Approved research

Replication of association of metabolically healthy obesity (MHO) with risk of cardiovascular and total mortality in the UK Biobank

Lay summary

Overweight and obesity can lead to major health problems and diseases, however not everyone with increased body weight will develop complications such as heart disease and premature death. These people can potentially be identified based on their cardiometabolic risk profile and thus be classified as having metabolically healthy obesity (MHO). However, currently there is no definition of this state of metabolic health commonly agreed upon. Rather, a number of varying definitions have been proposed. Frequently, classification of metabolically healthy or unhealthy has been based on blood measurements (i.e. cholesterol, blood sugar levels etc.), blood pressure levels and body size measurements, such as waist circumference. However, none of these definitions have been shown to reflect a state of low risk comparable to healthy normal-weight individuals. We have compared a number of pre-existing definitions with an empirically derived definition in the third National Health and Nutrition Examination Survey (NHANES-III) and its mortality follow-up. To be certain, that our findings can be generalised beyond the NHANES-III cohort, we aim to validate our findings in the UK Biobank. We will apply various definitions of metabolic health to this large cohort and then investigate if subgroups, divided according to BMI and metabolic health, have different risks of cardiovascular and total mortality. We are aiming to specify which group of people has an increased risk of premature death in order to better prevent adverse outcomes like these, which is in line with the stated purpose of the UK Biobank.