Metabolic status as a predictor of cardiovascular disease in a working cohort: beyond body mass index

Bustamante-Rodríguez J.C.; Zuzunaga-Montoya F.E.; Ballena-Caicedo J.; Valladolid-Sandoval L.A.M.; Vásquez-Romero L.E.M.; Loayza-Castro J.A.; De Carrillo C.I.G.; Vera-Ponce V.J. · Nutricion Clinica y Dietetica Hospitalaria (2025) · DOI: 10.12873/451bustamante

Resumen

Introduction: Cardiovascular diseases (CVD) are a leading cause of global morbidity and mortality. Recent research suggests that metabolic status could better predict cardiovascular risk than body mass index (BMI) alone. Objective: To evaluate different metabolic phenotypes and the risk of developing CVD in a cohort of workers. Methodology: A retrospective analytical observational cohort study with 4,158 workers followed for up to 8 years. The outcome variable was the presence of CVD, defined as the self-reported diagnosis of stroke or myocardial infarction. The combination of metabolic status and BMI resulted in six phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). CVD incidence was calculated, and Cox regression models were used to estimate adjusted hazard ratios (HR). Results: The overall incidence of CVD was 5.64 per 1,000 person-years. Compared to the MHNW phenotype, metabolically unhealthy phenotypes showed a significantly higher risk of CVD: MUNW (aHR: 5.19, 95% CI: 1.29-20.84), MUOW (aHR: 7.07, 95% CI: 2.40-20.86), and MUO (aHR: 7.35, 95% CI: 2.43-22.21). Conclusion: The findings underscore the importance of metabolic status, independent of BMI, in predicting cardiovascular risk. This has significant implications for clinical practice and public health, suggesting the need to implement comprehensive metabolic assessments and personalized prevention strategies across all BMI categories, especially in the workplace.

Instituciones: Universidad Continental; Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas