Dark and light side of obesity: mortality of metabolically healthy obese people

Abstract

Evaluation of: Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J. Clin. Endocrinol. Metab. 97(7), 2482–2488 (2012).The health effects of different obesity phenotypes remain unclear. In this observational voluminous study with prospective linkage to mortality records, participants were classified as metabolically healthy (zero or one metabolic abnormality) or unhealthy (two or more metabolic abnormalities) based on blood pressure, HDL-cholesterol, diabetes, waist circumference and low-grade inflammation signs. Obesity was defined as a BMI of 30 kg/m2 or greater. The association between metabolically healthy obesity and risk of cardiovascular disease and all-cause mortality was examined after follow-up, on average, of more than 7.0 ± 3.0 years. Participants with ‘standard’ (metabolically unhealthy) obesity were at elevated risk of cardiovascular disease and all-cause mortality compared with their metabolically healthy obese counterparts. No significant difference in mortality has been found between metabolically healthy obese and referent group (metabolically healthy nonobese participants). By adding new information to the data collected previously, this important paper calls for further clarifications, including an analysis of mortality in cancer and diabetic patients with various obesity types.