High CVD burden for ‘metabolically benign’ overweight/obese women
MedWire News: US researchers say women with metabolically benign overweight/obesity have a greater burden for subclinical cardiovascular disease (CVD) than those who are of normal weight.
The team reports that metabolically benign overweight/obese women have significantly higher carotid artery intima media thickness (cIMT) and aortic pulse wave velocity (PWV), and a greater prevalence of coronary (CAC) and aortic (AC) calcification than normal-weight women.
This differs from findings of previous studies, which indicated a similar CVD risk for both groups.
As reported in the journal Atherosclerosis, Rachel Wildman (Albert Einstein College of Medicine, New York) and team compared measures of cIMT, aortic PWV, CAC, and AC in 475 female participants of the Study of Women's Health Across the Nation (SWAN), who were aged between 45 and 58 years.
Women were categorized as normal weight (body mass index [BMI] <25 kg/m2) or overweight/obese (BMI ≥25 kg/m2), and then assigned to one of three cardiometabolic risk groups: metabolically benign overweight/obese (<3 of the five metabolic syndrome components or elevated C-reactive protein [CRP ≥3.0 mg/dl]), at-risk overweight/obese (≥3 metabolic syndrome components/elevated CRP), or healthy normal weight.
In total, 55% of the cohort were classed as metabolically benign overweight/obese, 15% were in the at-risk overweight group, and 31% were in the normal-weight group.
Metabolically benign overweight/obese women had significantly higher median cIMT (0.67 vs 0.64 mm) and aortic PWV (796.7 vs 734.8 cm/sec) measures than normal-weight women, and a greater prevalence of CAC (22% vs 9%) and AC (53% vs 34%), and these differences remained significant after multivariable adjustment.
Overall, at-risk overweight/obese women had the highest measures of cIMT and aortic PWV, and the greatest prevalence of CAC and AC of the three groups, at 0.72 mm, 944.6 cm/sec, 43% and 85%, respectively.
Commenting on their findings, Wildman et al conclude that compared with healthy normal-weight individuals, metabolically benign overweight/obese women have an enhanced risk for developing CVD, but appear to develop overt disease more slowly than their at-risk counterparts.
They add: "Whether the presence of subclinical disease among individuals with the metabolically benign overweight/obese phenotype leads to an actual increase in risk of clinical endpoints over extended follow-up remains unclear, and will require additional prospective studies."
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By Nikki Withers