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Metabolic Syndrome Beats Obesity for Heart Failure Risk

Higher heart failure risk for normal weight patients with metabolic syndrome than healthy obese

TUESDAY, Sept. 13 (HealthDay News) -- Obese individuals who are metabolically healthy have a lower risk of heart failure than those with metabolic syndrome (MetS) who are normal weight, according to a study published in the Sept. 20 issue of the Journal of the American College of Cardiology.

Christina Voulgari, M.D., Ph.D., from the Athens University Medical School in Greece, and colleagues compared the risk of heart failure between metabolically healthy obese individuals and normal-weight individuals with MetS. A cohort of 550 individuals without diabetes or baseline macrovascular complications were classified by presence (271) or absence (279) of MetS and according to body mass index (BMI): normal (177), overweight (234), and obese (139). Participants were followed up for six years. Echocardiography was used to assess left ventricular functional capacity, myocardial structure, and performance.

The investigators found that increased heart failure risk was not associated with BMI, whereas the presence of MetS predicted a 2.5-fold increased risk. Compared with normal-weight individuals with MetS, the lowest six-year heart failure risk was observed for overweight and obese individuals without MetS (hazard ratio [HR], 2.33, 1.12, and 0.41, respectively). Increased heart failure risk was associated with impaired fasting glucose (HR, 1.09), high blood pressure (HR, 2.36), low high-density lipoprotein cholesterol (HR, 1.88), and central obesity (HR, 2.22). Factors often correlated with MetS, including insulin resistance and inflammation, were independently associated with incidence of heart failure.

"In contrast to normal weight insulin-resistant individuals, metabolically healthy obese individuals show decreased heart failure risk in a six-year follow-up study," the authors write.

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