The Relationship between Metabolically Healthy Obesity and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Methods
2.1. Definition of Metabolic Health and Outcomes
2.2. Data Sources and Search Strategy
2.3. Study Selection and Methodological Quality Assessment
2.4. Data Extraction
2.5. Statistical Analyses
3. Results
3.1. Description of Studies and Quality Assessment
3.2. Results of the Meta-Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Risk of Cardiovascular Disease | All-Cause Mortality | |||||||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | p Value for between-Group Differences | I2 (%) | Number of Studies | OR (95% CI) | p Value for between-Group Differences | I2 (%) | Number of Studies | |
Overall | 1.52 (1.38; 1.66) | 61 | 35 | 1.23 (1.05; 1.43) | 62 | 20 | ||
Subgroups | ||||||||
Definitions of metabolic health | 0.17 | 0.32 | ||||||
Modified ATP-III | 1.43 (1.10; 1.85) | 63 | 11 | 1.29 (1.00; 1.66) | 0 | 5 | ||
Modified IDF | 1.30 (1.06; 1.60) | 53 | 5 | NA | NA | NA | ||
Insulin resistance | 1.72 (1.30; 2.26) | 0 | 5 | 1.56 (1.19; 2.05) | 12 | 5 | ||
Modified JIS | 1.45 (1.23; 1.72) | 19 | 5 | 1.12 (0.78; 1.62) | 77 | 4 | ||
Others | 1.79 (1.49; 2.16) | 77 | 9 | 1.10 (0.81; 1.49) | 76 | 6 | ||
Definitions of obesity | 0.83 | 0.27 | ||||||
Body mass index | 1.52 (1.38; 1.67) | 62 | 34 | 1.20 (1.02; 1.43) | 64 | 18 | ||
Waist circumference | 1.40 (0.65; 2.98) | NA | 1 | 1.45 (1.09; 1.94) | 0 | 2 | ||
Different outcomes | 0.14 | |||||||
Coronary heart disease/myocardial infarction | 1.39 (1.17; 1.65) | 49 | 7 | |||||
CVD mortality | 1.64 (1.12; 2.39) | 0 | 5 | |||||
Fatal and nonfatal CVD | 1.57 (1.40; 1.77) | 68 | 22 | |||||
Heart failure | 0.41 (0.11; 1.48) | NA | 1 |
Risk of Cardiovascular Disease | ||||||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | |||||||
Unadjusted OR (95% CI) | p Value | I2 (%) | R2 (%) | Adjusted OR (95% CI) | p Value | I2 (%) | R2 (%) | |
Sex | ||||||||
Men | 1 (Reference) | NA | 1 (Reference) | NA | ||||
Women | 0.77 (0.50; 1.19) | 0.23 | 59.3 | 0 | 0.65 (0.46; 0.90) | 0.014 | 59.3 | 0 |
Age, per year increase | 0.99 (0.97; 1.00) | 0.06 | 60.6 | 1.6 | 0.98 (0.97; 1.00) | 0.030 | 39.1 1 | 28.5 1 |
Smoke status | ||||||||
Nonsmoker | 1 (Reference) | NA | 1 (Reference) | NA | ||||
Smoker | 1.00 (0.99; 1.01) | 0.94 | 65.5 | 0 | 1.01 (1.00; 1.02) | 0.17 | 0 2 | 99.99 2 |
Follow-up duration, per year increase | 1.01 (0.99; 1.03) | 0.43 | 64.5 | 2.2 | 1.00 (0.97; 1.02) | 0.69 | 41.1 3 | 18.1 3 |
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Yeh, T.-L.; Chen, H.-H.; Tsai, S.-Y.; Lin, C.-Y.; Liu, S.-J.; Chien, K.-L. The Relationship between Metabolically Healthy Obesity and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis. J. Clin. Med. 2019, 8, 1228. https://doi.org/10.3390/jcm8081228
Yeh T-L, Chen H-H, Tsai S-Y, Lin C-Y, Liu S-J, Chien K-L. The Relationship between Metabolically Healthy Obesity and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2019; 8(8):1228. https://doi.org/10.3390/jcm8081228
Chicago/Turabian StyleYeh, Tzu-Lin, Hsin-Hao Chen, Szu-Ying Tsai, Chien-Yu Lin, Shu-Jung Liu, and Kuo-Liong Chien. 2019. "The Relationship between Metabolically Healthy Obesity and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 8, no. 8: 1228. https://doi.org/10.3390/jcm8081228