title: All-cause mortality risk of metabolically healthy abdominal obese individuals: the EPIC-MORGEN study.
abstract: OBJECTIVE
  It appears that a certain proportion of obese individuals have a normal metabolic profile despite having excess weight. Whether these so-called "metabolically healthy" obese express lower disease and mortality risks than "metabolically unhealthy" obese is still unclear. The mortality risk of "metabolically healthy" abdominal obese (MHAO) individuals was investigated.
  
  
  METHODS
  Prospective cohort study (EPIC-MORGEN) among 22,654 individuals aged 20-59 years followed for an average of 13.4 years (SD 2.3). MHAO was assessed at baseline (1993-1997) and defined as abdominal obesity (waist circumference ≥102 cm/≥88 cm (men/women)) with normal glucose, blood pressure, and plasma lipids. All-cause mortality risks adjusted for age and sex were estimated using Cox proportional hazards models.
  
  
  RESULTS
  Individuals who were "metabolically healthy" nonabdominal obese (MHNAO) comprised the reference group. As compared to MHNAO, mortality risk for MHAO was around 40% higher (Hazard ratio (HR) 1.43; 95% confidence interval (CI): 1.00-2.04) and of the same magnitude as that for "metabolically unhealthy" nonabdominal obese (MUNAO) (HR 1.31; 95% CI: 1.08-1.59). The HR for MUAO was 1.99 (95% CI: 1.62-2.43).
  
  
  CONCLUSIONS
  Mortality risk of MHAO individuals was significantly higher than that of MHNAO individuals and lower than, but not statistically significantly different from, that of MUAO individuals.
authors.affiliation: Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Daphne L
authors.initials: DL
authors.lastname: van der A
authors.forename: Astrid C J
authors.initials: AC
authors.lastname: Nooyens
authors.forename: Fränzel J B
authors.initials: FJ
authors.lastname: van Duijnhoven
authors.forename: Monique M W
authors.initials: MM
authors.lastname: Verschuren
authors.forename: Jolanda M A
authors.initials: JM
authors.lastname: Boer
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055105:Waist Circumference; D055815:Young Adult