title: Predictors of incident obesity phenotype in nonobese healthy adults.
abstract: BACKGROUND
  Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy obesity (MUHO). This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study.
  
  
  METHODS
  Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, nonobese, otherwise healthy individuals, aged > 20 years (n = 3489) were recruited and followed up for a median of 13·4 years.
  
  
  RESULTS
  At the follow-up, MHO incidence rate in obese individuals was 36·6%. Comparing MHO vs. MUHO, female gender [odds ratio (OR) = 3·28, 95% confidence interval (CI) 1·27, 8·46)], increased body mass index (BMI; OR = 1·32, 95% CI: 1·12, 1·60) and elevated high-density lipoprotein cholesterol (HDL-C) levels (OR = 1·04, 95% CI: 1·02, 1·07) were related to higher odds of incident MHO, while older age (OR = 0·95, 95% CI: 0·92, 0·98), increased waist circumference (WC; OR = 0·86, 95% CI: 0·81, 0·91), higher WC gain (OR = 0·91, 95% CI: 0·87, 0·95) and increased diastolic blood pressure (DBP; OR = 0·94, 95% CI: 0·91, 0·98) prevented progression towards MHO.
  
  
  CONCLUSIONS
  While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy nonobese individuals.
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Anita
authors.identifier: http://orcid.org/0000-0001-7237-5141
authors.initials: A
authors.lastname: Eftekharzadeh
authors.affiliation: Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Golaleh
authors.initials: G
authors.lastname: Asghari
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Serahati
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Hosseinpanah
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Azizi
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Barzin
authors.affiliation: Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Mirmiran
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D000067329:Obesity, Metabolically Benign / Q000097:blood / Q000453:epidemiology*; D016017:Odds Ratio; D010641:Phenotype; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL
keywords: Metabolically healthy obesity; Tehran Lipid and Glucose Study; metabolically unhealthy obesity; obesity phenotypes; predictors