Individual and joint associations of obesity and metabolic health parameters on arterial stiffness: evidence from the UK Biobank
Author(s)
Ananda, Roshan A
Solomon, Bethlehem
Ray, Kausik K
Type
Journal Article
Abstract
Aims
There is conflicting evidence regarding whether excess adiposity without metabolic abnormalities reflects a truly benign phenotype. This study evaluated the independent and joint associations of the presence of excess adiposity and metabolic abnormalities on arterial stiffness.
Materials and Methods
Participants in UK Biobank with body mass index (BMI) and arterial stiffness index (ASI) recorded between 2006 and 2010, free from cardiovascular diseases and not underweight (BMI <18.5 kg/m2) were included. The primary outcome was severity of ASI analysed using multivariate-adjusted linear regression.
Results
Of 162 590 participants, 42.5% were overweight and 24.4% were obese. Within the normal BMI strata, 50.7% had ≥1 metabolic abnormality. Compared to individuals with normal BMI and no metabolic abnormality (reference group), increased BMI or metabolic abnormalities were similarly associated with higher ASI: normal BMI with metabolic abnormalities (adjusted β-coefficient and 95% CI, 0.35; 0.30–0.40); overweight without metabolic abnormalities (0.32; 0.26–0.37). Individuals with obesity and no metabolic abnormality had higher ASI (0.65; 0.57–0.74) but was lower than individuals with overweight and metabolic abnormalities (0.80; 0.75–0.84). Individuals with obesity and metabolic abnormalities had the highest ASI (1.07; 1.02–1.12) among all six metabolic combinations, p < 0.001 for each versus reference group. Sensitivity analysis suggested higher ASI with increasing number of metabolic abnormalities within BMI categories and higher ASI in the presence of abdominal obesity within metabolic categories.
Conclusions
Excess adiposity and metabolic abnormalities are independently associated with increased arterial stiffness to a similar degree, suggesting that metabolically healthy individuals with overweight and obesity are not benign groups. This reinforces the need to prevent excess adiposity and consider primary prevention strategies even before metabolic abnormalities emerge.
There is conflicting evidence regarding whether excess adiposity without metabolic abnormalities reflects a truly benign phenotype. This study evaluated the independent and joint associations of the presence of excess adiposity and metabolic abnormalities on arterial stiffness.
Materials and Methods
Participants in UK Biobank with body mass index (BMI) and arterial stiffness index (ASI) recorded between 2006 and 2010, free from cardiovascular diseases and not underweight (BMI <18.5 kg/m2) were included. The primary outcome was severity of ASI analysed using multivariate-adjusted linear regression.
Results
Of 162 590 participants, 42.5% were overweight and 24.4% were obese. Within the normal BMI strata, 50.7% had ≥1 metabolic abnormality. Compared to individuals with normal BMI and no metabolic abnormality (reference group), increased BMI or metabolic abnormalities were similarly associated with higher ASI: normal BMI with metabolic abnormalities (adjusted β-coefficient and 95% CI, 0.35; 0.30–0.40); overweight without metabolic abnormalities (0.32; 0.26–0.37). Individuals with obesity and no metabolic abnormality had higher ASI (0.65; 0.57–0.74) but was lower than individuals with overweight and metabolic abnormalities (0.80; 0.75–0.84). Individuals with obesity and metabolic abnormalities had the highest ASI (1.07; 1.02–1.12) among all six metabolic combinations, p < 0.001 for each versus reference group. Sensitivity analysis suggested higher ASI with increasing number of metabolic abnormalities within BMI categories and higher ASI in the presence of abdominal obesity within metabolic categories.
Conclusions
Excess adiposity and metabolic abnormalities are independently associated with increased arterial stiffness to a similar degree, suggesting that metabolically healthy individuals with overweight and obesity are not benign groups. This reinforces the need to prevent excess adiposity and consider primary prevention strategies even before metabolic abnormalities emerge.
Date Issued
2025-02-01
Date Acceptance
2024-11-10
Citation
Diabetes, Obesity and Metabolism, 2025, 27 (2), pp.899-910
ISSN
1462-8902
Publisher
Wiley
Start Page
899
End Page
910
Journal / Book Title
Diabetes, Obesity and Metabolism
Volume
27
Issue
2
Copyright Statement
© 2024 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39587367
Subjects
ADIPOSITY
arterial stiffness
BMI
CARDIOVASCULAR-DISEASE
Endocrinology & Metabolism
HYPERTENSION
LEPTIN
Life Sciences & Biomedicine
metabolic health
obesity
PREVALENCE
preventive cardiology
RISK
Science & Technology
STATEMENT
UK Biobank
vascular health
WEIGHT
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2024-11-25