Metabolic syndrome in healthy obese, overweight, and normal weight individuals: The atherosclerosis risk in communities study
Bradshaw,P.T., Monda,K.L. and Stevens (2013)J Obesity (Silver Spring) 21:203-209
Objective: To evaluate factors associated with subgroups of body size defined by MetS, and to examine the course of the metabolically healthy subgroups, including factors associated with its transition.
Design: Cross-sectional (baseline) and prospective (9 y).
Setting: US - data from the Atherosclerosis Risk in Communities (ARIC) Study.
Participants: 14663 men and women aged 45 - 64 y, with adequate information to define or preclude a classification of MeTs as defined by the National Cholesterol Program's Adult Treatment Panel-III guidelines.
Main outcome measures: Blood pressure, anthropometric measures and fasting blood samples. Diet via FFQ and PA by questionnaire. Various other covariates ascertained by interview (e.g. age, gender, education level, smoking status, alcohol use, total energy intake, weight change).
Results: At baseline, MeTs was most prevalent in the obese (60% of obese). Odds ratios for MeTs by BMI category revealed MeTs to be more common in older individuals, and those who currently smoked regardless of BMI. Other associations varied by BMI category.
In those who were healthy at baseline and followed for 9 y, the hazard ratios for development of Mets was greatest in overweight (2.73, 95%CI 2.49, 2.99) and obese (4.53, 95%CI 4.09, 5.01) vs. normal BMI. Other than BMI category, examination of HRs by BMI category revealed the greatest risk was for normal weight subjects who gained >5% weight (1.61, 95%CI 1.28, 2.02) with greatest reduced risk for normal weight subjects who were college educated (0.65, 95%CI 0.53, 0.81).
Conclusions: Lifestyle factors may play a stronger role in the development of MeTs in normal weight individuals compared with obese. Metabolically healthy obesity may not be a stable condition.
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