Funding agencies: The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN) Study was financially supported by the Dutch Ministry of Public Health, Welfare and Sports (VWS), the National Institute for Public Health and the Environment and the Europe against Cancer Program of the European Union.
All-cause mortality risk of metabolically healthy abdominal obese individuals: The EPIC-MORGEN study
Article first published online: 5 JUL 2013
Copyright © 2013 The Obesity Society
Volume 22, Issue 2, pages 557–564, February 2014
How to Cite
van der A, D. L., Nooyens, A. C.J., van Duijnhoven, F. J.B., Verschuren, M. M.W. and Boer, J. M.A. (2014), All-cause mortality risk of metabolically healthy abdominal obese individuals: The EPIC-MORGEN study. Obesity, 22: 557–564. doi: 10.1002/oby.20480
Disclosure: The authors declared no conflict of interest.
Author contributions: The author' contributions were as follows: DLvdA and JMAB conceived and designed the research. DLvdA and ACJN performed the statistical analyses. DLvdA, ACJN and JMAB wrote the manuscript. FJBvD and WMMV contributed to the interpretation of the data and critically reviewed the manuscript. All authors read and approved the final manuscript.
- Issue published online: 3 FEB 2014
- Article first published online: 5 JUL 2013
- Accepted manuscript online: 17 APR 2013 01:05PM EST
- Manuscript Accepted: 19 MAR 2013
- Manuscript Received: 8 OCT 2012
It appears that a certain proportion of obese individuals have a normal metabolic profile despite having excess weight. Whether these so-called “metabolically healthy” obese express lower disease and mortality risks than “metabolically unhealthy” obese is still unclear. The mortality risk of “metabolically healthy” abdominal obese (MHAO) individuals was investigated.
Design and Methods
Prospective cohort study (EPIC-MORGEN) among 22,654 individuals aged 20-59 years followed for an average of 13.4 years (SD 2.3). MHAO was assessed at baseline (1993-1997) and defined as abdominal obesity (waist circumference ≥102 cm/≥88 cm (men/women)) with normal glucose, blood pressure, and plasma lipids. All-cause mortality risks adjusted for age and sex were estimated using Cox proportional hazards models.
Individuals who were “metabolically healthy” nonabdominal obese (MHNAO) comprised the reference group. As compared to MHNAO, mortality risk for MHAO was around 40% higher (Hazard ratio (HR) 1.43; 95% confidence interval (CI): 1.00-2.04) and of the same magnitude as that for “metabolically unhealthy” nonabdominal obese (MUNAO) (HR 1.31; 95% CI: 1.08-1.59). The HR for MUAO was 1.99 (95% CI: 1.62-2.43).
Mortality risk of MHAO individuals was significantly higher than that of MHNAO individuals and lower than, but not statistically significantly different from, that of MUAO individuals.