Association of metabolic health and obesity with coronary heart disease in adult cancer survivors

Author:

Kim Kyuwoong12ORCID,Di Giovanna Edvige3,Jung Hyeyun4,Bethineedi Lakshimi Deepak5,Jun Tae Joon6,Kim Young‐Hak67

Affiliation:

1. National Cancer Control Institute National Cancer Center Goyang Republic of Korea

2. Graduate School of Cancer Science and Policy National Cancer Center Goyang Republic of Korea

3. Department of Diagnostic and Interventional Radiology Ammerland‐Klinik Westerstede Lower Saxony Germany

4. Department of Computing Newcastle University Newcastle upon Tyne UK

5. Andhra Medical College Medical College Road King George Hospital Visakhapatnam Andhra Pradesh India

6. Big Data Research Center, Asan Institute for Life Science, Asan Medical Center Seoul Republic of Korea

7. Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea

Abstract

AbstractBackgroundThe metabolically healthy obese (MHO) phenotype is associated with an increased risk of coronary heart disease (CHD) in the general population. However, association of metabolic health and obesity phenotypes with CHD risk in adult cancer survivors remains unclear. We aimed to investigate the associations between different metabolic health and obesity phenotypes with incident CHD in adult cancer survivors.MethodsWe used National Health Insurance Service (NHIS) to identify a cohort of 173,951 adult cancer survivors aged more than 20 years free of cardiovascular complications. Metabolically healthy nonobese (MHN), MHO, metabolically unhealthy nonobese (MUN), metabolically unhealthy obese (MUO) phenotypes were created using as at least three out of five metabolic health criteria along with obesity (body mass index ≥ 25.0 kg/m2). We used Cox proportional hazards model to assess CHD risk in each metabolic health and obesity phenotypes.ResultsDuring 1,376,050 person‐years of follow‐up, adult cancer survivors with MHO phenotype had a significantly higher risk of CHD (hazard ratio [HR] = 1.52; 95% confidence intervals [CI]: 1.41 to 1.65) as compared to those without obesity and metabolic abnormalities. MUN (HR = 1.81; 95% CI: 1.59 to 2.06) and MUO (HR = 1.92; 95% CI: 1.72 to 2.15) phenotypes were also associated with an increased risk of CHD among adult cancer survivors.ConclusionsAdult cancer survivors with MHO phenotype had a higher risk of CHD than those who are MHN. Metabolic health status and obesity were jointly associated with CHD risk in adult cancer survivors.

Funder

Korea Health Industry Development Institute

Publisher

Wiley

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