HealthDay News — Obesity is associated with increased risk of cardiovascular disease risk even among metabolically healthy women, according to a study published online May 30 in The Lancet Diabetes & Endocrinology.

Nathalie Eckel, from the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal, and colleagues followed 90,257 female nurses from 1980 to 2010 for incident cardiovascular disease. Participants were cross-classified by body mass index categories, metabolic health, and change in metabolic health status. 

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The researchers documented 6306 cases of cardiovascular disease, including 3304 myocardial infarction cases and 3,080 strokes, during 2,127,391 person-years of follow-up (median follow-up, 24 years). Women with metabolically healthy obesity had elevated cardiovascular disease risk compared with women with metabolically healthy normal-weight (hazard ratio, 1.39); women with metabolically unhealthy normal-weight, overweight, and obesity had considerably higher risk (hazard ratios, 2.43, 2.61, and 3.15, respectively). Most metabolically healthy women converted to unhealthy phenotypes, including 84 and 68% of women with obesity and normal-weight, respectively, after 20 years. Compared to women with stable healthy normal-weight, women who maintained metabolically healthy obesity during follow-up were still at elevated cardiovascular risk (hazard ratio, 1.57); this risk was lower than for initially metabolically healthy women who converted to an unhealthy phenotype (hazard ratios, 1.90 and 2.74 for normal-weight and obesity, respectively).

“Even when metabolic health is maintained during long periods of time, obesity remains a risk factor for cardiovascular disease,” the authors write.

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