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Subclinical Atherosclerosis Up in Metabolically Healthy Obese

Association attenuated after further adjustment for metabolic risk factors

Subclinical Atherosclerosis Up in Metabolically Healthy Obese

THURSDAY, May 1, 2014 (HealthDay News) -- The prevalence of coronary calcification is higher for metabolically healthy obese (MHO) than for metabolically healthy normal-weight individuals, according to a study published online April 30 in the Journal of the American College of Cardiology.

Yoosoo Chang, M.D., from Kangbuk Samsung Hospital in Seoul, South Korea, and colleagues conducted a cross sectional study involving 14,828 metabolically healthy adults, aged 30 to 59 years, to compare coronary artery calcium (CAC) scores of obese and normal-weight individuals. Participants with no known cardiovascular disease underwent a health check-up exam, including cardiac tomography estimation of CAC scores.

The researchers found that the prevalence of coronary calcification was higher in MHO versus those of normal weight. The CAC score ratio was 2.26 comparing MHO to normal-weight participants in multivariable adjusted models (95 percent confidence interval, 1.48 to 3.43). This association was markedly attenuated after further adjustment for metabolic risk factors and was no longer significant (CAC score ratio, 1.24; 95 percent confidence interval, 0.79 to 1.96). There was no difference in these associations by clinically relevant subgroups.

"MHO participants had a higher prevalence of subclinical coronary atherosclerosis compared to metabolically healthy normal-weight participants, supporting that MHO is not a harmless condition," the authors write. "This association, however, was mediated by metabolic risk factors at levels below those considered abnormal, suggesting that label of metabolically healthy for obese subjects may be an artifact of the cut-off levels used in the definition of metabolic health."

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