By Colin Kenny, GP, County Down
In this large meta-analysis, 61,386 individuals who participated in studies were evaluated to determine the effect of existing metabolic status on all-cause mortality and cardiovascular events. Individuals in the analysis were of normal weight, overweight or obese. The analysis aimed to discover if overweight and obese individuals who have normal metabolic features despite increased adiposity were at increased risk. The individuals’ metabolic state was assessed by the presence or absence of components of the metabolic syndrome according to International Diabetes Federation criteria.
There were 3988 events in the group examined. Metabolically healthy but obese individuals had an increased risk of events, compared with metabolically healthy normal-weight individuals, in studies with 10 or more years of follow-up. All metabolically unhealthy groups had a similarly elevated risk. A drawback of the study was that it was not clear how long the individuals had been obese. However, compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes, even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
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