A simple blood test has revealed one in five people living with overweight and ‘unhealthy fat’ could have a heart attack in the next 10 years, in a study funded by us.
In this group of people, one in 10 are predicted to develop heart failure in the next decade, based on research by the University of Leeds, and presented at the annual conference of the British Cardiovascular Society in Manchester.
Understanding how fat behaves in people’s bodies is as important as simply looking at their body mass index (BMI), the researchers conclude, and could help better target weight loss drugs to the right people.
Unhealthy fat was investigated using blood test results from almost 22,000 people who signed up to the UK Biobank health study between the ages of 40 and 69 and were living with overweight. Researchers looked at levels of 12 red-flag proteins in people’s blood which may change when their fat tissue is behaving abnormally.
Among people with abnormal levels of at least 10 of the 12 proteins, one in five (20%) had a heart attack in the next decade and almost one in four (23%) developed diabetes.
Patient test possible in five years
The researchers hope their findings could help develop a blood test for GPs, which could be available within five years, to flag people’s risk of cardiovascular disease and diabetes.
Dr Oliver Brown, who led the study from the University of Leeds said: “We found that some people living with overweight already have fat tissue showing signs of stress. If we can look for this unhealthy fat with a simple blood test, that may help identify high-risk individuals earlier who may benefit from being prescribed weight loss drugs before they suffer a major medical event.”
Our Chief Scientific and Medical Officer, Professor Bryan Williams, said: “BMI is a useful measure to help work out whether someone is a healthy weight, but we already know it only provides part of the picture as it is cannot differentiate between fat, muscle and bone.
“Now we have further evidence that, beyond BMI, changes in someone’s fat tissue could also be important for their cardiovascular health.
“If we can predict people’s risk of cardiovascular disease, we can signpost them towards the treatments which can help them to live better for longer. So we are always looking to improve the prediction of that risk, and tests analysing fat tissue health could be a promising tool.”
Researchers discovered 425 ‘badly behaved’ genes in the fat tissue of people living with overweight which were overactive or underactive. These 425 genes were the first step in developing a simple blood test to show if someone has unhealthy fat.
Genes instruct the body to make proteins, which can be detected in the blood. And researchers found 12 of the 425 genes produced abnormal levels of proteins which were significantly linked to diabetes.
The researchers suspected the same proteins could indicate cardiovascular disease, which may also be triggered by unhealthy fat.
Heart attacks predicted
As the researchers had hoped, the test was able to predict people’s risk of cardiovascular disease. In the UK Biobank group of 21,692 people who did not have diabetes, but were living with overweight, 20 per cent of those with a protein score of 10 or above had a heart attack in the next decade, Meanwhile 10 per cent developed heart failure and 12 per cent were diagnosed with atrial fibrillation.
The study results suggest the time when people are living with overweight may be a crucial window of time to prescribe weight-loss jabs for some people. Currently the weight management injection (tirzepatide, which has the brand name Mounjaro) is available through the NHS only for people living with overweight who also have weight-related health problems.
That is because people living with overweight had almost nine times the number of abnormally behaving genes in their fat tissue compared to people living with obesity.
The study was also funded by NIHR Biomedical Research Centre (BRC): Leeds at Leeds Teaching Hospitals NHS Trust.
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