title: Obesity phenotype and cardiovascular changes.
abstract: OBJECTIVE
  Healthy obese phenotype with favorable metabolic profiles is proposed. However, whether healthy obesity leads to target organ changes is controversial. We investigated the impact of a healthy obesity on cardiovascular structure and function.
  
  
  METHODS
  A total of 2540 participants without known cardiovascular disease were enrolled. According to BMI and the metabolic syndrome (MetS) component, the participants were divided into six groups: healthy (none of five MetS components) normal weight (BMI <23 kg/m²), unhealthy (one or more of five MetS components) normal weight, healthy overweight (BMI 23-24.9 kg/m²), unhealthy overweight, healthy obesity (BMI ≥25 kg/m²), and unhealthy obesity. The cardiovascular changes were assessed by echocardiography, tissue Doppler imaging (TDI), carotid ultrasonography, and pulse wave velocity (PWV).
  
  
  RESULTS
  In a multivariate analysis after adjusting for age, sex, heart rate, high-sensitivity C-reactive protein, and medication for hypertension and diabetes mellitus, the unhealthy overweight and obese groups showed statistically significant changes in the left ventricular mass index, mitral E/A ratio, E/Ea ratio, TDI Ea velocity, common carotid artery intima-media thickness (CCA-IMT), and brachial-ankle PWV (P < 0.001), compared with the healthy normal weight individuals. In the healthy overweight and obese groups, CCA-IMT and brachial-ankle PWV values were similar, but left-ventricular mass index and TDI Ea velocity were significantly different (P < 0.001).
  
  
  CONCLUSIONS
  Healthy obesity was associated with subtle changes in left ventricular structure and function. These data provide evidence that metabolically healthy phenotypes with excess weight may not be a benign condition.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Juri
authors.initials: J
authors.lastname: Park
authors.forename: Seong H
authors.initials: SH
authors.lastname: Kim
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.forename: Inkyung
authors.initials: I
authors.lastname: Baik
authors.forename: Nan H
authors.initials: NH
authors.lastname: Kim
authors.forename: Hong E
authors.initials: HE
authors.lastname: Lim
authors.forename: Eung J
authors.initials: EJ
authors.lastname: Kim
authors.forename: Chang G
authors.initials: CG
authors.lastname: Park
authors.forename: Sang Y
authors.initials: SY
authors.lastname: Lim
authors.forename: Yong H
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.forename: Seung K
authors.initials: SK
authors.lastname: Lee
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000503:physiopathology*; D010641:Phenotype