Is metabolic-healthy obesity associated with risk of dementia? An age-stratified analysis of the Whitehall II cohort study

Metabolically healthy obesity is hypothesized to be a benign condition but whether this is the case for dementia remains debated. We examined the role of age at assessment of metabolic-obesity phenotypes in associations with incident dementia. Obesity (body mass index ≥ 30 kg/m ) and poor metabolic...

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Published in:BMC medicine 2023-11, Vol.21 (1), p.436-436, Article 436
Main Authors: Machado-Fragua, Marcos D, Sabia, Séverine, Fayosse, Aurore, Hassen, Céline Ben, van der Heide, Frank, Kivimaki, Mika, Singh-Manoux, Archana
Format: Article
Language:English
Subjects:
Age
Blood pressure
BMI
Body mass
Body Mass Index
Body size
Cardiometabolic risk factors
Cholesterol
Cognition & reasoning
Cohort Studies
Complications and side effects
Dementia
Dementia - complications
Dementia - etiology
Dementia disorders
Dextrose
Drugs
Electronic health records
Glucose
Health aspects
Health risks
High density lipoprotein
Humans
Hypertension
Hypotheses
Measurement
Metabolic status
Metabolic syndrome
Metabolic Syndrome - complications
Middle Aged
Missing data
Mortality
Obesity
Obesity - complications
Obesity - epidemiology
Obesity, Metabolically Benign - complications
Obesity, Metabolically Benign - epidemiology
Phenotype
Phenotypes
Prevention
Questionnaires
Risk
Risk Factors
Semantics
Standard scores
Statistical analysis
Triglycerides
Weight control
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container_title BMC medicine
container_volume 21
creator Machado-Fragua, Marcos D
Sabia, Séverine
Fayosse, Aurore
Hassen, Céline Ben
van der Heide, Frank
Kivimaki, Mika
Singh-Manoux, Archana
description Metabolically healthy obesity is hypothesized to be a benign condition but whether this is the case for dementia remains debated. We examined the role of age at assessment of metabolic-obesity phenotypes in associations with incident dementia. Obesity (body mass index ≥ 30 kg/m ) and poor metabolic health (≥ 2 of elevated serum triglycerides, low HDL-C, elevated blood pressure, and elevated serum fasting glucose) were used to define four metabolic-obesity phenotypes (metabolically healthy (MHNO) and unhealthy non-obesity (MUNO), metabolically healthy (MHO) and unhealthy obesity (MUO)) at 
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An age-stratified analysis of the Whitehall II cohort study</title><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Machado-Fragua, Marcos D ; Sabia, Séverine ; Fayosse, Aurore ; Hassen, Céline Ben ; van der Heide, Frank ; Kivimaki, Mika ; Singh-Manoux, Archana</creator><creatorcontrib>Machado-Fragua, Marcos D ; Sabia, Séverine ; Fayosse, Aurore ; Hassen, Céline Ben ; van der Heide, Frank ; Kivimaki, Mika ; Singh-Manoux, Archana</creatorcontrib><description><![CDATA[Metabolically healthy obesity is hypothesized to be a benign condition but whether this is the case for dementia remains debated. We examined the role of age at assessment of metabolic-obesity phenotypes in associations with incident dementia. Obesity (body mass index ≥ 30 kg/m ) and poor metabolic health (≥ 2 of elevated serum triglycerides, low HDL-C, elevated blood pressure, and elevated serum fasting glucose) were used to define four metabolic-obesity phenotypes (metabolically healthy (MHNO) and unhealthy non-obesity (MUNO), metabolically healthy (MHO) and unhealthy obesity (MUO)) at < 60, 60 to < 70, and ≥ 70 years using 6 waves of data from the Whitehall II study and their associations with incident dementia was examined using Cox regression. Analyses with exposures measured < 60, 60 to < 70, and ≥ 70 years involved 410 (5.8%), 379 (5.6%), and 262 (7.4%) incident dementia cases over a median follow-up of 20.8, 10.3, and 4.2 years respectively. In analyses of individual components, obesity before 60 years (HR 1.41, 95% CI: [1.08, 1.85]) but not at older ages was associated with dementia; unhealthy metabolic status when present < 60 years (HR 1.33, 95% CI: [1.08, 1.62]) and 60 to < 70 years (HR 1.32, 95% CI: [1.07, 1.62]) was associated with dementia. Compared to the metabolically healthy non-obesity group, the risk of dementia was higher in those with metabolically healthy obesity before 60 years (1.69; 95% CI: [1.16, 2.45]); this was not the case when metabolic-obesity phenotype was present at 60 to < 70 years or ≥ 70 years. Analyses at older ages were on smaller numbers due to death and drop-out but inverse probability weighting to account for missing data yielded similar results. Individuals with metabolically healthy obesity before age 60 had a higher risk of incident dementia over a 27-year follow-up; the excess risk dissipates when metabolic health and obesity are measured after 70 years.]]></description><identifier>ISSN: 1741-7015</identifier><identifier>EISSN: 1741-7015</identifier><identifier>DOI: 10.1186/s12916-023-03155-4</identifier><identifier>PMID: 37957712</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Age ; Blood pressure ; BMI ; Body mass ; Body Mass Index ; Body size ; Cardiometabolic risk factors ; Cholesterol ; Cognition &amp; reasoning ; Cohort Studies ; Complications and side effects ; Dementia ; Dementia - complications ; Dementia - etiology ; Dementia disorders ; Dextrose ; Drugs ; Electronic health records ; Glucose ; Health aspects ; Health risks ; High density lipoprotein ; Humans ; Hypertension ; Hypotheses ; Measurement ; Metabolic status ; Metabolic syndrome ; Metabolic Syndrome - complications ; Middle Aged ; Missing data ; Mortality ; Obesity ; Obesity - complications ; Obesity - epidemiology ; Obesity, Metabolically Benign - complications ; Obesity, Metabolically Benign - epidemiology ; Phenotype ; Phenotypes ; Prevention ; Questionnaires ; Risk ; Risk Factors ; Semantics ; Standard scores ; Statistical analysis ; Triglycerides ; Weight control</subject><ispartof>BMC medicine, 2023-11, Vol.21 (1), p.436-436, Article 436</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c490t-bac66a99e68c73bd72c0f36f2d204d7eccaa059119665b74375e72708bc195c73</cites><orcidid>0000-0003-2646-1510</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2890072206?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,25731,27901,27902,36989,36990,44566</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37957712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Machado-Fragua, Marcos D</creatorcontrib><creatorcontrib>Sabia, Séverine</creatorcontrib><creatorcontrib>Fayosse, Aurore</creatorcontrib><creatorcontrib>Hassen, Céline Ben</creatorcontrib><creatorcontrib>van der Heide, Frank</creatorcontrib><creatorcontrib>Kivimaki, Mika</creatorcontrib><creatorcontrib>Singh-Manoux, Archana</creatorcontrib><title>Is metabolic-healthy obesity associated with risk of dementia? An age-stratified analysis of the Whitehall II cohort study</title><title>BMC medicine</title><addtitle>BMC Med</addtitle><description><![CDATA[Metabolically healthy obesity is hypothesized to be a benign condition but whether this is the case for dementia remains debated. We examined the role of age at assessment of metabolic-obesity phenotypes in associations with incident dementia. Obesity (body mass index ≥ 30 kg/m ) and poor metabolic health (≥ 2 of elevated serum triglycerides, low HDL-C, elevated blood pressure, and elevated serum fasting glucose) were used to define four metabolic-obesity phenotypes (metabolically healthy (MHNO) and unhealthy non-obesity (MUNO), metabolically healthy (MHO) and unhealthy obesity (MUO)) at < 60, 60 to < 70, and ≥ 70 years using 6 waves of data from the Whitehall II study and their associations with incident dementia was examined using Cox regression. Analyses with exposures measured < 60, 60 to < 70, and ≥ 70 years involved 410 (5.8%), 379 (5.6%), and 262 (7.4%) incident dementia cases over a median follow-up of 20.8, 10.3, and 4.2 years respectively. In analyses of individual components, obesity before 60 years (HR 1.41, 95% CI: [1.08, 1.85]) but not at older ages was associated with dementia; unhealthy metabolic status when present < 60 years (HR 1.33, 95% CI: [1.08, 1.62]) and 60 to < 70 years (HR 1.32, 95% CI: [1.07, 1.62]) was associated with dementia. Compared to the metabolically healthy non-obesity group, the risk of dementia was higher in those with metabolically healthy obesity before 60 years (1.69; 95% CI: [1.16, 2.45]); this was not the case when metabolic-obesity phenotype was present at 60 to < 70 years or ≥ 70 years. Analyses at older ages were on smaller numbers due to death and drop-out but inverse probability weighting to account for missing data yielded similar results. Individuals with metabolically healthy obesity before age 60 had a higher risk of incident dementia over a 27-year follow-up; the excess risk dissipates when metabolic health and obesity are measured after 70 years.]]></description><subject>Age</subject><subject>Blood pressure</subject><subject>BMI</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body size</subject><subject>Cardiometabolic risk factors</subject><subject>Cholesterol</subject><subject>Cognition &amp; reasoning</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Dementia</subject><subject>Dementia - complications</subject><subject>Dementia - etiology</subject><subject>Dementia disorders</subject><subject>Dextrose</subject><subject>Drugs</subject><subject>Electronic health records</subject><subject>Glucose</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypotheses</subject><subject>Measurement</subject><subject>Metabolic status</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - complications</subject><subject>Middle Aged</subject><subject>Missing data</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Obesity, Metabolically Benign - complications</subject><subject>Obesity, Metabolically Benign - epidemiology</subject><subject>Phenotype</subject><subject>Phenotypes</subject><subject>Prevention</subject><subject>Questionnaires</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Semantics</subject><subject>Standard scores</subject><subject>Statistical analysis</subject><subject>Triglycerides</subject><subject>Weight control</subject><issn>1741-7015</issn><issn>1741-7015</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1rFTEUhgdRbK3-ARcSEMTN1HxMkslKLsWPgYIbxWXIZE7u5DozqUmGcv315vbW2opkkXB43jecc96qeknwOSGteJcIVUTUmLIaM8J53TyqTolsSC0x4Y_vvU-qZyntMKZcyuZpdcKkKi9CT6tfXUIzZNOHydt6BDPlcY9CD8nnPTIpBetNhgFd-zyi6NMPFBwaYIYle_MebRZktlCnHE32zhfQLGbaJ58OXB4BfR99htFME-o6ZMMYYkYpr8P-efXEmSnBi9v7rPr28cPXi8_15ZdP3cXmsraNwrnujRXCKAWitZL1g6QWOyYcHShuBgnWGoO5IkQJwXvZMMlBUonb3hLFi-Ss6o6-QzA7fRX9bOJeB-P1TSHErTYxezuBdo61SvRcte3QEN72XFruOGAqWkbJULzeHr2uYvi5Qsp69snCNJkFwpo0bVulVPHgBX39D7oLayzDOVAKY0kpFn-prSn_-8WFMkl7MNUbWdpoGFOkUOf_ocopi_A2LOB8qT8QvLknOK41hWnNPizpIUiPoI0hpQjubkAE60PK9DFluqRM36RMN0X06ra1tZ9huJP8iRX7DYsKygQ</recordid><startdate>20231114</startdate><enddate>20231114</enddate><creator>Machado-Fragua, Marcos D</creator><creator>Sabia, Séverine</creator><creator>Fayosse, Aurore</creator><creator>Hassen, Céline Ben</creator><creator>van der Heide, Frank</creator><creator>Kivimaki, Mika</creator><creator>Singh-Manoux, Archana</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2646-1510</orcidid></search><sort><creationdate>20231114</creationdate><title>Is metabolic-healthy obesity associated with risk of dementia? An age-stratified analysis of the Whitehall II cohort study</title><author>Machado-Fragua, Marcos D ; Sabia, Séverine ; Fayosse, Aurore ; Hassen, Céline Ben ; van der Heide, Frank ; Kivimaki, Mika ; Singh-Manoux, Archana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-bac66a99e68c73bd72c0f36f2d204d7eccaa059119665b74375e72708bc195c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Blood pressure</topic><topic>BMI</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body size</topic><topic>Cardiometabolic risk factors</topic><topic>Cholesterol</topic><topic>Cognition &amp; reasoning</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Dementia</topic><topic>Dementia - complications</topic><topic>Dementia - etiology</topic><topic>Dementia disorders</topic><topic>Dextrose</topic><topic>Drugs</topic><topic>Electronic health records</topic><topic>Glucose</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypotheses</topic><topic>Measurement</topic><topic>Metabolic status</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - complications</topic><topic>Middle Aged</topic><topic>Missing data</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Obesity, Metabolically Benign - complications</topic><topic>Obesity, Metabolically Benign - epidemiology</topic><topic>Phenotype</topic><topic>Phenotypes</topic><topic>Prevention</topic><topic>Questionnaires</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Semantics</topic><topic>Standard scores</topic><topic>Statistical analysis</topic><topic>Triglycerides</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Machado-Fragua, Marcos D</creatorcontrib><creatorcontrib>Sabia, Séverine</creatorcontrib><creatorcontrib>Fayosse, Aurore</creatorcontrib><creatorcontrib>Hassen, Céline Ben</creatorcontrib><creatorcontrib>van der Heide, Frank</creatorcontrib><creatorcontrib>Kivimaki, Mika</creatorcontrib><creatorcontrib>Singh-Manoux, Archana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Machado-Fragua, Marcos D</au><au>Sabia, Séverine</au><au>Fayosse, Aurore</au><au>Hassen, Céline Ben</au><au>van der Heide, Frank</au><au>Kivimaki, Mika</au><au>Singh-Manoux, Archana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is metabolic-healthy obesity associated with risk of dementia? 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Obesity (body mass index ≥ 30 kg/m ) and poor metabolic health (≥ 2 of elevated serum triglycerides, low HDL-C, elevated blood pressure, and elevated serum fasting glucose) were used to define four metabolic-obesity phenotypes (metabolically healthy (MHNO) and unhealthy non-obesity (MUNO), metabolically healthy (MHO) and unhealthy obesity (MUO)) at < 60, 60 to < 70, and ≥ 70 years using 6 waves of data from the Whitehall II study and their associations with incident dementia was examined using Cox regression. Analyses with exposures measured < 60, 60 to < 70, and ≥ 70 years involved 410 (5.8%), 379 (5.6%), and 262 (7.4%) incident dementia cases over a median follow-up of 20.8, 10.3, and 4.2 years respectively. In analyses of individual components, obesity before 60 years (HR 1.41, 95% CI: [1.08, 1.85]) but not at older ages was associated with dementia; unhealthy metabolic status when present < 60 years (HR 1.33, 95% CI: [1.08, 1.62]) and 60 to < 70 years (HR 1.32, 95% CI: [1.07, 1.62]) was associated with dementia. Compared to the metabolically healthy non-obesity group, the risk of dementia was higher in those with metabolically healthy obesity before 60 years (1.69; 95% CI: [1.16, 2.45]); this was not the case when metabolic-obesity phenotype was present at 60 to < 70 years or ≥ 70 years. Analyses at older ages were on smaller numbers due to death and drop-out but inverse probability weighting to account for missing data yielded similar results. Individuals with metabolically healthy obesity before age 60 had a higher risk of incident dementia over a 27-year follow-up; the excess risk dissipates when metabolic health and obesity are measured after 70 years.]]></abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>37957712</pmid><doi>10.1186/s12916-023-03155-4</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2646-1510</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age
Blood pressure
BMI
Body mass
Body Mass Index
Body size
Cardiometabolic risk factors
Cholesterol
Cognition & reasoning
Cohort Studies
Complications and side effects
Dementia
Dementia - complications
Dementia - etiology
Dementia disorders
Dextrose
Drugs
Electronic health records
Glucose
Health aspects
Health risks
High density lipoprotein
Humans
Hypertension
Hypotheses
Measurement
Metabolic status
Metabolic syndrome
Metabolic Syndrome - complications
Middle Aged
Missing data
Mortality
Obesity
Obesity - complications
Obesity - epidemiology
Obesity, Metabolically Benign - complications
Obesity, Metabolically Benign - epidemiology
Phenotype
Phenotypes
Prevention
Questionnaires
Risk
Risk Factors
Semantics
Standard scores
Statistical analysis
Triglycerides
Weight control
title Is metabolic-healthy obesity associated with risk of dementia? An age-stratified analysis of the Whitehall II cohort study
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