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Endocrine

, Volume 63, Issue 3, pp 439–462 | Cite as

The long-term prognosis of heart diseases for different metabolic phenotypes: a systematic review and meta-analysis of prospective cohort studies

  • Atieh Mirzababaei
  • Kurosh Djafarian
  • Hadis Mozafari
  • Sakineh Shab-BidarEmail author
Meta Analysis
  • 71 Downloads

Abstract

Purpose

This meta-analysis aimed to assess the association of different categories of weight and metabolic status with risk of heart diseases including myocardial infarction (MI), cardiovascular diseases (CVDs), and heart failure (HF).

Methods

Data from relevant studies were identified systematically by searching PubMed and Scopus search engines up to 29 May 2018. Prospective studies were included in the analyses with metabolically healthy normal weight (MHNW) as the reference. Pooled RRs and 95% CI were calculated using random-effects or fixed-effect models when appropriate. Subgroup analysis was applied to define possible sources of heterogeneity.

Results

Overall, 21 studies (n = 778,401 participants) were eligible for the present meta-analysis. Generally, the risk of CVDs for all metabolic phenotypes in metabolically unhealthy obese increased compared with the MHNW group. A significant positive association between all metabolic phenotypes and the risk of HF was also observed expect for MHOW (RR = 1.10, 95% CI: 0.60–2.00, P = 0.76) and MHO phenotypes (RR = 0.96, 95% CI: 0.25–3.77, P = 0.95). Moreover, MUHO phenotype was associated with greater risk of MI compared with the MHNW phenotype (RR = 1.82, 95% CI: 1.50–2.22, P < 0.001, respectively).

Conclusions

Our findings showed that all metabolically unhealthy phenotypes in different categories of weight were associated with increased incident of CVDs/HF and MI. Furthermore, healthy overweight and obese subjects had increased risk of CVDs.

Keywords

BMI Obesity Metabolic healthy Metabolic unhealthy Cardiovascular diseases Risk Myocardial infarction Heart failure 

Abbreviations

ATPIII

Adult Treatment Panel III

BMI

body mass index

BP

blood pressure

BF

body fat

CVDs

cardiovascular diseases

CIs

confidence intervals

JCDGC

Joint Committee for Developing Chinese Guidelines

JIS

Joint Interim Statement

FBG

fasting blood glucose

HDL-C

high-density lipoprotein cholesterol

HRs

hazard ratios

HOMA-IR

homeostatic model assessment-insulin resistance

hs-CRP

high-sensitivity C-reactive protein

HF

heart failure

IMT

intima-media thickness

IR

insulin resistance

LDL-C

low-density lipoprotein cholesterol

IDF

International Diabetes Federation

MI

myocardial infarction

MH

metabolically healthy

MHNW

metabolically healthy normal weight

MHO

metabolically healthy obese

MHOW

metabolically healthy overweight

MUH

metabolically unhealthy

MUHNW

metabolically unhealthy normal weight

MUHO

metabolically unhealthy obese

MUHOW

metabolically unhealthy overweight

MOOSE

meta-analysis of observational studies in epidemiology

MetS

metabolic syndrome

NW

normal weight

NOS

Newcastle-Ottawa scale

ORs

odds ratios

OB

obesity

OW

overweight

RRs

relative risks

T2D

type 2 diabetes

TG

triglyceride

TyG

triglyceride glucose

WC

waist circumference

WHO

World Health Organization

Notes

Acknowledgements

This study was supported by the Student’s Scientific Research Center, Tehran, Iran.

Author contributions

A.M. and S.S.-B. contributed to the study concept and design; H.M. and A.B. designed search strategy and screened papers. A.B., S.S.-B. and K.D. performed statistical analysis; A.M. wrote the first draft of manuscript; all authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

12020_2019_1840_MOESM1_ESM.docx (913 kb)
Supplementary Figures

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Atieh Mirzababaei
    • 1
    • 2
  • Kurosh Djafarian
    • 3
  • Hadis Mozafari
    • 1
  • Sakineh Shab-Bidar
    • 1
    Email author
  1. 1.Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences (TUMS)TehranIran
  2. 2.Student’s Scientific Research Center, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences (TUMS)TehranIran
  3. 3.Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences (TUMS)TehranIran

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