Table 4.
Hazard ratios of cardiovascular disease mortality and incidence in metabolically healthy but obese individuals compared with metabolically abnormal obese and metabolically healthy normal-weight individuals, using both body mass index and body fat percentage to define obesity
| BMI-based obesity |
BF%-based obesity |
|||||
|---|---|---|---|---|---|---|
| Cases (total) | HR (95% CI)a | Fitness-adjusted HR (95% CI)b | Cases (total) | HR (95% CI)a | Fitness-adjusted HR (95% CI)b | |
| CVD mortality | ||||||
| Metabolically abnormal obesec | 81 (3911) | 1.77 (1.05–2.99) | 1.48 (0.87–2.52) | 153 (6900) | 1.76 (1.31–2.37) | 1.44 (1.06–1.95) |
| Metabolically healthy but obese | 17 (1738) | 1 (Ref.) | 1 (Ref.) | 64 (5959) | 1 (Ref.) | 1 (Ref.) |
| Metabolically healthy normal-weight/fatd | 98 (16 002) | 0.41 (0.24–0.70) | 0.73 (0.42–1.28) | 144 (21 023) | 0.74 (0.54–1.00) | 1.13 (0.82–1.56) |
| Non-fatal CVD eventse | ||||||
| Metabolically abnormal obesec | 107 (1300) | 1.44 (0.96–2.17) | 1.39 (0.92–2.10) | 231 (2598) | 1.61 (1.29–2.01) | 1.51 (1.20–1.89) |
| Metabolically healthy but obese | 30 (544) | 1 (Ref.) | 1 (Ref.) | 123 (2340) | 1 (Ref.) | 1 (Ref.) |
| Metabolically healthy normal-weight/fatd | 261 (7001) | 0.58 (0.39–0.86) | 0.78 (0.52–1.18) | 353 (9263) | 0.78 (0.63–0.96) | 0.95 (0.76–1.20) |
CI, confidence interval.
aModel adjusted for age, sex, examination year, smoking, alcohol consumption and parental history of CVD.
bAdditional adjustment for fitness.
cTheoretically unhealthiest group.
dTheoretically healthiest group.
eNon-fatal CVD events include: myocardial infarction, stroke, and coronary revascularization (i.e. bypass, coronary angioplasty); data available in a subsample of 18 430 participants.