Diabetes Forecast

Poor Metabolic Health, But Not Obesity, Is Linked to Early Heart Disease in Mexican Americans

What to Know

Obesity appears to contribute to plaque buildup in the arteries, a condition called atherosclerosis, which can lead to heart attack and stroke. However, some obese people do not have the other metabolic risk factors, such as high LDL (“bad”) cholesterol, that would elevate that risk. Curiously, Mexican Americans, even those who are obese, are no more likely to die from heart and blood vessel disease than whites. Are some ethnic groups more or less likely to develop heart disease and, if so, why? Researchers investigated whether overall metabolic health plays a bigger role than obesity in the development of early atherosclerosis in Mexican Americans.

The Study

The researchers divided 503 Mexican Americans into four groups, according to whether or not they were obese and/or metabolically healthy. Participants were metabolically healthy if they had fewer than two of the following conditions: high blood pressure, high triglycerides (fats in the blood), low HDL ("good") cholesterol, high fasting glucose, high insulin resistance, or high C-reactive protein (a measure that tells of how much insulin is produced by the pancreas). The researchers then checked each participant for plaque in their carotid arteries (an early sign of heart and blood vessel disease). They then compared the results from each of the four groups.

The Results

Most of the participants (77.8 percent) were metabolically unhealthy, particularly those who were male, were older, had fewer years of education, and did not eat the recommended number of daily fruit and vegetable servings. One-third (31.8 percent) had plaque in their arteries. However, obese participants were no more likely than non-obese participants to have such buildups. The researchers’ conclusion: Poor metabolic health, rather than obesity, was linked to atherosclerosis.


Overall metabolic health, it appears, plays a larger role than body weight in the development of heart and blood vessel disease in Mexican Americans. Helping all Mexican Americans improve their metabolic health—by lowering their blood pressure, for example—may be a more important goal than focusing efforts on weight loss. Longer-term studies including more participants are needed to confirm these results.

Subclinical atherosclerosis and obesity phenotypes among Mexican Americans, by Laing and colleagues. Journal of the American Heart Association 2015;4:e001540 https://doi.org/10.1161/JAHA.114.001540

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