TY - JOUR
T1 - Coronary artery disease risk among obese metabolically healthy young men
AU - Twig, Gilad
AU - Gerstein, Hertzel C.
AU - Shor, Dana Ben Ami
AU - Derazne, Estela
AU - Tzur, Dorit
AU - Afek, Arnon
AU - Tirosh, Amir
N1 - Publisher Copyright:
© 2015 The authors.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Objective: The aim of this study was to assess coronary artery disease (CAD) risk among obese young men without metabolic risk factors. Design: A longitudinal study in a historical cohort. Methods: Incident CAD during a median follow-up of 6.1 years was assessed among 31 684 young men (mean age 31.2G5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥30 kg/m2 in the presence of normal blood pressure (BP) and normal levels of fasting glucose, triglyceride, and HDL-cholesterol (HDL-c) levels (n=599; 1.9%). Cox proportional hazard models were applied. Results: There were 198 new cases of CAD that were diagnosed during 209 971 person-years of follow-up, of which six cases occurred among MH obese. The incidence of CAD among MH lean, overweight, and obese participants was 0.23, 0.45, and 1.0/1000 person-years respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (hazard ratio=3.08; 95% CI=1.10-8.68, P=0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-c, triglycerides, or BP were added to the model. Similar results were also obtained when a more permissive definition of MH was used. Conclusions: Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.
AB - Objective: The aim of this study was to assess coronary artery disease (CAD) risk among obese young men without metabolic risk factors. Design: A longitudinal study in a historical cohort. Methods: Incident CAD during a median follow-up of 6.1 years was assessed among 31 684 young men (mean age 31.2G5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥30 kg/m2 in the presence of normal blood pressure (BP) and normal levels of fasting glucose, triglyceride, and HDL-cholesterol (HDL-c) levels (n=599; 1.9%). Cox proportional hazard models were applied. Results: There were 198 new cases of CAD that were diagnosed during 209 971 person-years of follow-up, of which six cases occurred among MH obese. The incidence of CAD among MH lean, overweight, and obese participants was 0.23, 0.45, and 1.0/1000 person-years respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (hazard ratio=3.08; 95% CI=1.10-8.68, P=0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-c, triglycerides, or BP were added to the model. Similar results were also obtained when a more permissive definition of MH was used. Conclusions: Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.
UR - http://www.scopus.com/inward/record.url?scp=84940668483&partnerID=8YFLogxK
U2 - 10.1530/EJE-15-0284
DO - 10.1530/EJE-15-0284
M3 - Article
C2 - 26041076
AN - SCOPUS:84940668483
SN - 0804-4643
VL - 173
SP - 305
EP - 312
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 3
ER -
