{"doi":"10.1210/clinem/dgaf684","title":"Associations of Metabolic Phenotypes with Cardiac Structure and Clinical Outcomes: Insights from the UK Biobank","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Context</jats:title>\n                    <jats:p>Metabolic syndrome and obesity represent major cardiovascular risk factors, yet their combined effects on cardiac structure and clinical outcomes remain incompletely understood.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To examine associations between metabolic phenotypes, cardiac magnetic resonance imaging (CMR), and clinical outcomes.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Design</jats:title>\n                    <jats:p>Prospective study with a median 5.1-year follow-up.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting</jats:title>\n                    <jats:p>Population-based cohort from the UK Biobank.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants</jats:title>\n                    <jats:p>A total of 22 789 participants (mean age 64.1 ± 7.5 years, 52.6% female) were categorized as metabolically healthy nonobese (MHN) vs obese (MHO) or unhealthy nonobese (MUN) vs obese (MUO), based on obesity (body mass index ≥30 kg/m²) and metabolic status (prevalent diabetes or both hypertension and hyperlipidemia).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)</jats:title>\n                    <jats:p>Primary and secondary endpoints were major adverse cardiovascular events (MACE) and all-cause mortality, respectively. CMR included left ventricular ejection fraction (LVEF, %), end-diastolic volume (LVEDV, mL), myocardial mass (g), wall thickness (mm), cardiac output (L/min), and left atrial volume (mL). Linear regression and Cox proportional hazards models, adjusted for age, sex, and smoking, assessed associations between metabolic phenotypes, CMR, and clinical outcomes.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>In adjusted models, all phenotypes demonstrated increased WT (MHO: β=.53 [.50, .55]; MUN: β=.24 [.21, .27]; MUO: β=.66 [.61, .70]), compared to MHN. LVEDV was increased in obesity phenotypes (MHO: β=4.67 [4.07, 5.27]; MUO: β=5.14 [4.05, 6.22]) and decreased in MUN (β=−1.25 [−1.95, −.55]), while MUO showed reduced LVEF (β=−.48 [−.91, −.04]). MACE risk was increased in unhealthy phenotypes (MUN: adjusted hazard ratio (aHR) = 1.55 [1.16-2.07]; MUO: aHR = 1.95 [1.28-2.97]). All phenotypes showed increased all-cause mortality risk (MHO: aHR = 1.65 [1.23-2.21]; MUN: aHR = 1.41 [1.05-1.90]; MUO: 2.10 [1.41-3.15]).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Metabolic phenotypes show distinct cardiac structural changes and increased mortality risk, supporting their potential in cardiovascular risk stratification.</jats:p>\n                  </jats:sec>","journal":"The Journal of Clinical Endocrinology &amp; Metabolism","year":2026,"id":626390,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1392877,"name":"Matthias Jung","orcid":"0000-0001-6808-6494","position":1,"is_corresponding":false},{"id":898664,"name":"Marco Reisert","orcid":"0000-0003-2742-1940","position":2,"is_corresponding":false},{"id":1620291,"name":"Juliane Maushagen","orcid":"0009-0007-1224-1628","position":3,"is_corresponding":false},{"id":1548077,"name":"Susanne Rospleszcz","orcid":"0000-0002-4788-2341","position":4,"is_corresponding":false},{"id":1620292,"name":"Janis M Nolde","orcid":null,"position":5,"is_corresponding":false},{"id":58321,"name":"Christopher L. Schlett","orcid":"0000-0002-1576-1481","position":6,"is_corresponding":false},{"id":58322,"name":"Fabian Bamberg","orcid":"0000-0002-7460-3942","position":7,"is_corresponding":false},{"id":690882,"name":"Andreas A. Kammerlander","orcid":"0000-0002-7632-9879","position":8,"is_corresponding":false},{"id":1014359,"name":"Jakob Weiss","orcid":"0000-0002-1574-9589","position":9,"is_corresponding":false},{"id":503214,"name":"Jana Taron","orcid":"0000-0002-1388-7531","position":10,"is_corresponding":false},{"id":1620290,"name":"Balázs Bogner","orcid":"0009-0004-8578-295X","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Associations of Metabolic Phenotypes with Cardiac Structure and Clinical Outcomes: Insights from the UK Biobank","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Context</jats:title>\n                    <jats:p>Metabolic syndrome and obesity represent major cardiovascular risk factors, yet their combined effects on cardiac structure and clinical outcomes remain incompletely understood.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To examine associations between metabolic phenotypes, cardiac magnetic resonance imaging (CMR), and clinical outcomes.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Design</jats:title>\n                    <jats:p>Prospective study with a median 5.1-year follow-up.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting</jats:title>\n                    <jats:p>Population-based cohort from the UK Biobank.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants</jats:title>\n                    <jats:p>A total of 22 789 participants (mean age 64.1 ± 7.5 years, 52.6% female) were categorized as metabolically healthy nonobese (MHN) vs obese (MHO) or unhealthy nonobese (MUN) vs obese (MUO), based on obesity (body mass index ≥30 kg/m²) and metabolic status (prevalent diabetes or both hypertension and hyperlipidemia).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)</jats:title>\n                    <jats:p>Primary and secondary endpoints were major adverse cardiovascular events (MACE) and all-cause mortality, respectively. CMR included left ventricular ejection fraction (LVEF, %), end-diastolic volume (LVEDV, mL), myocardial mass (g), wall thickness (mm), cardiac output (L/min), and left atrial volume (mL). Linear regression and Cox proportional hazards models, adjusted for age, sex, and smoking, assessed associations between metabolic phenotypes, CMR, and clinical outcomes.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>In adjusted models, all phenotypes demonstrated increased WT (MHO: β=.53 [.50, .55]; MUN: β=.24 [.21, .27]; MUO: β=.66 [.61, .70]), compared to MHN. LVEDV was increased in obesity phenotypes (MHO: β=4.67 [4.07, 5.27]; MUO: β=5.14 [4.05, 6.22]) and decreased in MUN (β=−1.25 [−1.95, −.55]), while MUO showed reduced LVEF (β=−.48 [−.91, −.04]). MACE risk was increased in unhealthy phenotypes (MUN: adjusted hazard ratio (aHR) = 1.55 [1.16-2.07]; MUO: aHR = 1.95 [1.28-2.97]). All phenotypes showed increased all-cause mortality risk (MHO: aHR = 1.65 [1.23-2.21]; MUN: aHR = 1.41 [1.05-1.90]; MUO: 2.10 [1.41-3.15]).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Metabolic phenotypes show distinct cardiac structural changes and increased mortality risk, supporting their potential in cardiovascular risk stratification.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41428372","pmcid":"PMC13183448","openalex_id":"https://openalex.org/W7116839846","authors":[],"funders":[],"total_grants":0,"fwci":0.6799,"citation_percentile":0.75849146,"influential_citations":0,"citation_trend":[{"year":2025,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1210/clinem/dgaf684","host_type":"journal"},{"url":"https://doi.org/10.1210/clinem/dgaf684","host_type":"publisher"},{"url":"https://academic.oup.com/jcem/advance-article-pdf/doi/10.1210/clinem/dgaf684/66106604/dgaf684.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/jcem/article-pdf/111/6/e1595/66106604/dgaf684.pdf","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41428372","host_type":"repository"},{"url":"https://freidok.uni-freiburg.de/data/275398","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13183448/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13183448","host_type":"Europe_PMC"}],"fields_of_study":["Cardiac Imaging and Diagnostics","Diabetes, Cardiovascular Risks, and Lipoproteins","Advanced MRI Techniques and Applications"],"mesh_terms":["UK Biobank","Aged","Cardiovascular Diseases","Female","Follow-Up Studies","United Kingdom","Heart","Humans","Magnetic Resonance Imaging","Male","Middle Aged","Obesity","Phenotype","Prospective Studies","Risk Factors","Biological Specimen Banks","Metabolic Syndrome"],"keywords":["Biobank","Phenotype","Disease","Clinical phenotype","Population","Metabolism","Cardiovascular diseases","Obesity","Mortality","Magnetic Resonance Imaging"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-04T13:40:33.168649Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}