Transition of Metabolic Health Status and the Risk of Cardiovascular Diseases in a Japanese Population: the Hisayama Study

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  • Higashioka Mayu
    Department of Diabetes and Molecular Genetics, Graduate School of Medicine, Ehime University
  • Sakata Satoko
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Oishi Emi
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Honda Takanori
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Shibata Mao
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Hata Jun
    Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University
  • Kitazono Takanari
    Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Osawa Haruhiko
    Department of Diabetes and Molecular Genetics, Graduate School of Medicine, Ehime University
  • Ninomiya Toshiharu
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University

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<p> Aims: To investigate the association between metabolic health status, defined by the combination of metabolic syndrome (MetS) and obesity, and cardiovascular disease (CVD) in a Japanese community.</p><p>Methods: A total of 2,842 participants without prior CVD, aged 40 years or older, were followed up from 2007 until 2017. Participants were classified into 4 metabolic health statuses based on the presence of obesity (body mass index ≥ 25 kg/m2) and MetS: metabolically healthy normal weight (MHN) (obesity [-] and MetS [-]), metabolically unhealthy normal weight (MUN) (obesity [-] and MetS [+]), metabolically healthy obesity (MHO) (obesity [+] and MetS [-]), and metabolically unhealthy obesity (MUO) (obesity [+] and MetS [+]). The risk estimates were computed by using a Cox hazard regression analysis.</p><p> Results: During the follow-up period, 190 participants developed CVD. The MUO group had a 1.94-times greater risk of developing CVD than the MHN group after adjusting for confounders, but no excess risk was observed in the MHO group. Moreover, in 1,595 participants who had undergone a health checkup in 2002, 5 years before baseline, the risk of developing CVD was 2.18-times greater in the group that transitioned from MHO to MUO and 1.75-times higher in the stable MUO group than in the stable MHN group, but was not higher in the stable MHO group.</p><p>Conclusions: The present findings suggest that cardiovascular risk increases when metabolic abnormalities are present simultaneously with obesity. In individuals with obesity, it may be important to maintain metabolic health and/or lose weight to prevent CVD.</p>

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