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

Introduction. Childhood obesity and associated metabolic comorbidities is a major global health concern. Metabolic syndrome (MS) is a cluster of metabolic abnormalities that confers a substantial increase in cardiovascular disease risk. In the context of the childhood obesity pandemic, a distinct subgroup of youth with obesity less prone to the development of metabolic disturbances, called “metabolically healthy obese” (MHO), recently has come into focus. However, the diagnostic criteria of both conditions are still controversial in children. Therefore, the purpose of our research is to estimate the prevalence of metabolic syndrome and metabolically healthy obesity in school-age boys using international reference standards and to recognize the most sensitive metabolic markers. Materials and methods. This study was carried out at the Ternopil regional hospital (Western Ukraine) and involved randomly chosen 112 boys from rural and urban population; aged 10–17 years (mean ± SD, 14.6 ± 0.25). Height, weight and waist and hip circumferences were measured by standard methods in each patient. Body mass index (BMI, kg/m2), waist-to-height ratio (WtHR), waist-to-hip ratio (WHR) were calculated by common formulas. Obesity was defined as a BMI ≥ 2SD for age and gender. Blood pressure was measured and estimated according to European Society of Hypertension guidelines (2016). Biomarkers of carbohydrate and lipid metabolism were tested. Discussion. The study identified prominent physical and metabolic differences in groups of patients with MHO and manifested MS, as well as in the high-risk group for the realization of MS. As a result of this project, MHO and MS were confirmed in 49.11 % and 9.82 % surveyed boys, respectively. The rest of teenagers (32.14 %) based on metabolic disturbances, formed a cluster of the high-risk realization of MS. Moreover, fasting hyperglycemia and glucose intolerance were identified only in patients with manifested MS in 10.91 % and 5.45 % cases, respectively. It was found that the waist-to-height ratio > 0.5 is an informative test of obesity in general, and the waist-to-hip ratio > 0.9 is a sensitive screening tool for abdominal obesity in boys in our population. Based on the results, the triglyceride index is the most sensitive biomarker of insulin resistance compared to triglyceride-to-high density lipids cholesterol ratio and atherogenic coefficient in school-age boys. The results can be applied in pediatric practice for early identification of patients with metabolically unhealthy obesity with WHR and the triglyceride index at the early preclinical stage of MS manifestation. Keywords children, metabolically healthy obesity, metabolic syndrome, triglyceride index.

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Metabolically healthy obesity and risk of stroke: a meta-analysis of prospective cohort studies

Annals of Translational Medicine ◽

10.21037/atm-20-4387 ◽

2021 ◽

Vol 9 (3) ◽

pp. 197-197

Author(s):

Ling-Zhi Ma ◽

Fu-Rong Sun ◽

Zuo-Teng Wang ◽

Lin Tan ◽

Xiao-He Hou ◽

...

Keyword(s):

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Metabolically Healthy Obesity ◽

Prospective Cohort Studies ◽

Metabolically Healthy

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THE CHARACTERISTICS OF SECRETION OF ADIPONECTIN AND ITS RELATIONSHIP WITH PARTICULAR INDICESOF METABOLISM IN MALES OF ABLE-BODIED AGE IN CASE OF OBESITY

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2017-23-6-312-315 ◽

2017 ◽

Vol 23 (6) ◽

pp. 312-315

Author(s):

Olga V. Karataeva

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Low Density Lipoproteins ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Metabolically Healthy Obesity ◽

Significant Difference ◽

Fasting Glycaemia ◽

Metabolically Healthy ◽

Degree Of Severity

The sampling consisted of 79 examined males of able-bodied age. The arterial hypertension stage I and II was established in 58% of them; obesity of various degree of severity was diagnosed in 63% of them; metabolic syndrome according criteria ATP-III was noted in 46.8% of examined patients. The general clinical and anthropometric examination was carried out. The laboratory analyses included estimation of lipidogram, fasting glycaemia and also hormones adiponectin and insulin with following calculation of index of insulin resistance HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). The study was organized to investigate effecting of obesity on secretion of adiponectin and its relationship with indices of lipidogram and level of insulin resistance. The comparative analysis of groups with and absence of obesity established no significant difference in level of adiponectin and indices of lipidogram. the significant differences were established in the levels of basal insulin hence in value of index NOMA-IR that points to hyperinsulinemia and expressed insulin resistance in patients with obesity. The patients were separated in two groups depending on presence of manifestations of metabolic syndrome: with metabolically healthy obesity and metabolically complicated obesity. The analysis established a significant decreasing of level of adiponectin in the group of metabolically complicated obesity accompanied by insulin resistance, dyslipidemia and increased level of glycaemia. The study established no effect of degree of obesity on decreasing of level of adiponectin. The significant differences between levels of adiponectin in comparison between group without obesity and group of metabolically healthy obesity. The correlation analysis in group with obesity demonstrated back-coupling between level of adiponectin and content of total cholesterol, low density lipoproteins and coefficient of atherogenicity. The comparison of groups according median of adiponectin established significant differences in rate of development of metabolic syndrome and value of coefficient of atherogenicity.

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The association between transition from metabolically healthy obesity to metabolic syndrome, and incidence of cardiovascular disease: Tehran lipid and glucose study

PLoS ONE ◽

10.1371/journal.pone.0239164 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0239164

Author(s):

Farhad Hosseinpanah ◽

Erfan Tasdighi ◽

Maryam Barzin ◽

Maryam Mahdavi ◽

Arash Ghanbarian ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Metabolically Healthy Obesity ◽

Metabolically Healthy

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Metabolically healthy obesity and metabolic syndrome in Nigerian adults with major mental illness

Egyptian Journal of Psychiatry ◽

10.4103/1110-1105.193014 ◽

2016 ◽

Vol 37 (2) ◽

pp. 97 ◽

Cited By ~ 1

Author(s):

KehindeS Akinlade ◽

OlawumiO Satope ◽

VictorO Lasebikan ◽

SheuK Rahamon

Keyword(s):

Metabolic Syndrome ◽

Mental Illness ◽

Metabolically Healthy Obesity ◽

Metabolically Healthy

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Metabolically healthy obesity and risk of incident type 2 diabetes: a meta‐analysis of prospective cohort studies

Obesity Reviews ◽

10.1111/obr.12157 ◽

2014 ◽

Vol 15 (6) ◽

pp. 504-515 ◽

Cited By ~ 224

Author(s):

J. A. Bell ◽

M. Kivimaki ◽

M. Hamer

Keyword(s):

Type 2 Diabetes ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Metabolically Healthy Obesity ◽

Incident Type ◽

Prospective Cohort Studies ◽

Incident Type 2 Diabetes ◽

Metabolically Healthy

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Prevalence of Metabolically Healthy Obesity (MHO) and its relation with incidence of metabolic syndrome, hypertension and type 2 Diabetes amongst individuals aged over 20 years in Ahvaz: A 5 Year cohort Study (2009–2014)

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2017.07.036 ◽

2017 ◽

Vol 11 ◽

pp. S1037-S1040 ◽

Cited By ~ 10

Author(s):

Seyed Mahmoud Latifi ◽

Majid Karandish ◽

Hajieh Shahbazian ◽

Jalaly Mohammad taha ◽

Bahman Cheraghian ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Cohort Study ◽

Metabolically Healthy Obesity ◽

Metabolically Healthy

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Association between being metabolically healthy/unhealthy and metabolic syndrome in Iranian adults

PLoS ONE ◽

10.1371/journal.pone.0262246 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262246

Author(s):

Ozra Tabatabaei-Malazy ◽

Sahar Saeedi Moghaddam ◽

Masoud Masinaei ◽

Nazila Rezaei ◽

Sahar Mohammadi Fateh ◽

...

Keyword(s):

Metabolic Syndrome ◽

Public Awareness ◽

Normal Weight ◽

Healthy Lifestyles ◽

Adult Treatment Panel ◽

Metabolically Healthy Obesity ◽

Anthropometric Data ◽

Metabolic Markers ◽

Obese Subjects ◽

Metabolically Healthy

Introduction The prevalence of metabolically healthy obesity (MHO) varies based on different criteria. We assessed the prevalence of MHO and metabolic unhealthiness based on body mass index (BMI) and their association with metabolic syndrome (MetS) in a nation-wide study. Methods Data were taken from the STEPs 2016 study, from 18,459 Iranians aged ≥25 years. Demographic, metabolic, and anthropometric data were collected. Subjects were stratified by BMI, metabolic unhealthiness, and having MetS. The latter was defined based on National Cholesterol Education Program Adult Treatment Panel III 2004 (NCEP ATP III), was then assessed. Results The prevalence of MHO and metabolic unhealthiness in obese subjects was 7.5% (about 3.6 million) and 18.3% (about 8.9 million), respectively. Most of the metabolic unhealthy individuals were female (53.5%) or urban residents (72.9%). Low physical activity was significantly and positively associated (Odds Ratio: 1.18, 95% CI: 1.04–1.35) with metabolic unhealthiness, while being a rural residence (0.83, 0.74–0.93), and having higher education (0.47, 0.39–0.58) significantly but negatively affected it. Dyslipidemia was the most frequent MetS component with a prevalence rate of 46.6% (42.1–51.1), 62.2% (60.8–63.6), 76.3% (75.1–77.5), and 83.4% (82.1–84.6) among underweight, normal weight, overweight and obese phenotypes, respectively. Conclusion BMI aside, an additional set of criteria such as metabolic markers should be taken into account to identify normal weight but metabolically unhealthy individuals. Given the highest prevalence of dyslipidemia among obese subjects, further interventions are required to raise public awareness, promote healthy lifestyles and establish lipid clinics.

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Vasodilator responses and endothelin-dependent vasoconstriction in metabolically healthy obesity and the metabolic syndrome

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00278.2015 ◽

2015 ◽

Vol 309 (9) ◽

pp. E787-E792 ◽

Cited By ~ 26

Author(s):

Francesca Schinzari ◽

Micaela Iantorno ◽

Umberto Campia ◽

Nadia Mores ◽

Valentina Rovella ◽

...

Keyword(s):

Metabolic Syndrome ◽

Vascular Reactivity ◽

Forearm Blood Flow ◽

Control Group ◽

Obese Patients ◽

Metabolic Abnormalities ◽

Metabolically Healthy Obesity ◽

Arterial Infusion ◽

The Metabolic Syndrome ◽

Metabolically Healthy

Patients with metabolically healthy obesity (MHO) do not present the cluster of metabolic abnormalities that define the metabolic syndrome (MetS). Whether MHO is associated with lower impairment of vasoreactivity than the MetS is unknown. For this purpose, forearm blood flow (FBF) responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine (ACh), sodium nitroprusside (SNP), and/or the selective endothelin type A (ETA) receptor blocker BQ-123 in 119 obese individuals with MHO ( n = 34) or with the MetS ( n = 85) and in healthy lean controls ( n = 56). ACh and SNP caused a significant vasodilation in both obese and lean participants (all P < 0.001). However, the response to both agents was significantly lower in the obese than in the control group (both P < 0.001). Among the obese participants, the reactivity to ACh was higher in MHO than in MetS patients, whereas the responsiveness to SNP was equally impaired in both groups ( P = 0.45). Infusion of BQ-123 significantly increased FBF in obese patients ( P < 0001), but not in the lean participants; hence, FBF following ETA receptor blockade was higher in both obese groups than in controls (both P < 0.001). FBF response to BQ-123 was significantly higher in patients with the MetS than in those with MHO ( P = 0.007). In conclusion, patients with MHO have abnormal vascular reactivity, although their endothelial dysfunction is less pronounced than in patients with the MetS. These findings indicate that obesity is associated with vascular damage independent of those metabolic abnormalities underlying the MetS.

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