Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk-Reference-Cited by-同舟云学术

Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk

Published:2024-06-21 Issue:13 Volume:14 Page:1314
ISSN:2075-4418
Container-title:Diagnostics
language:en
Short-container-title:Diagnostics

Author:

Palatini Paolo¹^ORCID,Virdis Agostino²^ORCID,Masi Stefano²^ORCID,Mengozzi Alessandro²^ORCID,Casiglia Edoardo¹^ORCID,Tikhonoff Valerie³^ORCID,Cicero Arrigo⁴^ORCID,Ungar Andrea⁵,Parati Gianfranco⁶⁷^ORCID,Rivasi Giulia⁵^ORCID,Salvetti Massimo⁸^ORCID,Barbagallo Carlo⁹^ORCID,Bombelli Michele¹⁰^ORCID,Dell’Oro Raffaella¹⁰,Bruno Berardino¹¹,Lippa Luciano¹²^ORCID,D’Elia Lanfranco¹³^ORCID,Masulli Maria¹³,Verdecchia Paolo¹⁴,Reboldi Gianpaolo¹⁵^ORCID,Angeli Fabio¹⁶¹⁷^ORCID,Cianci Rosario¹⁸,Mallamaci Francesca¹⁹,Cirillo Massimo²⁰^ORCID,Rattazzi Marcello³²¹,Cirillo Pietro²²^ORCID,Gesualdo Loreto²²,Russo Elisa²³^ORCID,Mazza Alberto²⁴^ORCID,Giannattasio Cristina²⁵,Maloberti Alessandro²⁵^ORCID,Volpe Massimo²⁶²⁷^ORCID,Tocci Giuliano²⁸^ORCID,Iaccarino Guido²⁹^ORCID,Nazzaro Pietro³⁰,Galletti Ferruccio¹³,Ferri Claudio¹¹^ORCID,Desideri Giovambattista¹¹,Viazzi Francesca²³^ORCID,Pontremoli Roberto²³^ORCID,Muiesan Maria⁸^ORCID,Grassi Guido¹⁰,Borghi Claudio⁴^ORCID

Affiliation:

1. Department of Medicine, Studium Patavinum, University of Padova, 35128 Padua, Italy

2. Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy

3. Department of Medicine, University of Padova, 35128 Padua, Italy

4. Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy

5. Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy

6. Istituto Auxologico Italiano, S. Luca Hospital, University of Milan-Bicocca, 20126 Milan, Italy

7. Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy

8. Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy

9. Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy

10. Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy

11. Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy

12. Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy

13. Department of Clinical Medicine and Surgery, Medical School, “Federico II” University of Naples, 80133 Naples, Italy

14. Hospital S. Maria della Misericordia, 06100 Perugia, Italy

15. Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy

16. Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy

17. Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, 21100 Varese, Italy

18. Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy

19. CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy

20. Department of Public Health, “Federico II” University of Naples, 80133 Naples, Italy

21. Medicina Interna 1°, Ca’ Foncello University Hospital, 31100 Treviso, Italy

22. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy

23. Department of Internal Medicine, University of Genoa, Policlinico San Martino, 16132 Genova, Italy

24. Department of Internal Medicine, Hypertension Unit, General Hospital, 45100 Rovigo, Italy

25. Cardiology IV, ‘A. De Gasperis’ Department, Niguarda Ca’ Granda Hospital, 20162 Milano, Italy

26. Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00161 Rome, Italy

27. IRCCS San Raffaele, 00161 Rome, Italy

28. Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, 00185 Rome, Italy

29. Department of Advanced Biomedical Sciences, “Federico II” University of Naples, 80133 Naples, Italy

30. Department of Medical Basic Sciences, Neurosciences and Sense Organs, Medical School, University of Bari, 70122 Bari, Italy

Abstract

The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic status. Healthy metabolic status was identified with and without including LDL-cholesterol. The risk of MACE during 11.8 years of follow-up was evaluated with multivariable Cox regressions. Among the participants aged <70 years, high BMI was associated with an increased risk of MACE, whereas among the older subjects it was associated with lower risk. Compared to the group with normal weight/healthy metabolic status, the metabolically healthy participants aged <70 years who were overweight/obese had an increased risk of MACE with an adjusted hazard ratio of 3.81 (95% CI, 1.34–10.85, p = 0.012). However, when LDL-cholesterol < 130 mg/dL was included in the definition of healthy metabolic status, no increase in risk was found in the overweight/obese adults compared to the normal weight individuals (hazard ratio 0.70 (0.07–6.71, p = 0.75). The present data show that the risk of MACE is increased in metabolically healthy overweight/obese individuals identified according to standard criteria. However, when LDL-cholesterol is included in the definition, metabolically healthy individuals who are overweight/obese have no increase in risk.

Funder

Fondazione of the Italian Society of Hypertension

Publisher

MDPI AG

Link

https://www.mdpi.com/2075-4418/14/13/1314/pdf

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