Relations of Metabolically Healthy and Unhealthy Obesity to Digital Vascular Function in Three Community-Based Cohorts: A Meta-Analysis.

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diabetes mellitus 6 endocrinologydiseases
metabolic syndrome 3 endocrinologydiseases
obesity 23 endocrinologydiseases

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diabetes mellitus 5466 associations of impaired PAT responses to be with male sex and metabolic risk factors, such as obesity, diabetes mellitus , and dyslipidemia.11, 12, 13By using meta‐analysis of aggregate data from 3 large cohort studies,
diabetes mellitus 7080 cohort of 15 105 civil servants designed to investigate the determinants of cardiovascular diseases and diabetes mellitus .16 Eligibility criteria included active or retired employees of 5 universities and 1 research center,
diabetes mellitus 11159 covariate definitions. As in the GHS, the period of fasting before assessing blood glucose was variable, diabetes mellitus was defined as individuals with self‐reported diabetes mellitus or treated with a hypoglycemic agent,
diabetes mellitus 11225 assessing blood glucose was variable, diabetes mellitus was defined as individuals with self‐reported diabetes mellitus or treated with a hypoglycemic agent, or who had a fasting blood glucose ≥126 mg/dL if fasting more
diabetes mellitus 15200 across cohorts. The mean glucose was higher in ELSA‐Brasil, contributing to a higher prevalence of diabetes mellitus when compared to GHS and FHS. In FHS, there was a higher proportion of participants using lipid‐lowering
diabetes mellitus 17687 vascular measures. Male sex, prevalent cardiovascular disease, and metabolic risk factors (prevalent diabetes mellitus , and higher mean BMI, glucose, triglycerides, and total/HDL cholesterol) were significantly associated
metabolic syndrome 2781 or obese by body mass index (BMI) and stratified by healthy or unhealthy metabolic status based on metabolic syndrome using the ATP‐III criteria. Male sex, BMI, and metabolic risk factors were associated with higher
metabolic syndrome 12412 was diagnosed in the presence of any 3 of the following traits, based on the ATP III criteria for metabolic syndrome 21: abdominal obesity, defined as a waist circumference in men ≥102 cm (40 in) and in women ≥88 cm
metabolic syndrome 13088 <6 hours, participants could not be classified if glucose ≥100 mg/dL and none of the other criteria for metabolic syndrome were satisfied.Statistical AnalysisDichotomous variables are expressed as frequencies and continuous
obesity 2163 impaired microvascular function remains unclear. The aim of this study was to evaluate the relation of obesity phenotypes stratified by metabolic status to microvascular function.Methods and ResultsWe meta‐analyzed
obesity 3019 amplitude and lower PAT ratio. There was stepwise impairment of vascular measures from normal weight to obesity in both metabolic status strata. Metabolically healthy obese individuals had more impaired vascular
obesity 3748 impairment is less marked than in metabolically unhealthy obese individuals. Our findings suggest that obesity is detrimental to vascular health irrespective of metabolic status.(J Am Heart Assoc. 2017;6:e004199.
obesity 4095 mostly due to cardiovascular disease.1, 2 According to the World Health Organization, the prevalence of obesity has increased more than 100% worldwide since 1980, and the number of obese individuals in 2014 has been
obesity 4250 1980, and the number of obese individuals in 2014 has been estimated to be about 600 million, making obesity a healthcare public health problem worldwide.3 Previous works have shown that obese persons without
obesity 4497 metabolically healthy obese, account for around 10% to 51% of obese individuals.4 Whether metabolically healthy obesity is a benign condition in terms of cardiovascular risk is still a matter of controversy.5, 6Endothelial
obesity 5457 strongest associations of impaired PAT responses to be with male sex and metabolic risk factors, such as obesity , diabetes mellitus, and dyslipidemia.11, 12, 13By using meta‐analysis of aggregate data from 3 large
obesity 5711 relation of body mass index (BMI) to microvascular function, studying individuals stratified by their obesity status and metabolic phenotype. We hypothesized that metabolically healthy obesity has more impaired
obesity 5794 stratified by their obesity status and metabolic phenotype. We hypothesized that metabolically healthy obesity has more impaired microvascular function than normal‐weight metabolically healthy individuals.Subjects
obesity 12444 of any 3 of the following traits, based on the ATP III criteria for metabolic syndrome21: abdominal obesity , defined as a waist circumference in men ≥102 cm (40 in) and in women ≥88 cm (35 in.); triglycerides
obesity 21320 Study; GHS, Gutenberg Heart Study; PAT, peripheral arterial tonometry.As shown in Table 2, increasing obesity was associated with more impaired vascular function in both metabolically healthy and metabolically
obesity 21567 the metabolically unhealthy participants had greater impairment of vascular function at each level of obesity .Figure 2 displays the greater degree of vascular abnormality associated with both greater obesity and
obesity 21666 obesity.Figure 2 displays the greater degree of vascular abnormality associated with both greater obesity and with metabolically unhealthy status as compared to the normal‐weight metabolically healthy individuals.Figure
obesity 22415 cohorts of geographically diverse background, we confirmed the associations of impaired PAT measures with obesity and metabolic risk factors. In obese individuals with a metabolically healthy profile, we observed impairment
obesity 23823 measures and advancing age was not correlated to PAT ratio. These findings confirm the associations of obesity and metabolic risk factors with small vessel dysfunction across multiple cohorts.12, 20Obesity, Metabolic
obesity 24801 dysfunction, is associated with heightened cardiovascular mortality.24The relation of metabolically healthy obesity to vascular function has been previously evaluated in a community‐based setting in 1016 participants
obesity 25682 unhealthy obese subjects.27Our results add information to the controversy of whether metabolically healthy obesity is benign in terms of cardiovascular disease. We found that, in a large sample of geographically diverse
obesity 26425 cardiovascular system at an early stage of vascular injury. Moreover, the vascular dysfunction that results from obesity may contribute to the development of metabolic disturbances.9The mechanisms by which higher weight leads
obesity 27976 important to emphasize 2 other findings of our study. First, even though studying the metabolically healthy obesity is important to better understand the complex interaction between the adipose tissue and the cardiovascular
obesity 28459 disturbances, and thus are in the subgroup of greater cardiovascular risk, emphasizing the burden of obesity . Secondly, PAT measures of overweight individuals are intermediate between normal‐weight and obese
obesity 32241 to refine cardiovascular risk prediction in obese individuals. Reversal of vascular dysfunction in obesity may be possible with both weight loss and treatments directed at metabolic risk factors. Furthermore,
obesity 32451 treatments targeted at the endothelium may protect the vasculature from the adverse consequences of obesity and metabolic dysfunction. It may be that vascular function assessment has potential to risk stratify
obesity 33330 to vascular health irrespective of metabolic status, challenging the concept of a healthy pattern of obesity .Sources of FundingThe ELSA‐Brasil baseline study was supported by the Brazilian Ministries of Health

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