The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies

Jana V van Vliet-Ostaptchouk, Marja-Liisa Nuotio, Sandra N Slagter, Dany Doiron, Krista Fischer, Luisa Foco, Amadou Gaye, Martin Gögele, Margit Heier, Tero Hiekkalinna, Anni Joensuu, Christopher Newby, Chao Pang, Eemil Partinen, Eva Reischl, Christine Schwienbacher, Mari-Liis Tammesoo, Morris A Swertz, Paul Burton, Vincent FerrettiIsabel Fortier, Lisette Giepmans, Jennifer R Harris, Hans L Hillege, Jostein Holmen, Antti Jula, Jenny E Kootstra-Ros, Kirsti Kvaløy, Turid Lingaas Holmen, Satu Männistö, Andres Metspalu, Kristian Midthjell, Madeleine J Murtagh, Annette Peters, Peter P Pramstaller, Timo Saaristo, Veikko Salomaa, Ronald P Stolk, Matti Uusitupa, Pim van der Harst, Melanie M van der Klauw, Melanie Waldenberger, Markus Perola, Bruce Hr Wolffenbuttel

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies.

METHODS: Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease.

RESULTS: Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes.

CONCLUSIONS: Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.

Original languageEnglish
Pages (from-to)9
JournalBMC Endocrine Disorders
Publication statusPublished - 1 Feb 2014
Externally publishedYes


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