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Conversions between metabolically unhealthy and healthy obesity from midlife to late-life
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States ; School of Health and Welfare, Jönkoping University, Sweden.
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2024 (English)In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 48, p. 433-436Article in journal (Refereed) Published
Abstract [en]

Introduction: Metabolically healthy obesity may be a transient phenotype, but studies with long follow-up, especially covering late-life, are lacking. We describe conversions between cross-categories of body mass index (BMI) and metabolic health in 786 Swedish twins with up to 27 years of follow-up, from midlife to late-life. Methods: Metabolic health was defined as the absence of metabolic syndrome (MetS). We first visualized conversions between BMI-metabolic health phenotypes in 100 individuals with measurements available at ages 50–64, 65–79, and ≥80. Next, we modeled conversion in metabolic health status by BMI category in the full sample using Cox proportional hazards regression. Results: The proportion of individuals with MetS and with overweight or obesity increased with age. However, one-fifth maintained a metabolically healthy overweight or obesity across all three age categories. Among those metabolically healthy at baseline, 59% converted to MetS during follow-up. Conversions occurred 56% more often among individuals with metabolically healthy obesity, but not overweight, compared to normal weight. Among those with MetS at baseline, 60% regained metabolic health during follow-up, with no difference between BMI categories. Conclusions: Conversions between metabolically healthy and unhealthy status occurred in both directions in all BMI categories. While conversions to MetS were more common among individuals with obesity, many individuals maintained or regained metabolic health during follow-up. 

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 48, p. 433-436
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gerontology, specialising in Medical and Health Sciences
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
URN: urn:nbn:se:his:diva-23473DOI: 10.1038/s41366-023-01425-yISI: 001112290100002PubMedID: 38042933Scopus ID: 2-s2.0-85178490780OAI: oai:DiVA.org:his-23473DiVA, id: diva2:1819520
Funder
Karolinska InstituteForte, Swedish Research Council for Health, Working Life and Welfare, 2018-01201Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-00672Swedish Research Council, 2016-03081Karolinska Institute, 2022-01296Karolinska Institute, 2023-01854The Karolinska Institutet's Research Foundation, 2022-01718NIH (National Institutes of Health), R01 AG060470NIH (National Institutes of Health), AG059329NIH (National Institutes of Health), AG04563NIH (National Institutes of Health), AG10175Forte, Swedish Research Council for Health, Working Life and Welfare, 97:0147:1BForte, Swedish Research Council for Health, Working Life and Welfare, 2009-0795Swedish Research Council, 825-2007-7460Swedish Research Council, 825- 2009-6141Swedish Research Council, 2021-00180
Note

CC BY 4.0 DEED

© 2023, The Author(s).

Published: 02 December 2023

Brief communication

Correspondence Address: I.K. Karlsson; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden; email: ida.karlsson@ki.se; CODEN: IJOBD

This work was supported by the Strategic Research Program in Epidemiology at Karolinska Institutet; the Swedish Research Council for Health, Working Life and Welfare (2018-01201 and 2022-00672); the Swedish Research Council (2016-03081); Loo and Hans Osterman Foundation for Medical Research (2022-01222 and 2023-01855); Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296 and 2023-01854); Karolinska Institutet’s Research Foundation (2022-01718); and the National Institutes of Health (R01 AG060470 and AG059329). The funding sources had no involvement in the current work. SATSA was supported by the National Institutes of Health (NIH; grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (FAS; Grants 97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). We acknowledge the Swedish Twin Registry for access to data. The Swedish Twin Registry is managed by Karolinska Institutet and receives funding through theSwedish Research Council under the grant no. 2021-00180.

Open access funding provided by Karolinska Institute.

Available from: 2023-12-14 Created: 2023-12-14 Last updated: 2024-04-03Bibliographically approved

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Dahl Aslan, Anna K.

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