 434 individuals had obesity, and 117 were classified as having MHO. During a median follow-up of 9.2 years, 245 cardiovascular events occurred.

Researchers found that metabolically unhealthy individuals had a higher risk of cardiovascular events irrespective of BMI category. In contrast, people with MHO did not show an increased short-term cardiovascular risk compared with metabolically healthy normal-weight individuals. However, metabolomic analysis showed that individuals with MHO had metabolic patterns linked to glucose regulation and cardiovascular risk, similar to those seen in metabolically unhealthy obesity. These findings suggest that even metabolically healthy obesity may require early monitoring and intervention.

(Reference: Wei D, González-Marrachelli V, Melgarejo JD, Liao CT, Hu A, Janssens S, Verhamme P, Van Aelst L, Vanassche T, Redon J, Tellez-Plaza M. Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study. Cardiovascular diabetology. 2023 Apr 7;22(1):82.)