title: Metabolically Healthy Obesity and Carotid Intima-Media Thickness: Effects of Cardiorespiratory Fitness.
abstract: OBJECTIVE
  To test the hypothesis that cardiorespiratory fitness modifies the association between metabolically healthy obesity (MHO) phenotype and carotid intima-media thickness.
  
  
  METHODS
  We evaluated 3838 men (mean age, 51 ± 6 years) who participated in the general health examination program at Samsung Medical Center, Seoul, South Korea, between January 2, 2008, and December 31, 2008. Participants were divided into 4 groups on the basis of body habitus and metabolic health status using the Asia-Pacific criteria. On the basis of Asian criteria, MHO was defined as body mass index greater than or equal to 25 kg/m(2) with less than 3 metabolic abnormalities. Cardiorespiratory fitness (fitness) was directly measured by using peak oxygen uptake and divided into unfit (lower tertile of fitness) and fit (middle and upper tertiles of fitness) categories on the basis of age-specific peak oxygen uptake percentiles. The prevalence of subclinical carotid atherosclerosis was defined as a mean carotid intima-media thickness greater than the 75th percentile.
  
  
  RESULTS
  Compared with metabolically healthy normal weight (MHNW), MHO was associated with a higher prevalence of subclinical carotid atherosclerosis (odds ratio, 1.39; 95% CI, 1.12-1.72) after adjusting for potential confounding variables. Using multivariate logistic regression analysis, we found that the MHO unfit group had 2.00 times (95% CI, 1.48-2.73) and the metabolically unhealthy obesity unfit group had 1.84 times (95% CI, 1.26-2.67) higher risk of subclinical carotid atherosclerosis as compared with the MHNW fit group (reference group). However, MHO fit (OR, 1.25; 95% CI, 0.97-1.62) and metabolically unhealthy obesity fit (OR, 1.31; 95% CI, 0.90-1.92) groups had odds ratios for subclinical carotid atherosclerosis similar to those of the MHNW fit group.
  
  
  CONCLUSIONS
  Metabolically healthy obesity was associated with a higher prevalence of subclinical carotid atherosclerosis, but this association was attenuated by increasing levels of cardiorespiratory fitness.
authors.affiliation: Department of Sport Science, University of Seoul, Seoul, South Korea. Electronic address: syjae@uos.ac.kr.
authors.forename: Sae Young
authors.initials: SY
authors.lastname: Jae
authors.affiliation: Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI.
authors.forename: Barry
authors.initials: B
authors.lastname: Franklin
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago.
authors.forename: Bo
authors.initials: B
authors.lastname: Fernhall
mesh_terms: D000328:Adult; D001161:Arteriosclerosis / Q000175:diagnosis* / Q000453:epidemiology; D044466:Asian People / Q000706:statistics & numerical data; D002339:Carotid Arteries / Q000473:pathology*; D005080:Exercise Test; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000473:pathology; D010809:Physical Fitness; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*