Obese people without metabolic risk factors for diabetes and heart disease, such as high blood pressure and cholesterol, do not have the elevated cardiovascular risk typical of obesity, but they represent only a small percentage of the obese population, according to a long-term study. The results will be presented Saturday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

“Some obese persons have a normal cardiovascular risk profile, and they have no increased risk for heart and blood vessel disease [because of their weight],” said study co-author André van Beek, MD, PhD, of University Medical Center Groningen, Groningen, the Netherlands. “However, periodic evaluation of their risk profile remains essential.”

The Dutch study found that in a large population of obese individuals, only 6.8 percent were “metabolically healthy,” meaning they had no history of heart disease or stroke, no diabetes or high blood pressure, and no dyslipidemia (irregularities in blood fats, including cholesterol and triglycerides) or any use of cholesterol-lowering medications.

To conduct the research, the authors identified 1,325 obese individuals from 8,356 subjects participating in the Dutch PREVEND (Prevention of Renal and Vascular Endstage Disease) study, who ranged in age from 28 to 75 years. Only 90 obese subjects were metabolically healthy.

Over 7½ years, cardiovascular disease developed in just one of these 90 individuals. This percentage (1.1 percent) was not significantly higher than that in metabolically healthy subjects who were overweight (1.3 percent) or of normal weight (0.6 percent), the researchers reported.

These results indicate that metabolically healthy obese individuals appear to have protection against cardiovascular disease, van Beek said. However, he added, “They are a small subset of the total obese population. And they may still suffer from other obesity-associated diseases like muscle and joint complaints.”

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