Metabolically healthy obese individuals present similar chronic inflammation level but less insulin-resistance than obese individuals with metabolic syndrome

Introduction. Obesity is a major factor for cardiometabolic risk. However, there is a category of obese patients without disorders of lipid, carbohydrate metabolism and cardiovascular disease metabolically healthy obese (MHO). Aim. Our goal was to investigate the prevalence and characteristics of this phenotype compared to patients with metabolic syndrome (MS). Materials and methods. To evaluate the prevalence of the MHO phenotype we analyzed 389 medical records of females aged 1860 years with obesity. Three types of MHO criteria were used: 1) HOMA index (2.7); 2) IDF-criteria of metabolic syndrome, 2005; 3) the BioSHaRE-EU 2013 criteria (obese patients without any symptoms of MS). We conducted a comparative analysis of anthropometry, status of lipid and carbohydrate metabolism, the functional state of the liver. Results. The MHO prevalence was: 34.5% according to HOMA index, according to the definitions of MS 2005 38.6%, in BioSHaRE-EU 9.6%. In groups of MHO and MS dyslipidemia was observed in 27.3 and 49.5% (p0.05), hypertension in 25% and 71.6% (p0.05), steatogepatosis in 47.7% vs 51.3% (p0.05) of observations, respectively. Among comorbidities the gynecological pathology was most prevalent - 50.8 and 61.4% (p0.05), disorders of carbohydrate metabolism differed significantly in frequency- 6.82 and 39.1% of patients (p0.05). Patients with MHO had a shorter duration of the existence of obesity than MS (18.7 vs. 24 years) (p=0.0004) and less likely to have attempted to reduce weight 85.8% and 91.6%. Average BMI, waist circumference, hip circumference, fasting glucose, total cholesterol, insulin basal, basal C-peptide, HOMA index in groups of MHO and MS differed significantly (p0.05). Median ALT was 20 and 23.2 U/l, AST 20 and 23 U/l, triglycerides 1.1 and 1.8 mmol/l, high-density lipoprotein 1.4 and 1.1 mmol/l, respectively. Conclusions. The MHO prevalence was maximal according to the MS definitions from 2005, and minimal with BioSHaRE-EU criteria. The main analyzed indicators differed significantly in groups MHO and MS. Longer obesity existence in the MS group may suggest an instability of MHO phenotype over time.

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Increased Heart Failure Risk in Normal-Weight People With Metabolic Syndrome Compared With Metabolically Healthy Obese Individuals

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2011.04.047 ◽

2011 ◽

Vol 58 (13) ◽

pp. 1343-1350 ◽

Cited By ~ 143

Author(s):

Christina Voulgari ◽

Nicholas Tentolouris ◽

Polychronis Dilaveris ◽

Dimitris Tousoulis ◽

Nicholas Katsilambros ◽

...

Keyword(s):

Heart Failure ◽

Metabolic Syndrome ◽

Normal Weight ◽

Metabolically Healthy Obese ◽

Failure Risk ◽

Healthy Obese ◽

Metabolically Healthy

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Metabolically healthy obese and metabolic syndrome of the lean: the importance of diet quality. Analysis of MAGNETIC cohort

Nutrition Journal ◽

10.1186/s12937-020-00532-0 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Kamila Osadnik ◽

Tadeusz Osadnik ◽

Marta Lonnie ◽

Mateusz Lejawa ◽

Rafał Reguła ◽

...

Keyword(s):

Metabolic Syndrome ◽

Diet Quality ◽

Quality Analysis ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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2061-P: Inflammation Status Is Independent Risk Factor for the Development of Metabolic Syndrome in Both Metabolically Healthy Obese and Nonobese Adults

Diabetes ◽

10.2337/db19-2061-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 2061-P

Author(s):

KYU YEON HUR ◽

MIN SUN CHOI ◽

SUNG WOON PARK ◽

SEUNG-EUN LEE ◽

JIYEON AHN ◽

...

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Independent Risk Factor ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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Adipose Tissue, Inflammation (Meta-inflammation) and Obesity Management

The Indonesian Biomedical Journal ◽

10.18585/inabj.v7i3.185 ◽

2015 ◽

Vol 7 (3) ◽

pp. 129 ◽

Cited By ~ 7

Author(s):

Anna Meiliana ◽

Nurrani Mustika Dewi ◽

Andi Wijaya

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

M2 Macrophage ◽

Fat Depots ◽

Metabolically Healthy Obese ◽

New Concepts ◽

Increased Risk ◽

Treatment Paradigm ◽

Metabolically Healthy

BACKGROUND: Obesity-induced inflammation contributes to the development of type 2 diabetes, metabolic syndrome, and cardiovascular disease.CONTENT:The last decade has seen a sharp increase in our appreciation for the macrophage as a critical regulator of metabolic status in obesity. Activation of adipose tissue (AT) macrophages within fat depots is coupled with the development of obesity-induced proinflammatory state and insulin resistance (IR). The activation of classically activated M1 macrophages at the expense of anti-inflammatory M2 macrophages has been causally linked to the development of AT inflammation and metabolic syndrome, a pathophysiological state aptly termed as ‘metainflammation’. It is recognized that several proinflammatory cytokines, including interleukin (IL)-1β, are implicated in disrupting insulin signaling. Our developing appreciation of links among obesity, inflammation and cardiovascular disease will require multiple complementary approaches to leverage new concepts into translatable outcomes. Careful characterization of human patients, particularly analysis of AT distribution, will be needed to stratify subjects that are most likely obese/metabolically healthy from those that are obese/metabolically unhealthy.SUMMARY: It has been suggested that individuals with the condition known as metabolically healthy obese (MHO) may not have the same increased risk for the development of metabolic abnormalities as their non-metabolically healthy counterparts. A complications-centric model for the medical management of obesity emphasizes the identification and staging of complications, and treatment paradigm directed at patients who would gain the most benefit from weight loss.KEYWORDS: obesity, inflammation, insulin resistance, M1/M2 macrophage.

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Metabolically healthy obese women have longer telomere length than obese women with metabolic syndrome

PLoS ONE ◽

10.1371/journal.pone.0174945 ◽

2017 ◽

Vol 12 (4) ◽

pp. e0174945 ◽

Cited By ~ 5

Author(s):

Andrea E. Iglesias Molli ◽

Julieta Panero ◽

Patricia C. Dos Santos ◽

Claudio D. González ◽

Jorge Vilariño ◽

...

Keyword(s):

Metabolic Syndrome ◽

Telomere Length ◽

Obese Women ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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Association of Metabolically Healthy Obesity and Future Depression: Using National Health Insurance System Data in Korea from 2009–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010063 ◽

2020 ◽

Vol 18 (1) ◽

pp. 63

Author(s):

Yongseok Seo ◽

Seungyeon Lee ◽

Joung-Sook Ahn ◽

Seongho Min ◽

Min-Hyuk Kim ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Metabolic Status ◽

National Health Insurance System ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

(1) Background: The health implications associated with the metabolically healthy obese (MHO) phenotype, in particular related to symptoms of depression, are still not clear. the purpose of this study is to check whether depression and metabolic status are relevant by classifying them into four groups in accordance with the MHO diagnostic standard. Other impressions seen were the differences between sexes and the effects of the MHO on the occurrence of depression. (2) Methods: A sample of 3,586,492 adult individuals from the National Health Insurance Database of Korea was classified into four categories by their metabolic status and body mass index: (1) metabolically healthy non-obese (MHN); (2) metabolically healthy obese (MHO); (3) metabolically unhealthy non-obese (MUN); and (4) metabolically unhealthy obese (MUO). Participants were followed for six to eight years for new incidences of depression. The statistical significance of the general characteristics of the four groups, as well as the mean differences in metabolic syndrome risk factors, was assessed with the use of a one-way analysis of variance (ANOVA). (3) Results: The MHN ratio in women was higher than in men (men 39.3%, women 55.2%). In both men and women, depression incidence was the highest among MUO participants (odds ratio (OR) = 1.01 in men; OR = 1.09 in women). It was concluded as well that, among the risk factors of metabolic syndrome, waist circumference was the most related to depression. Among the four groups, the MUO phenotype was the most related to depression. Furthermore, in women participants, MHO is also related to a higher risk of depressive symptoms. These findings indicate that MHO is not a totally benign condition in relation to depression in women. (4) Conclusion: Therefore, reducing metabolic syndrome and obesity patients in Korea will likely reduce the incidence of depression.

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Increasing the Duration of Light Physical Activity Ameliorates Insulin Resistance Syndrome in Metabolically Healthy Obese Adults

Cells ◽

10.3390/cells9051189 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1189

Author(s):

Fatema Al-Rashed ◽

Abdulwahab Alghaith ◽

Rafaat Azim ◽

Dawood AlMekhled ◽

Reeby Thomas ◽

...

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Inflammatory Cytokines ◽

Insulin Resistance Syndrome ◽

Lifestyle Changes ◽

Enzyme Linked Immunosorbent Assay ◽

Model Assessment ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

Obesity is a well-known risk factor for insulin resistance syndrome (IRS). Nevertheless, limited data are available regarding the effects of physical activity (PA) intensity on the ability to modulate IRS. The study aim was to investigate the beneficial effects of the longer duration of light PA vs. a single bout of the acute moderate or vigorous PA for improvement in IRS indicators. Sixty metabolically healthy obese (MHO) participants, 30 males and 30 females, with body mass index (BMI) of ≥30 were enrolled in this study. PA levels were measured using an accelerometer, and the expression of monocytic surface markers was analyzed using flow cytometry. Plasma cytokines’ secretion was determined by enzyme-linked immunosorbent assay (ELISA). Univariate regression analysis evaluated the actigraphy-assessed PA measures, inflammatory cytokines, and insulin resistance. The longer duration of PA was found to be associated with the homeostatic model assessment of insulin resistance (HOMA-IR), a lower lipid profile, and the expression of inflammatory cytokines by monocytes. Even though, higher intensities of PA were found to be associated with lower body fat percentage, only the light intensity PA was found to be beneficial as it associated with the improved insulin sensitivity and lower expression of inflammatory markers. In conclusion, maintaining the longer duration of low-intensity PA throughout the day could be more beneficial for reducing inflammation and improving insulin resistance. This study supports a more feasible approach model to gain beneficial lifestyle changes for the prevention of IRS in metabolically healthy adults with obesity.

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Metabolic profiles of obese women

Batna Journal of Medical Sciences (BJMS) ◽

10.48087/bjmsoa.2019.6203 ◽

2019 ◽

Vol 6 (2) ◽

pp. 93-96

Author(s):

Mohamed Ridha GUEDJATI ◽

◽

Adeila Dalel Taibi ◽

Ghania Hebboul ◽

Khaoula Lachekhab ◽

...

Keyword(s):

Metabolic Syndrome ◽

Metabolic Profiles ◽

Obese Women ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy ◽

Surcharge Pondérale

Introduction. Certains sujets obèses, parait-il, sont plus exposés à encourir des complications cardiométaboliques. Par ailleurs, d’autres sujets ne le sont peut-être pas. Objectif. Profiler les sujets obèses métaboliquement sains (Metabolically Healthy Obese ou MHO) et des sujets obèses métaboliquement malades (Metabolically UnHealthy Obese ou MUHO) en utilisant deux critères de définition. Méthode. 49 femmes en surcharge pondérale (IMC ≥ 25 Kg/m2) ou obèses (IMC ≥ 30 Kg/m2), ont été sélectionneés pour répondre à une identification de leur profil métabolique en utilisant deux types de critères, Les critères Wildman modifié avec Triglycérides ≥ 1,5 g/l, HDLc < 0,5 g/l, Glycémie à Jeun ≥ 1g/l. Les critères du Consensus Sociaties on Metabolic Syndrome avec, en plus, des mêmes valeurs glucido-lipidiques, la présence d’un diabète ou d’une HTA. Pour Wildman, il faut au moins 2 critères pour qu’un obèse soit métaboliquement sain (MHO). Pour le consensus, il faut au moins trois critères. Résultats. Chez les 49 femmes, le phénotype MHO représente 77 % (n=38) selon les critères du consensus vs 57 % (n=28) selon les critères de Wildman modifiés. En utilisant les critères du Consensus, 10 sujets MUHO (20 %) basculent dans le profil MHO. Discussion. Dans notre étude, la taille de l’échantillon étant très faible et les critères étant limités au bilan lipidique et aux antécédents personnels, nos résultats ne font qu’orienter l’instabilité d’un consensus fixant clairement les critères de définition des phénotypes métaboliques des sujets obèses notamment leur caractère sain. Conclusion. L’absence de consensus sur les critères de définition des MHO et des MUHO conditionne fortement la classification de ces deux catégories d’obèses.

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Associations between Urinary Advanced Glycation End Products and Cardiometabolic Parameters in Metabolically Healthy Obese Women

Journal of Clinical Medicine ◽

10.3390/jcm8071008 ◽

2019 ◽

Vol 8 (7) ◽

pp. 1008

Author(s):

Estifanos Baye ◽

Alicja B Mark ◽

Malene W Poulsen ◽

Jeanette M Andersen ◽

Lars O Dragsted ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Advanced Glycation End Products ◽

Obese Women ◽

Advanced Glycation ◽

Metabolically Healthy Obese ◽

Glycation End Products ◽

End Products ◽

Healthy Obese ◽

Metabolically Healthy

Advanced glycation end products (AGEs) have been implicated in the pathophysiology of type 2 diabetes and cardiovascular disease. We aimed to determine the associations of urinary carboxymethyl-lysine (CML) and methylglyoxal-hydroimidazolone (MG-H1) levels with cardiometabolic parameters in metabolically healthy obese women. Anthropometric, glycemic, cardiovascular, and urinary AGE parameters were measured in 58 metabolically healthy obese women (age: 39.98 ± 8.72 years; body mass index (BMI): 32.29 ± 4.05 kg/m2). Urinary CML levels were positively associated with BMI (r = 0.29, p = 0.02). After adjustment for age and BMI, there was a trend for positive associations between urinary CML levels and fasting (p = 0.06) and 2 h insulin (p = 0.05) levels, and insulin resistance measured by homeostatic model assessment (HOMA-IR) (p = 0.06). Urinary MG-H1 levels were positively associated with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and total and low-density lipoprotein cholesterol after adjustment for age, BMI, and HOMA-IR (all p ˂ 0.05). There were no associations between urinary CML levels and cardiovascular parameters, and between urinary MG-H1 levels and glycemic measurements. Our data support a role of urinary AGEs in the pathophysiology of insulin resistance and cardiovascular disease; however, future studies are highly warranted.

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