Genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of type 2 diabetes and coronary artery disease.
Coronary artery disease -and complications that arise from it, such as heart attacks and heart failure- is the leading cause of death in the United States and across the world.
While other factors such as high cholesterol have been tied to coronary artery disease, the association between obesity and cardiovascular disease has not been clearly established.
How was the Study Conducted?
For the study, researchers performed an analysis of five studies with more than 880,000 participants.
Researchers examined participants’ genetic variations using a method called Mendelian randomization, which offers insight into the relationships between health risks and health outcomes.
This method cannot prove causality, but it can be suggestive of a causal association.
“This study is important because we can conclude that it is not solely factors like high blood pressure, high cholesterol or lack of exercise that tend to come with obesity that is harmful – the excess fat itself is harmful,” said Dr. Haitham Ahmed, the senior author of the study and a preventive cardiologist at Cleveland Clinic.
“Patients may think their cardiovascular risk is mitigated if their other risk factors are normal or being treated, but this study suggests you cannot ignore the extra weight. Physicians should take heed and make sure they are counseling their patients about weight loss in a comprehensive and collaborative manner,” he added.
What were the results?
The study showed that each five-point rise in BMI, for example from a BMI of 25 to a BMI of 30, increased the odds of type 2 diabetes by 67 percent and coronary artery disease by 20 percent.
In light of the Mendelian randomization, these increases are thought to be independent of traditional risk factors.
This means the risks hold true even if the patient has, for example, normal cholesterol, blood pressure, and blood sugar.
Three of the studies analyzed also included stroke as a clinical outcome, but the researchers did not find a significant association between obesity and all-cause stroke.
“It is very important to recognize that while lifestyle factors certainly contribute to obesity, obesity is not simply a lifestyle choice. It is a disease, and there is a large genetic influence on your weight,” Ahmed said.
“Our data show that nearly 100 genetic variations influence the development of obesity and subsequently increase your risk of heart disease.”
The research was published in the Journal of the American Medical Association Network Open.
Cleveland Clinic genetic analysis links obesity with diabetes, coronary artery disease. EurekAlert! 2018, November 16. Retrieved: https://www.eurekalert.org/pub_releases/2018-11/cc-ccg111418.php