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Session: Exemplary Trainee Abstracts in Obesity Science Research (Poster Theater Flash Session 4)

(PTFS04-03-23) Metabolic Health and Obesity Status on Cardiovascular Disease Risk Among Men (the Health Professionals Follow-up Study): 30 Year Prospective Cohort Study

Sunday, July 23, 2023
10:13 AM – 10:17 AM ET
Location:  Fairfax

    Presenting Author(s)

  • Zhila Semnani-Azad, PhD (she/her/hers)

    Research Fellow
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • MG

    Marta Guasch-Ferre, PhD

    University of Copenhagen
    Boston, Massachusetts, United States

  • Frank B. Hu, MD, MPH, PhD

    Chair, Department of Nutrition Harvard T.H. Chan School of Public Health Fredrick J. Stare Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health Professor of Medicine, Harvard Medical School and Brigham and Women’s Hospital
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • JoAnn E. Manson, MD, DrPH

    Chief, Division of Preventive Medicine
    Brigham and Women's Hospital
    Boston, Massachusetts, United States

  • KR

    Kathryn M. Rexrode, MD

    Brigham and Women's Hospital and Harvard Medical School
    Boston, Massachusetts, United States

  • QS

    Qi Sun, PhD

    Associate Professor
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

Disclosure(s):
Zhila Semnani-Azad, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Frank B. Hu, MD, MPH, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Obesity is a major risk factor for cardiovascular disease (CVD). Moreover, obesity-associated metabolic disorders including hypertension, hyperglycemia, and hypercholesterolemia, have been shown to significantly increase CVD risk. However, there is growing evidence of the heterogeneity in metabolic health among subjects of similar weight, and their risk for cardiometabolic disease outcomes. Our aim was to examine the prospective association between metabolic health and obesity status with CVD risk in men.

Methods: Data included 38,177 men who were free of CVD and cancer and had available body mass index (BMI) measurements at baseline (1986) from the Health Professionals Follow-up Study (HPFS). Participants were cross-classified by baseline BMI categories (normal 18.5 – 24.9 kg/m2; overweight 25.0 – 29.9 kg/m2; and obese ≥30 kg/m2) and metabolic health status, which was defined based on self-reported metabolic disorders - diabetes, hypertension, and hypercholesterolemia. Subjects were classified as metabolically healthy by the absence of metabolic disorders, otherwise, they were classified as metabolically unhealthy. Incident CVD was assessed using follow-up data from baseline to 2016. Cox proportional hazard regressions were used to estimate CVD risk across metabolic health and BMI status stratification, adjusting for potential risk factors.

Results: During 30 years of follow-up, a total of 5,529 CVD cases were documented. The multivariable-adjusted hazard ratios (HR) showed a significant increase in CVD risk in men with metabolically healthy obesity and metabolically healthy overweight compared to men with metabolically healthy normal-weight (HR: 1.32 95% confidence interval (CI) 1.14 – 1.52 and HR: 1.19 95% CI 1.06 – 1.44, respectively). Across BMI status, men classified as metabolically unhealthy at baseline showed a considerably higher risk for CVD compared to men classified as metabolically healthy normal weight (all p< 0.01). Additionally, men with metabolically unhealthy obesity were at the greatest risk for CVD compared to metabolically healthy normal-weight men (HR: 2.61 95% CI 2.07 – 3.11).

Conclusions: Obesity is a critical risk factor for CVD; however, CVD risk is the highest for metabolically unhealthy men across all BMI categories.

Funding Sources: ZSA is funded by the Canadian Institutes for Health Research (CIHR) Fellowship.