J Clin Endocrinol Metab. 2019 Sep 23. pii: dgz040. doi: 10.1210/clinem/dgz040. [Epub ahead of print]

Weight Change and Development of Subclinical Carotid Atherosclerosis Among Metabolically Healthy Adults: A Cohort Study.

Sinn DH¹, Kang D^2,3, Cho SJ⁴, Chang Y⁵, Ryu S⁵, Song YB¹, Paik SW¹, Hong YS⁶, Zhao D⁶, Guallar E^3,6, Cho J^2,3,6, Gwak GY¹.

Author information

1

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine.

2

Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University.

3

Center for Clinical Epidemiology, Samsung Medical Center.

4

Center for Health Promotion, Samsung Medical Center.

5

Center for Total Health Studies, Kangbuk Samsung Hospital, Seoul, South Korea.

6

Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, USA.

Abstract

BACKGROUND:

The benefit of weight loss for reducing cardiovascular disease (CVD) risk in metabolically healthy obese people is unknown.

OBJECTIVES:

We evaluated the association between weight change and incident subclinical carotid atherosclerosis (SCA) in metabolically healthy but overweight or obese subjects.

METHODS:

Cohort study of 3,117 metabolically healthy overweight or obese adults who did not have any metabolic syndrome components or insulin resistance at baseline. SCA was assessed using carotid artery ultrasonography. The study outcome was the development of incident SCA among participants free of the disease at baseline.

RESULTS:

During 12,248 person-years of follow-up (median 3.42 years), 747 participants developed SCA. The proportion of participants with no reduction or increased weight, reduction in weight 0.1-4.9%, and reduction in weight ≥5% during follow-up were 47.0, 44.4, and 8.6%, respectively. The fully-adjusted HRs for incident SCA in participants with a reduction in weight of 0.1-4.9% and ≥5% compared to those with no reduction or increased weight were 0.84 (95% CI 0.72-0.98) and 0.66 (95% CI 0.50-0.87), respectively.

CONCLUSIONS:

In a large cohort study of metabolically healthy but overweight or obese adult men and women, weight reduction was associated with a lower incidence of SCA. Our findings suggest that metabolically healthy overweight or obese subjects may benefit from weight reduction in terms of CVD risk.

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