Evidence map›Paper›PMID 33952606›Full record

ArticleDiabetes care2021

High Burden of Subclinical and Cardiovascular Disease Risk in Adults With Metabolically Healthy Obesity: The Atherosclerosis Risk in Communities (ARIC) Study.

Yvonne Commodore-Mensah, Mariana Lazo, Olive Tang, Justin B Echouffo-Tcheugui, Chiadi E Ndumele, Vijay Nambi, Dan Wang, Christie Ballantyne, Elizabeth Selvin

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
4.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Yvonne Commodore-MensahJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0002-5054-3025
Mariana LazoJohns Hopkins School of Medicine, Baltimore, MD.
Olive TangJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0002-8075-1298
Justin B Echouffo-TcheuguiJohns Hopkins School of Medicine, Baltimore, MD.ORCID 0000-0002-8460-1617
Chiadi E NdumeleJohns Hopkins School of Medicine, Baltimore, MD.
Vijay NambiBaylor College of Medicine, Houston, TX.
Dan WangJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Christie BallantyneBaylor College of Medicine, Houston, TX.
Elizabeth SelvinJohns Hopkins Bloomberg School of Public Health, Baltimore, MD eselvin@jhu.edu.ORCID 0000-0001-6923-7151
Johns Hopkins University · USBaylor College of Medicine · USMichael E. DeBakey VA Medical Center · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Medical Scientist Training ProgramT32GM136577 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI ANDREA L COX · 2020 to 2026
$13.4M
Institute for Clinical and Translational ResearchKL2TR001077 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$9.2M
Diabetes and Prediabetes in Older Adults in ARICR01DK089174 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2011 to 2020
$6.4M
Elucidating the Role of Adipokines in Mediating and Predicting HF Associated with ObesityR01HL146907 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI NDUMELE, CHIADI E · 2019 to 2023
$4.0M
Profiling Cardiovascular Events and Biomarkers in the Very Old to Improve Personalized Approaches for the Prevention of Cardiac and Vascular DiseaseR01HL134320 · NHLBI · BAYLOR COLLEGE OF MEDICINE · PI BALLANTYNE, CHRISTIE MITCHELL, SELVIN, ELIZABETH · 2016 to 2019
$3.1M
Research and Mentoring in the Clinical Epidemiology of Cardiovascular Disease and Type 2 DiabetesK24HL152440 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2020 to 2024
$612k
Racial disparities in diabetes- and prediabetes-associated outcomes in older adultsF30DK120160 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI TANG, OLIVE · 2018 to 2020
$145k
NCATS NIH HHS KL2 TR001077NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS K24 HL152440NHLBI NIH HHS R01 HL134320NHLBI NIH HHS R01 HL146907NIDDK NIH HHS F30 DK120160NIDDK NIH HHS R01 DK089174NIGMS NIH HHS T32 GM007309NIGMS NIH HHS T32 GM136577
6 · The paper itself

Abstract

objectiveIt is controversial whether adults who are obese but "metabolically healthy" have cardiovascular disease (CVD) risk comparable with that of normal-weight adults. High-sensitivity cardiac troponin T (hs-cTnT), a biomarker of myocardial damage, is useful in characterizing subclinical CVD. We categorized obesity phenotypes and studied their associations with subclinical and clinical CVD and CVD subtypes, including heart failure (HF). RESEARCH DESIGN AND

methodsWe conducted cross-sectional and prospective analyses of 9,477 adults in the Atherosclerosis Risk in Communities (ARIC) study. We used the Adult Treatment Panel III criteria and BMI to define obesity phenotypes as follows: metabolically healthy normal weight, metabolically healthy overweight, metabolically healthy obese, metabolically unhealthy normal weight, metabolically unhealthy overweight, and metabolically unhealthy obese.

resultsAt baseline (1990-1992), mean age was 56 years, 56% were female, 23% were Black, and 25% had detectable hs-cTnT (≥6 ng/L). Over a median of 17 years of follow-up, there were 2,603 clinical CVD events. Those with the metabolically healthy obese (hazard ratio [HR] 1.38, 95% CI 1.15-1.67), metabolically unhealthy normal weight (HR 1.51, 95% CI 1.30-1.76), metabolically unhealthy overweight (HR 1.60, 95% CI 1.41-1.82), and metabolically unhealthy obese (HR 2.14, 95% CI 1.88-2.44) phenotypes had higher CVD risks in comparison with metabolically healthy normal weight. Detectable hs-cTnT (≥6 ng/L) was associated with higher CVD risk, even among metabolically healthy normal-weight adults. Metabolically healthy obese adults had higher HF risk (HR 1.65, 95% CI 1.30-2.09) in comparison with metabolically healthy normal weight.

conclusionsThe metabolically healthy obese phenotype was associated with excess burden of clinical CVD, primarily driven by an excess risk of HF. hs-cTnT was useful in stratifying CVD risk across all obesity phenotypes, even among obese individuals who appear otherwise metabolically healthy.

Indexed as

AtherosclerosisCardiovascular DiseasesObesity, Metabolically BenignBody Mass IndexCross-Sectional StudiesFemaleHumansMiddle AgedProspective StudiesRisk Factors

Identifiers

PMID33952606
PMCPMC8323178
OpenAlexW3159185858

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.