title: "Metabolically healthy" obesity: Prevalence, clinical features and association with myocardial ischaemia.
abstract: To evaluate the prevalence of the "metabolically healthy" (MH) or "metabolically unhealthy" (MU) obesity phenotypes and their association with cardiorespiratory fitness and inducible myocardial ischaemia.
  
  
  
  Individuals without known coronary artery disease undergoing myocardial perfusion single-photon emission computed tomography (MPS) were studied. Those without dyslipidemia, hypertension, or diabetes were considered MH, and when ≥1 of these was present, MU status was considered present. Summed stress and difference perfusion scores (SSS and SDS, respectively) were calculated; a SDS >1 defined ischaemic MPS.
  
  
  
  MH patients were 35.0% of the nonobese population and 23.5% of the obese (p<0.001). The prevalence of ischaemia was not significantly different between MH patients with obesity or MH patients without obesity (10.9% vs 9.1%, p=0.3), except for patients with body mass index ≥40kg/m2(21.9%). MH obese patients were less frequently able to exercise and had lower exercise capacity than the nonobese patients.
  
  
  
  The prevalence of myocardial ischaemia was not significantly different between MH obese or nonobese individuals, supporting the concept of the "metabolically healthy obesity". However, there are other factors involved, such as the ability to exercise, that influence the risk of myocardial ischaemia, limiting the "safety" of that obesity phenotype.
authors.affiliation: Clinica de Diagnostico por Imagem, Av. Ataulfo de Paiva 669, Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowsky s/n, Rio de Janeiro, RJ, Brazil. Electronic address: andlorenzo@hotmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Lorenzo
authors.affiliation: Universidade Federal do Rio de Janeiro.
authors.forename: Leticia
authors.initials: L
authors.lastname: Glerian
authors.affiliation: Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowsky s/n, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Amaral
authors.affiliation: Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowsky s/n, Rio de Janeiro, RJ, Brazil.
authors.forename: Thiago B
authors.initials: TB
authors.lastname: Reis
authors.affiliation: Clinica de Diagnostico por Imagem, Av. Ataulfo de Paiva 669, Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowsky s/n, Rio de Janeiro, RJ, Brazil.
authors.forename: Ronaldo S L
authors.initials: RSL
authors.lastname: Lima
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D000067329:Obesity, Metabolically Benign / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D010641:Phenotype; D015995:Prevalence; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Coronary artery disease; Myocardial perfusion SPECT; Obesity; Obesity phenotypes