[HTML][HTML] Incidence of metabolic risk factors among healthy obese adults: 20-year follow-up

JA Bell, M Hamer, GD Batty, A Singh-Manoux… - Journal of the American …, 2015 - jacc.org
Journal of the American College of Cardiology, 2015jacc.org
There is growing evidence that obese adults without metabolic risk factor clustering (the so-
called “healthy obese”) progress to unhealthy obesity over time (1). However, the
pathophysiological changes underlying the long-term transition into an unhealthy obese
state have not been well characterized. To inform clinical management of healthy obesity,
we aimed to identify the metabolic risk factors responsible for this transition, as well as the
timing of their onset. Repeat clinical data were drawn from the Whitehall II cohort study of …
There is growing evidence that obese adults without metabolic risk factor clustering (the so-called “healthy obese”) progress to unhealthy obesity over time (1). However, the pathophysiological changes underlying the long-term transition into an unhealthy obese state have not been well characterized. To inform clinical management of healthy obesity, we aimed to identify the metabolic risk factors responsible for this transition, as well as the timing of their onset. Repeat clinical data were drawn from the Whitehall II cohort study of British adults. We grouped participants as normal-weight (body mass index [BMI] 18.5 to 24.9 kg/m2), overweight (BMI 25 to 29 kg/m2), or obese (BMI $30 kg/m2), and as healthy (2) if they were free of any the following characteristics: high-density lipoprotein cholesterol< 1.03 mmol/l (men) and< 1.29 mmol/l (women); blood pressure $130/85 mm Hg or antihypertension medication use; fasting plasma glucose $5.6 mmol/l or diabetic medication use; triglycerides $1.7 mmol/l; and homeostatic model–assessed insulin resistance> 2.83 (baseline 90th percentile value). Participants provided written
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