{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:55:53Z","timestamp":1792277753873,"version":"4.4.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>To investigate whether obesity with or without metabolic syndrome is prospectively associated with coronary artery calcium (CAC) progression and incident cardiovascular disease events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              A total of 1730 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included (age, 40.1\u00b13.6 years; 38.3% men), who completed computed tomography of CAC at baseline (year 15: 2000\u20132001) and follow-up (year 20 or 25). Metabolically healthy obesity (MHO) was defined as body mass index\u226530 kg\/m\n              <jats:sup>2<\/jats:sup>\n              without any metabolic syndrome components in our main analysis. Sensitivity analyses were conducted for several conditions characterizing 4 metabolic phenotypes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>During a mean follow-up of 9.1 years, 439 participants had CAC progression. MHO subjects had a significantly higher risk of CAC progression than their metabolically healthy normal weight counterparts (adjusted hazard ratios [95% CIs] from 1.761 [1.369\u20132.264] to 2.047 [1.380\u20133.036]) depending on the definition of MHO adopted. Obesity with unhealthy metabolic profile remained the highest significant risk of CAC progression and cardiovascular disease events whatever the definitions adopted for metabolically unhealthy status. Up to 60% of participants with MHO converted to metabolically unhealthy obesity from year 15 to year 20 or year 25. Further sensitivity analysis showed that MHO throughout carried a similar risk of incident cardiovascular disease events compared with metabolically healthy normal weight throughout.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Different metabolic phenotypes of obesity beginning at a young age exhibit distinct risks of CAC progression and subsequent cardiovascular disease events in later midlife. MHO represents an intermediate phenotype between metabolically low- to high-risk obese individuals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT00005130.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/atvbaha.122.317526","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T09:00:15Z","timestamp":1649322015000},"page":"677-688","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Different Metabolic Phenotypes of Obesity and Risk of Coronary Artery Calcium Progression and Incident Cardiovascular Disease Events: The CARDIA Study"],"prefix":"10.1161","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct00005130","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jing-Wei","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiology (J.-W.G., S.Y., Q.-Y.H., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"You","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., S.Y., Q.-Y.H., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao-Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Medical Research Center (Z.-Y.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Yun","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., S.Y., Q.-Y.H., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., S.Y., Q.-Y.H., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique A.","family":"Vuitton","sequence":"additional","affiliation":[{"name":"Research Unit EA 3181, Universit\u00e9 Bourgogne Franche-Comt\u00e9, Besan\u00e7on, France (D.A.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Ling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology (S.-L.Z.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin-Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., S.Y., Q.-Y.H., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32129-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2460"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23280"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.034"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.171016"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI129186"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.8505"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2007.11.004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-3475"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0574"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-14-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1971"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-11-201312030-00008"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072100"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy217"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.042"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20883"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2018.11.002"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.8815"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2013.07.005"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074564"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1760"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178741"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(91)90002-4"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90080-7"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"e_1_3_3_29_2","first-page":"i","article-title":"Obesity: preventing and managing the global epidemic. Report of a WHO consultation.","volume":"894","year":"2000","unstructured":"Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i\u2013xii, 1\u2013253.","journal-title":"World Health Organ Tech Rep Ser"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2341040439"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e31817579ee"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-t"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.11.008"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.10.025"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13551"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-198911000-00003"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003970"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2014.07.015"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487315623884"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx448"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.011"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.055"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.06.023"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30292-9"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaa151"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.118.311880"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.110.236596"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.107.153668"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.116.306258"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.2008"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2019.00132"}],"container-title":["Arteriosclerosis, Thrombosis, and Vascular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/ATVBAHA.122.317526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T23:43:43Z","timestamp":1715557423000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/ATVBAHA.122.317526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1161\/ATVBAHA.122.317526"],"URL":"https:\/\/doi.org\/10.1161\/atvbaha.122.317526","relation":{},"ISSN":["1079-5642","1524-4636"],"issn-type":[{"value":"1079-5642","type":"print"},{"value":"1524-4636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"2021-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}