ArticleObesity pillars2025
Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18-44 years): Insights from the National Inpatient Sample.
Article in Obesity pillars, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored. Methods: This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18-44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group. Results: Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, >84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70-1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4-3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39-30.53), drug users (aOR 2.87, 95%Cl 1.05-7.86), cancer patients (aOR 9.70, 95%Cl 2.14-44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07-116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86-11.08), elective admission (aOR 3.71, 95%Cl 0.74-18.58), and tobacco use (aOR 0.81, 95%Cl 0.26-2.60) were not statistically significant predictors. Conclusion: Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.
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