Weight reduction cuts CVD risk in metabolically healthy patients with high BMI

  • Sinn DH & al.
  • J Clin Endocrinol Metab
  • 23 Sep 2019

  • International Clinical Digest
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Takeaway

  • In people who are overweight or have obesity but are metabolically healthy, weight decrease is linked to reduced risk for subclinical carotid atherosclerosis.

Why this matters

  • Clinicians can let their patients with BMI outside the normal-weight range know that even with good metabolic measures, losing weight could further decrease their cardiovascular disease (CVD) risk.

Key results

  • 12,248 person-years of follow-up (median, 3.42 [range, 0.5-8.7] years).
  • 47.0% lost no weight or gained weight during follow-up.
  • 44.4% lost 0.1%-4.9% of body weight; 8.6% lost 5% or more of body weight.
  • Compared with those who lost no weight or who gained some, subclinical carotid atherosclerosis risk decreased with:
    • 0.1%-4.9% loss: aHR, 0.84 (95% CI, 0.72-0.98).
    • ≥5% loss: aHR, 0.66 (95% CI, 0.50-0.87).
  • Those who lost no weight or gained weight tended to be younger and smoke; have lower BMI, body fat, and waist circumference; and have higher low-density lipoprotein cholesterol levels.

Study design

  • Cohort study, 3117 adults in Korea.
  • Atherosclerosis was assessed via carotid artery ultrasonography.
  • Outcome: development of subclinical carotid atherosclerosis.
  • Funding: None disclosed.

Limitations

  • Reasons for weight reduction were not known.
  • Weight change might not have been linear between 2 measurement points.