Predictors of cardiovascular outcomes in individuals with different obesity phenotypes

Obesity is recognized as a global non-communicable epidemic, and it is also a major medical and social problem that worsens with each passing year. Cardiometabolic risk associated with obesity is the basis for disability and a large number of premature deaths. Obese individuals are a heterogeneous group. Phenotypes of obesity have significant differences in metabolic profiles, predictions and are the subject of study aimed at developing personalized approaches to prevention and treatment. Objective. To study the predictors of cardiovascular outcomes in persons with different phenotypes of obesity. Materials and methods. A retrospective analysis on the ground of the MERIDIAN-RO epidemiological study base, which included 1622 persons aged 25—64 years, with assessment of the development of cardiovascular events in subjects with different phenotypes of obesity during 5 years, was performed. Endpoints were accepted: death from cardiovascular diseases, non-fatal infarction and stroke. Combined endpoint included all these states. Results. There have been no statistically significant differences in the coming of death from cardiovascular diseases, as well as in the development of non-fatal infarction and stroke in persons with different phenotypes of obesity. In the cohort of metabolically healthy obesity, death from cardiovascular diseases, non-fatal infarction, combined endpoint have been noted more frequently in men. Analysis of the relationship between other risk factors and outcomes has revealed that the combined endpoint was influenced by male sex, age over 55 years, history of diabetes mellitus and myocardial infarction, as well as fasting blood glucose above 6.1 mmol/L. Conclusion. The phenotype of metabolically healthy obesity cannot be a reliable and stable indicator of favorable prognosis and future risk.