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

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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Association of Metabolically Healthy and Unhealthy Obesity Phenotype with Markers Related to Obesity, Diabetes among Young, Healthy Adult Men. Analysis of MAGNETIC Study

Life ◽

10.3390/life11121350 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1350

Author(s):

Mateusz Lejawa ◽

Kamila Osadnik ◽

Zenon Czuba ◽

Tadeusz Osadnik ◽

Natalia Pawlas

Keyword(s):

Plasminogen Activator Inhibitor ◽

Normal Weight ◽

Obese Patients ◽

Metabolically Healthy Obesity ◽

Plasminogen Activator Inhibitor 1 ◽

Metabolic Markers ◽

Adult Men ◽

Metabolically Healthy Obese ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

Adipose tissue secretes many regulatory factors called adipokines. Adipokines affect the metabolism of lipids and carbohydrates. They also influence the regulation of the immune system and inflammation. The current study aimed to evaluate the association between markers related to obesity, diabesity and adipokines and metabolically healthy and unhealthy obesity in young men. The study included 98 healthy participants. We divided participants into three subgroups based on body mass index and metabolic health definition: 49 metabolically healthy normal-weight patients, 27 metabolically healthy obese patients and 22 metabolically unhealthy obese patients. The 14 metabolic markers selected were measured in serum or plasma. The analysis showed associations between markers related to obesity, diabesity and adipokines in metabolically healthy and unhealthy obese participants. The decreased level of adipsin (p < 0.05) was only associated with metabolically healthy obesity, not with metabolically unhealthy obesity. The decreased level of ghrelin (p < 0.001) and increased level of plasminogen activator inhibitor-1 (p < 0.01) were only associated with metabolically unhealthy obesity, not with metabolically healthy obesity. The decreased level of adiponectin and increased levels of leptin, c-peptide, insulin and angiopoietin-like 3 protein were associated with metabolically healthy and unhealthy obesity. In conclusion, our data show that metabolically healthy obesity was more similar to metabolically unhealthy obesity in terms of the analyzed markers related to obesity and diabesity.

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Determination of Peak Aerobic Capacity in Normal Weight Obesity and Metabolically Healthy Obesity

Current Developments in Nutrition ◽

10.1093/cdn/nzab055_025 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1215-1215

Author(s):

Samantha Hart ◽

Bryant Keirns ◽

Christina Sciarrillo ◽

Reese Guynes ◽

Sam Emerson

Keyword(s):

Body Composition ◽

Diagnostic Criteria ◽

Cardiometabolic Risk ◽

International Diabetes Federation ◽

Normal Weight ◽

Metabolically Healthy Obesity ◽

Metabolic Markers ◽

Significant Difference ◽

Normal Weight Obesity ◽

Metabolically Healthy

Abstract Objectives The true cardiometabolic risk of the novel body composition phenotypes normal-weight obesity (NWO) and metabolically healthy obesity (MHO) remains controversial. Cardiorespiratory fitness, as measured by peak oxygen uptake during exercise (VO2peak), is inversely correlated with CVD and mortality. The objective of this project was to determine VO2peak in NWO and MHO relative to appropriate positive and negative control groups. Methods For this cross-sectional study, participants aged 18–50 years were recruited into one of four groups based on BMI, body composition, and metabolic risk factors: NWO (normal BMI with high body fat percentage (BF%)); MHO (obese BMI, high BF%, and up to one of the diagnostic criteria for metabolic syndrome (MetS) as defined by the International Diabetes Federation); MetS (obese BMI, high BF%, and at least three of the diagnostic criteria for MetS); and healthy controls (HC; normal BMI, BF%, and metabolic markers). Participants engaged in a maximal exercise test on a cycle ergometer to determine VO2peak and a DEXA scan to assess BF%. Data were analyzed using one-way ANOVA. Results A total of 35 participants completed this study (HC: n = 10; NWO: n = 8; MHO: n = 10; MetS: n = 7). VO2peak was greater in HC (44.2 ± 11.0 ml/kg/min) compared to NWO (28.6 ± 5.1 ml/kg/min; P = 0.002), MHO (25.4 ± 6.7 ml/kg/min; P < 0.0001) and MetS (24.3 ± 8.8 ml/kg/min; P = 0.0002). VO2peak was similar among NWO, MHO, and MetS (p's ≥ 0.76). BF% was lower in HC (23.4 ± 5.5%) compared to NWO (32.6 ± 3.8%; P = 0.0099), MHO (41.9 ± 6.0%; P < 0.0001) and MetS (32.5 ± 6.1%; P = 0.016). BF% was also greater in MHO compared to NWO (P = 0.0085) and MetS (P = 0.0115). There was no significant difference in BF% between NWO and MetS (P > 0.9999). Across groups, there was a strong inverse correlation between BF% and VO2peak (r = −0.83). Conclusions VO2peak did not significantly differ among all three at-risk groups (NWO, MHO, and MetS), and all were lower than HC. BF% also did not significantly differ between NWO and MetS groups, and BF% was actually greater in MHO compared to MetS and NWO. NWO and MHO, despite normal BMI and metabolic markers, respectively, have a VO2peak more similar to MetS than HC, suggesting increased cardiometabolic risk. Funding Sources American Society for Nutrition Mars. Inc Predoctoral Fellowship.

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Metabolically healthy obesity and metabolically obese normal weight: a review

Journal of Physiology and Biochemistry ◽

10.1007/s13105-020-00781-x ◽

2021 ◽

Vol 77 (1) ◽

pp. 175-189 ◽

Cited By ~ 1

Author(s):

Saioa Gómez-Zorita ◽

Maite Queralt ◽

Maria Angeles Vicente ◽

Marcela González ◽

María P. Portillo

Keyword(s):

Normal Weight ◽

Metabolically Healthy Obesity ◽

Metabolically Obese Normal Weight ◽

Metabolically Healthy

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METABOLICALLY HEALTHY AND UNHEALTHY OBESITY IN CHILDREN FROM THE POINT OF VIEW OF EVIDENCE-BASED MEDICINE

Eastern Ukrainian Medical Journal ◽

10.21272/eumj.2020;8(3):255-267 ◽

2020 ◽

Vol 8 (3) ◽

pp. 255-267

Author(s):

V. Furdela ◽

I. Smiian ◽

M. Furdela

Keyword(s):

Metabolic Syndrome ◽

Childhood Obesity ◽

High Risk ◽

School Age ◽

Metabolically Healthy Obesity ◽

Metabolic Disturbances ◽

Height Ratio ◽

Waist To Hip Ratio ◽

Waist To Height Ratio ◽

Metabolically Healthy

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

BMC Endocrine Disorders ◽

10.1186/1472-6823-14-9 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 217

Author(s):

Jana V van Vliet-Ostaptchouk ◽

Marja-Liisa Nuotio ◽

Sandra N Slagter ◽

Dany Doiron ◽

Krista Fischer ◽

...

Keyword(s):

Metabolic Syndrome ◽

Cohort Studies ◽

Large Cohort ◽

Metabolically Healthy Obesity ◽

Metabolically Healthy ◽

Collaborative Analysis

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Serum concentrations and expressions of serum amyloid A and leptin in adipose tissue are interrelated: the Genobin Study

Acta Endocrinologica ◽

10.1530/eje-07-0598 ◽

2008 ◽

Vol 158 (3) ◽

pp. 333-341 ◽

Cited By ~ 19

Author(s):

T Lappalainen ◽

M Kolehmainen ◽

U Schwab ◽

L Pulkkinen ◽

D E Laaksonen ◽

...

Keyword(s):

Gene Expression ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Weight Reduction ◽

Serum Amyloid A ◽

Normal Weight ◽

Serum Amyloid ◽

Serum Concentrations ◽

Amyloid A ◽

Obese Subjects

ObjectiveSerum amyloid A (SAA) is a novel link between increased adipose tissue mass and low-grade inflammation in obesity. Little is known about the factors regulating its serum concentration and mRNA levels. We investigated the association between SAA and leptin in obese and normal weight subjects and analyzed the effect of weight reduction on serum SAA concentration and gene expression in adipose tissue of the obese subjects.MethodsSeventy-five obese subjects (60±7 years, body mass index (BMI) 32.9±2.8 kg/m2, mean±s.d.) with impaired fasting plasma glucose or impaired glucose tolerance and other features of metabolic syndrome, and 11 normal weight control subjects (48±9 years, BMI 23.7±1.9 kg/m2) were studied at the baseline. Twenty-eight obese subjects underwent a 12-week intensive weight reduction program followed by 5 months of weight maintenance. Blood samples and abdominal s.c. adipose tissue biopsies were taken at the baseline and after the follow-up. Gene expression was studied using real-time quantitative PCR.ResultsThe gene expressions in women and serum concentrations of leptin and SAA were interrelated independently of body fat mass in the obese subjects (r=0.54, P=0.001; r=0.24, P=0.039 respectively). In multiple linear regression analyses, leptin mRNA explained 38% of the variance in SAA mRNA (P=0.002) in the obese women. Weight loss of at least 5% increased SAA mRNA expression by 48 and 36% in men and women, but serum SAA concentrations did not change.ConclusionsThe association between SAA and leptin suggests an interaction between these two adipokines, which may have implications in inflammatory processes related to obesity and the metabolic syndrome.

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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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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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Association between metabolically healthy obesity/overweight and cardiovascular disease risk: A representative cohort study in Taiwan

PLoS ONE ◽

10.1371/journal.pone.0246378 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246378

Author(s):

Tzu-Lin Yeh ◽

Hsin-Yin Hsu ◽

Ming-Chieh Tsai ◽

Le-Yin Hsu ◽

Lee-Ching Hwang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Cox Regression ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Normal Weight ◽

Metabolically Healthy Obesity ◽

Cox Regression Analysis ◽

The Metabolic Syndrome ◽

Metabolically Healthy

Objectives To investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals. Methods Taiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5–23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis. Results Among 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99). Conclusions Individuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control.

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