title: Cardiovascular risk in different obesity phenotypes over a decade follow-up: Tehran Lipid and Glucose Study.
abstract: Considering the inconsistent data available on cardiovascular (CV) risk of different obesity phenotypes, the aim of this study was to investigate the development of cardiovascular disease (CVD) in different obesity phenotypes over a median follow-up of 12 years.
  
  
  
  In this large population-based cohort, 7842 participants (44.8% men), aged ≥ 30 years, were enrolled. Participants were divided into six phenotypes based on body mass index and metabolic status. Metabolic health was defined based on two definitions: 1) having ≤1 component of metabolic syndrome using the Joint Interim Statement (JIS) criteria and 2) homeostasis model assessment-insulin resistance (HOMA-IR) < 2.6 mole × μU/L2. Multivariate adjusted hazard ratios (HRs) were calculated for cardiovascular events.
  
  
  
  A total of 712 new CVD events occurred. CV risk increased in all metabolically unhealthy phenotypes. Multivariable adjusted HRs for CVD events in metabolically healthy overweight (MHOW) and metabolically healthy obese (MHO) participants were 1.22 (0.73-2.04) and 1.74 (0.68-4.44), respectively. CV risk increased in all obesity phenotypes based on insulin resistance except the insulin resistance-normal weight group. However, this increased risk disappeared after further adjustment for metabolic risk factors.
  
  
  
  Our findings showed that CV risk did not increase in MHOW and MHO phenotypes over a 12-year follow-up. However, all metabolically unhealthy phenotypes were associated with increased incident CVD. Further studies with longer follow-up are needed to confirm the benign nature of MHOW/MHO phenotypes.
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Bita
authors.initials: B
authors.lastname: Mirzaei
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Hengameh
authors.initials: H
authors.lastname: Abdi
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Serahati
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Barzin
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Mahtab
authors.initials: M
authors.lastname: Niroomand
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran. Electronic address: fhospanah@endocrine.ac.ir.
authors.forename: Farhad
authors.initials: F
authors.lastname: Hosseinpanah
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D007492:Iran / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D000067329:Obesity, Metabolically Benign / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D010641:Phenotype; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids