Abstract
Introduction: There is a paucity of data on the combined association of metabolic health status and obesity with coronary heart disease (CHD) in adult cancer survivors who are at excess risk of CHD associated with potentially harmful side effects from some cancer therapies. Long-term cardiovascular health among adult cancer survivors who are metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUN), and metabolically unhealthy obese (MUO) as compared to those who are metabolically healthy non-obese (MHN) remains uncertain. Hypothesis: The hypothesis of this study was that adult cancer survivors who are MHO, MUN, MUO would have higher risk of CHD as compared to those who are MHN. Methods: Data on metabolic health status and incident CHD among adult cancer survivors (n=2,336) were abstracted from the National Health Insurance Service-Health Screening Cohort, 2002-2019 along with information on confounding variables (sociodemographic factors, health status, health behavior, and family history of heart disease). Obesity was defined as body mass index≥25.0 kg/m 2 and the participants were considered metabolically unhealthy if they met more than three out of the five (fasting serum glucose, blood pressure, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) criteria for worsened metabolic health. Cox proportional hazards model adjusted for the confounding variables was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) for incident CHD according to the metabolic health and obesity categories. Results: Among adult cancer survivors, those who are MHO (HR=2.80; 95% CI: 1.65-4.76), MUN (HR=2.58; 95%: 1.12-5.97), and MUO (HR=4.88; 95% CI: 2.27-10.5) had higher risk of incident CHD as compared to those who are MHN. Conclusions: Adult cancer survivors who are MHO should also be of a clinical concern. Excess body weight and metabolic health status should be concurrently managed to reduce the risk of developing CHD among adult cancer survivors.
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