Metabolically Healthy Obesity and Risk of All-Cause and Cardiovascular Disease Mortality

We examined the association between metabolically healthy obesity and risk of cardiovascular disease (CVD) and all-cause mortality. DESIGN AND SETTING: This was an observational study with prospective linkage to mortality records in community-dwelling adults from the general population in Scotland and England.

A total of 22,203 men and women [aged 54.1 (SD 12.7 yr), 45.2% men] without known history of CVD at baseline. INTERVENTIONS: Based on blood pressure, high-density lipoprotein-cholesterol, diabetes diagnosis, waist circumference, and low-grade inflammation (C-reactive protein ≥ 3 mg/liter), participants were classified as metabolically healthy (0 or 1 metabolic abnormality) or unhealthy (two or more metabolic abnormalities). Obesity was defined as a body mass index of 30 kg/m(2) or greater. MAIN OUTCOME MEASURE: Study members were followed up, on average, more than 7.0 ± 3.0 yr for cause-specific mortality. Cox proportional hazards models were used to examine the association of metabolic health/obesity categories with mortality.