Obesidad metabólicamente sana y riesgo cardiovascular: análisis de escalas de riesgo en una amplia cohorte poblacional

Abstract

Introduction

Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial.

Objective

To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers.

Methods

Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATP III criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost.

Results

MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk.

Conclusions

Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.