Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Original Article

Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence?

Jovens iranianas obesas metabolicamente saudáveis têm maior risco de incidência de DCV?

Seyed Ahmad Hosseini; Vahideh Aghamohammadi; Damoon Ashtary-Larky; Meysam Alipour; Matin Ghanavati; Nasrin Lamuchi-Deli

Downloads: 0
Views: 775


Abstract: Background: The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear.

Objectives: We examined the association between MHO and CVD risk in young Iranian women.

Methods: We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants.

Results: The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO.

Conclusions: Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.


metabolically healthy obese, atherogenic index of plasma, cardiovascular disease


Resumo: Contexto: A associação entre o fenótipo obeso metabolicamente saudável (OMS) na ausência de síndrome metabólica e doença cardiovascular subsequente permanece incerta.

Objetivos: Examinamos a associação entre o fenótipo OMS e risco de DCV em jovens iranianas.

Métodos: Analisamos 183 mulheres com idade de 20-35 anos de uma população de 308 candidatas. Classificamos as participantes em quatro fenótipos. Mensuramos composição corporal, pressão arterial e fatores bioquímicos em todas as participantes.

Resultados: Os fenótipos com peso normal metabolicamente saudável (PNMS) e obeso com peso normal não apresentaram diferenças estatísticas em nenhuma das variáveis bioquímicas. Os níveis de glicemia sanguínea em jejum (GSJ), triglicerídeos (TG), relação LDL/HDL, HDL, proteína C reativa ultrassensível (PCR-us) e índice aterogênico do plasma (IAP) foram mais elevados em obesas metabolicamente não saudáveis (OMNS) do que em indivíduos OMSs, enquanto o HDL foi maior em OMSs do que em indivíduos OMNSs. A relação LDL/HDL e o nível de PCR-us foram mais elevados em participantes OMSs do que em participantes com PNMS, enquanto o HDL foi maior naquelas com PNMS do que nas OMSs.

Conclusões: Os resultados do presente estudo demonstram que mulheres jovens com o fenótipo OMS têm um perfil metabólico favorável, conforme demonstrado pelos níveis menores de GSJ, TG, relação LDL/HDL, HDL, PCR-us e IAP e pelos níveis maiores de HDL em comparação às mulheres com o fenótipo OMNS. Entretanto, indivíduos OMSs ainda apresentavam maior risco de DCV incidente (níveis menores de HDL e maiores de PCR-us) do que indivíduos com PNMS.


obeso metabolicamente saudável, índice aterogênico do plasma, doença cardiovascular


Kolahi AA, Moghisi A, Soleiman Ekhtiari Y. Socio-demographic determinants of obesity indexes in Iran: findings from a nationwide STEPS survey. Health Promot Perspect. 2018;8(3):187-94. PMid:30087841.

Tabrizi JS, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and associated factors of overweight or obesity and abdominal obesity in iranian population: a population-based study of Northwestern Iran. Iran J Public Health. 2018;47(10):1583-92. PMid:30524990.

Ruderman NB, Schneider SH, Berchtold P. The “metabolically-obese,” normal-weight individual. Am J Clin Nutr. 1981;34(8):1617-21. PMid:7270486.

Seo MH, Rhee EJ. Metabolic and cardiovascular implications of a metabolically healthy obesity phenotype. Endocrinol Metab. 2014;29(4):427-34. PMid:25559571.

Jung CH, Lee WJ, Song KH. Metabolically healthy obesity: a friend or foe? Korean J Intern Med. 2017;32(4):611-21. PMid:28602062.

Stefan N, Haring HU, Hu FB, Schulze MB. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol. 2013;1(2):152-62. PMid:24622321.

Samocha-Bonet D, Dixit VD, Kahn CR, et al. Metabolically healthy and unhealthy obese: the 2013 Stock Conference report. Obes Rev. 2014;15(9):697-708. PMid:25059108.

Blüher M. Are metabolically healthy obese individuals really healthy? Eur J Endocrinol. 2014;171(6):R209-19. PMid:25012199.

Phillips CM. Metabolically healthy obesity: definitions, determinants and clinical implications. Rev Endocr Metab Disord. 2013;14(3):219-27. PMid:23928851.

Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009;2(5-6):231-7. PMid:19407331.

Ashtary-Larky D, Daneghian S, Alipour M, et al. Waist circumference to height ratio: better correlation with fat mass than other anthropometric indices during dietary weight loss in different rates. Int J Endocrinol Metab. 2018;16(4):e55023. PMid:30464770.

Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-95. PMid:15161807.

Song Y, Manson JE, Meigs JB, Ridker PM, Buring JE, Liu S. Comparison of usefulness of body mass index versus metabolic risk factors in predicting 10-year risk of cardiovascular events in women. Am J Cardiol. 2007;100(11):1654-8. PMid:18036364.

Hinnouho GM, Czernichow S, Dugravot A, et al. Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. Eur Heart J. 2015;36(9):551-9. PMid:24670711.

Karelis AD, Faraj M, Bastard J-P, et al. The Metabolically Healthy but Obese Individual Presents a Favorable Inflammation Profile. J Clin Endocrinol Metab. 2005;90(7):4145-50. PMid:15855252.

Blaha MJ, Rivera JJ, Budoff MJ, et al. Association between obesity, high-sensitivity C-reactive protein ≥2 mg/L, and subclinical atherosclerosis: implications of JUPITER from the Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2011;31(6):1430-8. PMid:21474823.

Kutkiene S, Petrulioniene Z, Laucevicius A, et al. Cardiovascular risk profile of patients with atherogenic dyslipidemia in middle age Lithuanian population. Lipids Health Dis. 2018;17(1):208. PMid:30185180.

Koborová I, Gurecká R, Csongová M, et al. Association between metabolically healthy central obesity in women and levels of soluble receptor for advanced glycation end products, soluble vascular adhesion protein-1, and the activity of semicarbazide-sensitive amine oxidase. Croat Med J. 2017;58(2):106-16. PMid:28409494.

Chhezom K, Arslan MI, Hoque MM, Biswas SK. Biomarkers of cardiovascular and metabolic diseases in otherwise healthy overweight subjects in Bangladesh. Diabetes Metab Syndr. 2017;11(Suppl Suppl 1):S381-4. PMid:28285989.

Cure E, Icli A, Uslu AU, et al. Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis. Clin Rheumatol. 2018;37(5):1273-80. PMid:29435680.

Dobiás̆ová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate inapob-lipoprotein-depleted plasma (FERHDL). Clin Biochem. 2001;34(7):583-8. PMid:11738396.

Lee SK, Kim SH, Cho GY, et al. Obesity phenotype and incident hypertension: a prospective community-based cohort study. J Hypertens. 2013;31(1):145-51. PMid:23079679.

Dhana K, Koolhaas CM, Van Rossum EF, et al. Metabolically healthy obesity and the risk of cardiovascular disease in the elderly population. PLoS One. 2016;11(4):e0154273. PMid:27100779.

Submitted date:

Accepted date:

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5f5bc5370e8825c30ecdcc43 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections