SATURDAY, June 19 (HealthDay News) -- For a small number of
obese people, those extra pounds do not condemn them to heart
disease or diabetes, Dutch researchers report.
For those few without other risk factors such as high blood
pressure or high cholesterol, being obese doesn't raise their risk
of cardiovascular trouble.
"Metabolically healthy obese persons do not have the elevated cardiovascular risk of obesity, but represent only a small subset of the total obese population," said lead researcher Dr. Andre van Beek, from the University Medical Center in Groningen. "It's the metabolic risk profile that counts, and not the weight itself."
He was to present the findings Saturday at the Endocrine
Society's annual meeting in San Diego.
For the study, van Beek's group collected data on 1,325 obese
people from among 8,356 people who participated in a large Dutch
study.
Among the obese people, only 90 (6.8 percent) were metabolically
healthy, the researchers found. That meant they had no history of
heart disease, stroke, diabetes or high blood pressure, or high
cholesterol or triglycerides. In addition, none of the 90 were
taking cholesterol-lowering drugs.
Over more than seven years of follow-up, only one of these
people developed cardiovascular disease. As a percentage (1.1
percent) this was not significantly higher than heart disease seen
in metabolically healthy people who were overweight (1.3 percent)
or normal weight (0.6 percent), van Beek's team found.
To see whether you are at risk for heart disease, check your
metabolic risk profile, van Beek advised. "If this is normal, be
reassured that there is no excess cardiovascular risk independent
of weight class," he said.
At least one expert is not convinced that obesity itself does
not lead to an increased risk for heart disease.
Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA
Cardiomyopathy Center at the University of California, Los Angeles,
said that "while this study did not find increased risk associated
with obesity if no metabolic abnormalities were present, it is
important to note that other studies with longer-term follow-up
have shown there is an increased risk of cardiovascular events in
these individuals."
"The balance of evidence suggests that, over the long-term, obesity imparts higher cardiovascular risk, even if metabolic abnormalities are not present at baseline," he said.
A researcher specializing in diabetes and metabolic syndrome
also thinks the follow-up period in the study is too short to draw
firm conclusions about whether certain obese people are protected
from heart disease.
Dr. Tae-Hwa Chun, an assistant professor of internal medicine at
the University of Michigan, said that "clearly we need to know why
some overweight and obese individuals are protected from metabolic
deterioration and increased cardiovascular risk."
This study suggests that identifying the genetic and molecular
mechanism that underlies the deadly link between obesity and
cardiovascular risk, which is selectively found in a subset of
individuals, is more important than simply measuring body-mass
index, Chun said.
"There is a caveat in this study, however, as the cardiovascular event rate is so low in the short follow-up period, the study may not possess enough statistical power to detect a potential difference in cardiovascular risk," he said.
More information
For more information on obesity and heart disease visit the
American Heart Association.