The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies.
BACKGROUND
Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies.


METHODS
Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease.


RESULTS
Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes.


CONCLUSIONS
Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.
Jana V
JV
van Vliet-Ostaptchouk
Marja-Liisa
ML
Nuotio
Sandra N
SN
Slagter
Dany
D
Doiron
Krista
K
Fischer
Luisa
L
Foco
Amadou
A
Gaye
Martin
M
Gögele
Margit
M
Heier
Tero
T
Hiekkalinna
Anni
A
Joensuu
Christopher
C
Newby
Chao
C
Pang
Eemil
E
Partinen
Eva
E
Reischl
Christine
C
Schwienbacher
Mari-Liis
ML
Tammesoo
Morris A
MA
Swertz
Paul
P
Burton
Vincent
V
Ferretti
Isabel
I
Fortier
Lisette
L
Giepmans
Jennifer R
JR
Harris
Hans L
HL
Hillege
Jostein
J
Holmen
Antti
A
Jula
Jenny E
JE
Kootstra-Ros
Kirsti
K
Kvaløy
Turid Lingaas
TL
Holmen
Satu
S
Männistö
Andres
A
Metspalu
Kristian
K
Midthjell
Madeleine J
MJ
Murtagh
Annette
A
Peters
Peter P
PP
Pramstaller
Timo
T
Saaristo
Veikko
V
Salomaa
Ronald P
RP
Stolk
Matti
M
Uusitupa
Pim
P
van der Harst
Melanie M
MM
van der Klauw
Melanie
M
Waldenberger
Markus
M
Perola
Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P,O, Box 30001, Groningen RB 9700, The Netherlands. bwo@umcg.nl.
Bruce Hr
BH
Wolffenbuttel