Ahmad MI, et al. - Via involving a total of 3,700 candidates (58.7 ± 13.6 years) without cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey (NHANES III), researchers explored the relationship of metabolically healthy obesity (MHO) and other obesity phenotypes (metabolically healthy without obesity [MHNO; reference], metabolically unhealthy without obesity, MHO, and metabolically unhealthy obesity) with ECG markers to understand the pathophysiological basis of increased cardiovascular disease (CVD) risk related to these phenotypes. Among all phenotypes, higher odds of prolonged PR interval, P-wave duration, and QRS duration were noted relative to MHNO, with the highest in candidates with obesity with or without metabolic syndrome. However, the association trend with obesity phenotypes for the QT interval was as follows, from the strongest to the least powerful: metabolically unhealthy obesity, metabolically healthy without obesity, and then MHO, compared with MHNO. An association of obesity phenotypes with ECG abnormalities also raises doubts about MHO's concept as a healthy state. Variations in associations with ECG markers (PR interval, P-wave duration, QRS duration, and QT interval) may suggest a different relationship between metabolic syndrome and obesity with different CVD outcomes and may explain some of the inconsistent CVD estimates for MHO.