Table 4.

Summary of studies linking cardiometabolic disease with different obesity phenotypes

	MUNW	MHO	MUO	SO
MetS	–	↑ risk insulin resistance ↑ risk hyper-TAG ↑ risk low HDL ↑ risk hypertension vs. normal weight lean [217]	–
Atherosclerosis	↑ vascular inflammation [203] ↑ PWV ↑ soft plaques [201] ↑ CACS 218vs. normal weight lean	↑ peripheral microvascular dysfunction (PMID: 28,275,071) ↑ cIMT [219, 220] ↑ CACS [218] vs. normal weight lean ↑ cIMT [221] vs. MUNW < 60y old	↑ peripheral microvascular dysfunction [222] ↑ cIMT [220] ↑ CACS [218] vs. normal weight lean ↑ cIMT [221] vs. MUNW < 60y old	↑ arterial stiffness [223] ↑ CACS [224] vs. non-sarcopenic ↑ cIMT [225] vs. non-sarcopenic elderly
HF	↑ LVsD ↑ LVdD [226, 227] ↑ risk [228] vs. normal weight lean ↑ risk [183] vs. normal weight lean post-menopausal woman ↑ LVH [178] vs. MHO	↑ risk [199, 229, 230] vs. normal weight lean ↑ LVdD [231] vs. MUNW ↑ risk [230] over time  = risk than normal weight lean in post-menopausal woman (PMID: 33775111)	↑ risk [183] vs. normal weight lean post-menopausal woman ↑ LVH [178, 179, 232, 233] vs. MHO	↓ CRF [216, 234] vs. non-sarcopenic HFrEF
AF	↑ risk [228] vs. normal weight lean	↑ risk [186, 199, 229, 235] vs. normal weight lean ↓ risk [236] vs. MUO	↑ risk [186] vs. normal weight lean	↑ risk [225] vs. non-sarcopenic elderly
CV events/mortality	↑ risk [204, 230, 237] vs. normal weight lean ↑ risk [238] vs. obese (MHO/MUO)	↑ risk [199, 229, 237, 239, 240] vs. normal weight lean ↑ risk [206, 241] vs. MUNW	↑ risk [204, 230, 242] vs. normal weight lean	↑ risk [216, 243, 244] vs. non-sarcopenic HF and elderly ↑ risk [213] vs. non-sarcopenic after STEMI ↑ MI risk vs. non-sarcopenic elderly

Waist circumference categorized as normal (men < 102 cm and women < 88 cm) or high (men ≥ 102 cm and women ≥ 88 cm). Visceral adipose tissue and lean mass are non-standardized measures. Metabolic abnormalities refer to the metabolic syndrome defining criteria

BMI body mass index, MONW metabolically obese normal weight, NOW normal weight obese, MHO metabolically healthy obese, MO metabolically obese, SO sarcopenic obese