The transition of metabolic phenotypes and cardiovascular events: Panasonic cohort study 16

Abstract Objective The study objective was to investigate whether changes in metabolic phenotype affect the risk of cardiovascular events. Methods All 117,589 participants were included in this retrospective cohort study. The metabolic phenotypes of the participants were assessed at two points (the second evaluation was set 2 years after the first evaluation), and the incidence rate of cardiovascular events was observed for 11 years. The main outcome was 3‐point major adverse cardiac events (MACE), which comprises cardiovascular death, nonfatal coronary artery disease, and nonfatal stroke incidence. Results Of the participants, 2748 (2.3%) cases of 3‐point MACE were identified during follow‐up. The stable metabolically healthy obesity group had a higher risk of 3‐point MACE than those with stable metabolically healthy nonobesity (MHNO). Additionally, the change from metabolically healthy obesity to MHNO for 2 years decreased the risk of 3‐point MACE (hazard ratio [HR], 1.12: 95% CI: 0.84–1.47) to the same level as stable MHNO. However, the change from metabolically abnormal nonobesity and metabolically abnormal obesity to MHNO for 2 years maintained a higher risk of 3‐point MACE (HR, 1.66 [95% CI: 1.36–2.01]; HR, 1.91 [95% CI: 1.22–2.81]) than those with stable MHNO. Conclusions Change in metabolic phenotype is associated with incident 3‐point MACE.