Relations of metabolically healthy and unhealthy obesity to digital vascular function in three community-based cohorts: A meta-analysis

Luisa C.C. Brant, Na Wang, Francisco M. Ojeda, Michael LaValley, Sandhi M. Barreto, Emelia J. Benjamin, Gary F. Mitchell, Ramachandran S. Vasan, Joseph N. Palmisano, Thomas Münzel, Stefan Blankenberg, Philipp S. Wild, Tanja Zeller, Antonio L.P. Ribeiro, Renate B. Schnabel, Naomi M. Hamburg

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background-Microvascular dysfunction is a marker of early vascular disease that predicts cardiovascular events. Whether metabolically healthy obese individuals have impaired microvascular function remains unclear. The aim of this study was to evaluate the relation of obesity phenotypes stratified by metabolic status to microvascular function. Methods and Results-We meta-analyzed aggregate data from 3 large cohorts (Brazilian Longitudinal Study of Adult Health, the Framingham Heart Study, and the Gutenberg Heart Study; n=16 830 participants, age range 19-90, 51.3% men). Regression slopes between cardiovascular risk factors and microvascular function, measured by peripheral arterial tonometry (PAT), were calculated. Individuals were classified as normal-weight, overweight, or obese by body mass index (BMI) and stratified by healthy or unhealthy metabolic status based on metabolic syndrome using the ATP-III criteria. Male sex, BMI, and metabolic risk factors were associated with higher baseline pulse amplitude and lower PAT ratio. There was stepwise impairment of vascular measures from normal weight to obesity in both metabolic status strata. Metabolically healthy obese individuals had more impaired vascular function than metabolically healthy normal-weight individuals (baseline pulse amplitude 6.12±0.02 versus 5.61±0.01; PAT ratio 0.58±0.01 versus 0.76±0.01, all P < 0.0001). Metabolically unhealthy obese individuals had more impaired vascular function than metabolically healthy obese individuals (baseline pulse amplitude 6.28±0.01 versus 6.12±0.02; PAT ratio 0.49±0.01 versus 0.58±0.01, all P < 0.0001). Conclusions-Metabolically healthy obese individuals have impaired microvascular function, though the degree of impairment is less marked than in metabolically unhealthy obese individuals. Our findings suggest that obesity is detrimental to vascular health irrespective of metabolic status.

Original languageEnglish (US)
Article numbere004199
JournalJournal of the American Heart Association
Volume6
Issue number3
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Body mass index
  • Cardiovascular risk factors
  • Cohort studies
  • Endothelial function
  • Metabolic syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Relations of metabolically healthy and unhealthy obesity to digital vascular function in three community-based cohorts: A meta-analysis'. Together they form a unique fingerprint.

Cite this