TY  - JOUR
A1  - Lehn-Stefan, Angela
A1  - Peter, Andreas
A1  - Machann, Jürgen
A1  - Schick, Fritz
A1  - Randrianarisoa, Elko
A1  - Heni, Martin
A1  - Wagner, Robert
A1  - Birkenfeld, Andreas L.
A1  - Fritsche, Andreas
A1  - Schulze, Matthias Bernd
A1  - Stefan, Norbert
A1  - Kantartzis, Konstantinos
T1  - Impaired metabolic health and low cardiorespiratory fitness independently associate with subclinical atherosclerosis in obesity
JF  - The journal of clinical endocrinology & metabolism
N2  - Context
For a given body mass index (BMI), both impaired metabolic health (MH) and reduced cardiorespiratory fitness (CRF) associate with increased risk of cardiovascular disease (CVD). 

Objective
It remains unknown whether both risk phenotypes relate to CVD independently of each other, and whether these relationships differ in normal weight, overweight, and obese subjects. 

Methods
Data from 421 participants from the Tubingen Diabetes Family Study, who had measurements of anthropometrics, metabolic parameters, CRF (maximal aerobic capacity [VO2max]) and carotid intima-media thickness (cIMT), an early marker of atherosclerosis, were analyzed. Subjects were divided by BMI and MH status into 6 phenotypes. 

Results
In univariate analyses, older age, increased BMI, and a metabolic risk profile correlated positively, while insulin sensitivity and VO2max negatively with cIMT. In multivariable analyses in obese subjects, older age, male sex, lower VO2max (std. ss -0.21, P = 0.002) and impaired MH (std. ss 0.13, P = 0.02) were independent determinants of increased cIMT. After adjustment for age and sex, subjects with metabolically healthy obesity (MHO) had higher cIMT than subjects with metabolically healthy normal weight (MHNW; 0.59 +/- 0.009 vs 0.52 +/- 0.01 mm; P < 0.05). When VO2max was additionally included in this model, the difference in cIMT between MHO and MHNW groups became statistically nonsignificant (0.58 +/- 0.009 vs 0.56 +/- 0.02 mm; P > 0.05).

Conclusion
These data suggest that impaired MH and low CRF independently determine increased cIMT in obese subjects and that low CRF may explain part of the increased CVD risk observed in MHO compared with MHNW.
KW  - Metabolically healthy obesity
KW  - cardiorespiratory fitness
KW  - subclinical
KW  - atherosclerosis
KW  - obesity
KW  - carotid intima-media thickness
KW  - cardiovascular
KW  - disease
Y1  - 2022
U6  - https://doi.org/10.1210/clinem/dgac091
SN  - 0021-972X
SN  - 1945-7197
VL  - 107
IS  - 6
SP  - E2417
EP  - E2424
PB  - Endocrine Society
CY  - Washington
ER  -