Dataset Information

The effect of metabolic health and obesity phenotypes on risk of hypertension: A nationwide population-based study using 5 representative definitions of metabolic health.

ABSTRACT: Although obesity is clearly identified as a risk factor for hypertension, the association between its different metabolic phenotypes and hypertension remains unclear. We aimed to investigate this association and compare the degree of association between metabolic health and obesity phenotypes defined by 5 representative criteria and hypertension risk.This study used data from the China Health and Nutrition Survey 2009 wave, and the final analysis included 7632 subjects aged 18 to 85 years with available fasting blood samples and anthropometric measurements. Body mass index was used to define nonobese and obese status in subjects (cut-off value, 25?kg/m), and metabolic health state was respectively defined by 5 published criteria: the Adult Treatment Panel (ATP)-III, the Wildman, the Karelis, the homeostasis model assessment (HOMA), and the fasting blood glucose × triglyceride (TyG) criteria. Subjects were categorized into 4 phenotypes according to their metabolic health and obesity status: metabolically healthy nonobese (MHNO), metabolically unhealthy nonobese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO).A total of 2171 subjects (28.4% of the study population) had hypertension, and hypertension prevalence was significantly increased as weight increased for both metabolically healthy and metabolically unhealthy subjects. Within the MHO phenotypes, the prevalence ranged from 22.7% to 38.6% according to the Wildman and HOMA criteria, respectively. Compared to the MHNO phenotype, the MHO phenotype had an increased risk of hypertension, and the adjusted odds ratios for hypertension in MHO subjects were 1.94 (95% confidence interval 1.60-2.35) using the ATP-III criteria, 1.98 (1.61-2.43) using the Wildman criteria, 2.37 (1.88-2.99) using the Karelis criteria, 2.26 (1.96-2.61) using the HOMA criteria, and 2.54 (2.14-3.00) using the TyG criteria, respectively. A similar significant pattern was found in the MUO and MUNO phenotypes for risk of hypertension. Furthermore, the MUO phenotype consistently revealed the strongest degree of association with hypertension, following by the MHO and the MUNO phenotype.Both metabolically unhealthy status and obese status contributed to a higher risk of hypertension in Chinese adults. The MHO phenotype was not a benign condition and had substantial risk of hypertension compared to the MHNO phenotype. Thus, metabolic health status and obesity should be monitored together when managing hypertension risk.

SUBMITTER: Tian S

PROVIDER: S-EPMC6160160 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The effect of metabolic health and obesity phenotypes on risk of hypertension: A nationwide population-based study using 5 representative definitions of metabolic health.

Tian Simiao S Xu Yang Y Dong Huimin H

Medicine 20180901 38

Although obesity is clearly identified as a risk factor for hypertension, the association between its different metabolic phenotypes and hypertension remains unclear. We aimed to investigate this association and compare the degree of association between metabolic health and obesity phenotypes defined by 5 representative criteria and hypertension risk.This study used data from the China Health and Nutrition Survey 2009 wave, and the final analysis included 7632 subjects aged 18 to 85 years with a ...[more]

PMID: 30235720

Similar Datasets

Project description:BackgroundThe association between metabolic syndrome and increased cardiovascular disease (CVD) risk is well-established. However, in patients with incident CVD, the relationship between obesity, metabolic health, and subsequent CVD and mortality outcomes are less well-established. This study investigated the association between body mass index (BMI), metabolic health and the risk of subsequent cardiovascular mortality and morbidity outcomes in patients with incident CVD events.MethodsThis cohort study identified 130 685 patients from the nationwide Clinical Practice Research Datalink (CPRD GOLD) and Hospital Episode Statistics (HES) databases in the United Kingdom. Patients were ≥18 years with incident CVD [coronary heart disease (CHD), stroke, or peripheral vascular disease (PVD)] between 1 January 1998 and 31 December 2017. BMI (in kg/m2 ) was categorized as underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obese (≥30). Within each BMI category, patients were grouped by increasing count of 1, 2 or 3 metabolic risk factors [RF] (dyslipidaemia, diabetes mellitus and hypertension) and were regarded as metabolically unhealthy while absence of these factors was considered metabolically healthy (MH). Multivariable Cox regression was used to assess the risk (hazard ratio with 95% confidence interval) of subsequent outcomes (non-fatal CHD, stroke, PVD, incident heart failure, CVD-mortality and all-cause mortality) in BMI subgroups with incremental count of metabolic RFs.ResultsDuring a median follow-up of 13.0 years, a higher BMI was associated with reduced risk for stroke, PVD, CVD-mortality and all-cause mortality within each metabolic risk category, while increasing metabolic RFs within each BMI subgroup accounted for increasing risks. When compared with patients with normal BMI and no RF, CVD-mortality risk in overweight patients with no RF was 0.76 (0.70-0.84), and in obese patients with no RF was 0.85 (0.76-0.96). The respective risk for all-cause mortality in patients with overweight and no RF was 0.69 (0.65-0.72), and in obese patients with no RF was 0.75 (0.70-0.79). Subsequent outcomes of stroke and PVD showed similar trends. In contrast, the risk of subsequent non-fatal CHD events and incident HF increased with higher BMI and with incremental metabolic risk factors within each BMI category. Underweight was constantly associated with increased risk for all outcomes regardless of the presence of metabolic RFs except for non-fatal CHD events.ConclusionsIn patients with incident CVD, overweight and obesity were related to a more favourable prognosis for subsequent stroke, PVD and mortality (CVD-related and all-cause) irrespective of the presence of other metabolic risk factors.

Project description:BackgroundWe aimed to investigate the hazard of hospitalization for heart failure (hHF) according to the transitions in metabolic health and obesity status.MethodsThe Korean National Health Insurance Service datasets from 2002 to 2017 were used for this nationwide, longitudinal, population-based study. The hazard of hHF was analyzed according to the eight groups stratified by stability in metabolic health and transition in obesity status among initially metabolically healthy adults who underwent two cycles of health examinations in 2009-2010 and 2013-2014 (N = 7,148,763).ResultsDuring two examinations, 48.43% of the initially metabolically healthy obese (MHO) individuals and 20.94% of the initially metabolically healthy non-obese (MHNO) individuals showed changes in their metabolic health and obesity status. During a mean follow-up of 3.70 years, 3151 individuals were hospitalized for HF. When stable MHNO individuals were set as the reference, transition to metabolically unhealthy phenotype was associated with an increased hazard of hHF; the hazard ratio (HR) and 95% confidence interval (CI) in the individuals who transformed from MHO to metabolically unhealthy non-obese was 2.033 (1.579-2.616). The constant MHO group had a 17.3% increased hazard of hHF compared with the stable MHNO group [HR (95% CI) 1.173 (1.039-1.325)]. Individuals who shifted from MHO to MHNO showed a 34.3% lower hazard of hHF compared with those who maintained the MHO category [HR (95% CI) 0.657 (0.508-0.849)].ConclusionDynamic changes in metabolic health and obesity status were observed during a relatively short interval of 3-5 years. Loss of metabolic health was significantly associated with an increased hazard of hHF. Even if metabolic health was maintained, persistent obesity remained as a risk factor for hHF, and transition from MHO to MHNO had a protective effect against hHF. Therefore, the prevention and control of obesity while maintaining metabolic health would be crucial in preventing hHF.

Project description:BackgroundThe association between reproductive lifespan and risk of hypertension among postmenopausal women is unclear.MethodsA total of 94,141 postmenopausal women with a mean age of 64.8 years from the China Hypertension Survey were enrolled at baseline from 2012 to 2015. A standardized questionnaire was used to collect relevant information by well-trained interviewers. Blood pressure and physical examination of the participants were performed by trained medical staff. Logistic regression was used to estimate the odds ratios for hypertension by years of reproductive lifespan.ResultsThe average years of reproductive lifespan in Chinese women was 34.0 years. Women who were longer in reproductive lifespan were more likely to have older age at recruitment, higher body mass index, larger waist circumference, lower mean systolic blood pressure, and higher mean diastolic blood pressure (p < 0.05). After adjustments, odds ratios (95% confidence interval) for hypertension were 1.035 (0.988-1.085), 1.007 (0.966-1.048), 1.000 (reference), 0.932 (0.899-0.967), and 0.953 (0.909-0.997) for those with reproductive lifespan at ≤ 28, 29-31, 32-34 (reference), 35-37, and ≥ 38 years, respectively, with a significantly inverse association was seen in those with reproductive lifespan at 35-37 and ≥ 38 years. The overall risk of hypertension declined with the increase in reproductive lifespan, and the risk of hypertension was reduced by 1.1% for every 1-year increase in the reproductive lifespan (odds ratio, 0.989; 95% confidence interval, 0985-0.994) per year. The negative association between reproductive lifespan and hypertension was evident among age at recruitment groups, body mass index categories, and education levels, with the strongest association among women aged ≥ 70 years. Positive associations between reproductive lifespan and risk of hypertension were evident among women aged < 60 years, and this association was stronger among current alcohol drinkers.ConclusionBased on the large nationally representative sample, Chinese postmenopausal women with a shorter reproductive lifespan have a higher risk of hypertension.

Project description:PurposeSerum uric acid (UA) not only affects the development of obesity but also alters the metabolic status in obese subjects; thus we investigated the relationship between serum UA and the overweight/obese metabolic phenotypes.MethodsThe demographic, biochemical, and hematological data were collected for 12,876 patients undergoing routine physical examination, and 6,912 participants were enrolled in our study. Participants were classified into four obesity metabolic phenotypes according to their BMI and the presence of metabolic syndrome: metabolically healthy overweight/obese (MHOO), metabolically healthy and normal weighted (MHNW), metabolically abnormal and overweight/obese (MAOO), and metabolically abnormal but normal weighted (MANW). Univariate and multivariate logistic regression analysis, stratified analysis, and also interaction analysis were conducted to analyze the relationship between serum UA and obesity metabolic phenotypes.ResultsMultivariable logistic regression analysis showed that hyperuricemia was positively associated with MHOO, MANW, and MAOO phenotypes relative to MHNW. After adjusting for the confounding factors, the odds ratios (OR) for individuals with hyperuricemia to be MHOO, MANW, and MAOO phenotypes were 1.86 (1.42-2.45), 2.30 (1.44-3.66), and 3.15 (2.34-4.24), respectively. The ORs for having MHOO, MANW, and MAOO increased 6% [OR: 1.06 (1.05-1.07), P < 0.0001], 5% [OR: 1.05 (1.03-1.07), P < 0.0001], and 11% [OR: 1.11 (1.10-1.13), P < 0.0001] for each 10 unit (μmol/L) of increase in serum UA level. Stratification analysis as well as an interaction test showed that sex and age did not interfere with the association of hyperuricemia with each metabolic phenotype. In terms of the components of the metabolic syndrome, after adjusting for other confounding factors including all of the metabolic indicators except itself, hyperuricemia was positively associated with increased BMI [OR: 1.66 (1.32-2.09), P < 0.0001], hypertriglyceridemia [OR: 1.56 (1.21-2.02), P = 0.0006], and hypertension [OR: 1.22 (1.03-1.46), P = 0.0233], while it had no significant association with hyperglycemia and low HDL-C (all P > 0.05).ConclusionIn our study, we discovered that hyperuricemia was positively associated with MHOO, MANW, and MAOO phenotypes, and this relationship was independent of sex and age.

Project description:BackgroundAlthough the prevalence of obesity and metabolic syndrome (MetS) among dialysis patients has been exceeding than general population, little is known regarding obesity and MetS in non-dialysis chronic kidney disease (CKD). We aimed to find the magnitude of obesity and MetS and their associations with impaired renal function among type 2 diabetes mellitus (T2DM) patients.MethodsA national survey of T2DM patients was collected in the Thai National Health Security Office database during 2014-5. The sampling frame was designated as distinct geographic regions throughout the country. A stratified two-stage cluster sampling was used to select the study population. Anthropometry and 12-hour fasting blood samples were obtained by trained personnel. BMI of ?25 kg/m2 was classified as obesity. MetS was defined as having elevated waist circumference (>90 and >80 cm in men and women, respectively) plus any two of the followings: triglyceride ?150 mg/dL, HDL-C <40 in men or <50 mg/dL in women, blood pressure ?130/85 mmHg, and fasting blood sugar ?100 mg/dL. CKD was defined as an impaired renal function (eGFR <60 mL/min/1.73m2 according to the CKD-EPI equation). Logistic regression analysis was performed to examine the relationship between obesity and MetS with the presence of CKD.ResultsA total of 32,616 diabetic patients were finally recruited from 997 hospitals. The mean age was 61.5±10.9 years with 67.5% women. Of the participants, 35.4% were CKD patients. The prevalence of obesity was 46.5% in CKD and 54.1% in non-CKD patients with T2DM (p<0.001). In contrast, the prevalence of MetS in CKD patients was higher than their non-CKD counterparts (71.3 vs 68.8%, p<0.001). Moreover, there was an association between the prevalence of MetS with CKD stage from 3a to 5 (70.1, 72.3, 73.4, and 72.7%, respectively, p trend = 0.02). MetS, but not obesity, had a significant association with CKD in T2DM patients after adjusting for age, sex, and comorbidities [OR 1.14; 95% CI 1.06-1.22, p<0.001]. When stratified by each component of MetS, only high serum triglyceride and low HDL-C levels were increased in patients with CKD stage 4 and 5 compared with CKD stage 3 (p<0.001) and had a significant relationship with impaired renal function.ConclusionThere were relatively high prevalences of both obesity and MetS in T2DM patients. A higher prevalence of MetS, but lower prevalence of obesity, was observed among diabetic CKD group compared with their non-CKD counterparts. MetS, as a surrogate of insulin resistance, appeared to be more important than obesity in the development of impaired renal function in diabetic population.

Dataset Information

The effect of metabolic health and obesity phenotypes on risk of hypertension: A nationwide population-based study using 5 representative definitions of metabolic health.

Publications

The effect of metabolic health and obesity phenotypes on risk of hypertension: A nationwide population-based study using 5 representative definitions of metabolic health.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets