“Metabolically Healthy Obese” People at Higher Risk of Ischemic Heart Disease

In yet another blow to the idea that there are “metabolically healthy” obese people, Danish researchers have found that obesity carries with it a higher risk of ischemic heart disease (IHD), irrespective of metabolic health, according to a study recently published in The Journal of Clinical Endocrinology & Metabolism.

Researchers led by Kristine Færch, MSc, PhD, of the Steno Diabetes Center Copenhagen in Gentofte, Denmark, point out that recent studies have categorized some obese individuals as not having an increased risk of obesity-related complications, but obesity remains a major public health concern. “The concept of metabolically healthy obesity has been discussed over the past decade, and the conclusions are ambiguous,” the authors write. So the team set out to determine whether obesity is a risk factor for developing IHD, no matter how “metabolically healthy” an obese person is.

The team followed 6,238 men and women from the Danish prospective Inter99 study for more than 10 years. They classified the participants according to BMI, as well as four metabolic risk factors. “Metabolically healthy individuals were defined as having zero metabolic risk factors, and metabolically unhealthy individuals as having minimum one,” the authors write

Of the participants, 323 developed IHD during the follow-up period. The researchers found that metabolically healthy obese men were more likely to develop IHD than their healthy normal weight counterparts. The women’s results were less pronounced. What’s more, many of the metabolically healthy participants became metabolically unhealthy after five years of follow-up.

The authors conclude that based on these results, that not only do “metabolically healthy obese” individuals carry an increased risk of IHD, metabolically healthy obesity is also not a permanent state. “In conclusion,” they write, “our results suggest that the metabolically healthy obese phenotype is not a benign condition, and we question the feasibility of denoting a subgroup of obese individuals as metabolically healthy.”