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

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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Variable Changes of Circulating ANGPTL3 and ANGPTL4 in Different Obese Phenotypes: Relationship with Vasodilator Dysfunction

Biomedicines ◽

10.3390/biomedicines9081037 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1037

Author(s):

Francesca Schinzari ◽

Giuseppina Vizioli ◽

Umberto Campia ◽

Manfredi Tesauro ◽

Carmine Cardillo

Keyword(s):

Inverse Relationship ◽

Protein A ◽

Obese Patients ◽

Metabolically Healthy Obesity ◽

Premature Atherosclerosis ◽

Metabolic Phenotypes ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity ◽

Metabolic Regulators

Obesity associates with premature atherosclerosis and an increased burden of cardiovascular disease, especially when accompanied by abnormalities of lipid and glucose metabolism. Angiopoietin-like (ANGPTL)3 and ANGPTL4 are metabolic regulators, whose upregulation is associated with dyslipidemia, insulin resistance and atherosclerosis. We analyzed, therefore, changes in circulating ANGPTL3 and ANGPTL4 in obese patients with different metabolic phenotypes and their relation with impaired vasodilator reactivity, an early abnormality in atherosclerosis. Compared to the lean subjects (n = 42), circulating ANGPTL3 was elevated (both p > 0.001) in the patients with metabolically unhealthy obesity (MUO; n = 87) and type 2 diabetes (T2D; n = 31), but not in those with metabolically healthy obesity (MHO; n = 48, p > 0.05). Circulating ANGPTL4, by contrast, was increased in all obese subgroups (all p < 0.001 vs. lean subjects). Vasodilator responses to both acetylcholine and sodium nitroprusside were reduced in the three obese subgroups vs. lean subjects (all p < 0.001), with greater impairment in the patients with T2D than in those with MHO and MUO (all p < 0.05). In the whole population, an inverse relationship (r = 0.27; p = 0.003) was observed between circulating ANGPTL4 and endothelium-dependent vasorelaxation. Circulating ANGPTL3 and ANGPTL4 undergo variable changes in obese patients with different metabolic phenotypes; changes in ANGPTL4 relate to endothelial dysfunction, making this protein a possible target for vascular prevention in these patients.

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Metabolically healthy obesity: Is it really benign?

Journal of Atherosclerosis Prevention and Treatment ◽

10.53590/japt.02.1019 ◽

2021 ◽

pp. 24-26

Author(s):

Nikolaos Kourris ◽

Konstantinos Tziomalos

Keyword(s):

Cardiovascular Disease ◽

Metabolic Abnormalities ◽

Metabolically Healthy Obesity ◽

Metabolically Healthy Obese ◽

Increased Risk ◽

Healthy Obese ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

Recently, a subgroup of patients with obesity but without cardiometabolic abnormalities has attracted considerable attention and has been characterized as metabolically healthy obese (MHO) patients. MHO is quite prevalent among patients with obesity. Even though these subjects have less pronounced metabolic abnormalities compared with patients with metabolically unhealthy obesity (MUO), they are at increased risk for progressing to MUO and for developing cardiovascular disease. Accordingly, diet, exercise and appropriate pharmacotherapy should be recommended to patients with MHO as strongly as in those with MUO.

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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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Children with metabolically healthy obesity have a worse metabolic profile compared to normal weight peers: a cross-sectional study

10.21203/rs.3.rs-186568/v1 ◽

2021 ◽

Author(s):

Anastasios Serbis ◽

Vasilieios Giapros ◽

Stavroula A. Paschou ◽

Ekaterini Siomou

Keyword(s):

Metabolic Profile ◽

Cross Sectional Study ◽

Normal Weight ◽

Age Group ◽

Z Score ◽

Metabolically Healthy Obesity ◽

Cross Sectional ◽

Pediatric Populations ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

Abstract Purpose: A phenotype of metabolically healthy obesity (MHO) has been described in youth with obesity, but data are still scarce in this age group. The aim of the current study was to describe and compare clinical and laboratory parameters related to obesity among three different groups of youth, namely youth with normal weight (NW), with MHO, and with metabolically unhealthy obesity (MUO). Methods: 103 youngsters with obesity were divided according to 2018 consensus-based criteria into those with MHO [n=49, age (± SD): 10.9 ± 2.9 years] and those with MUO [n=54, 11.5 ± 2.7 years] and were compared to age-, sex- and Tanner-matched NW [n=69, 11.3 ± 2.9 years]. Several obesity related parameters were investigated for both groups of children. Comparisons were made by analysis of variance (ANOVA) followed by the Fisher’s PLSD test. Results: Youth with MHO had lower systolic (p<0.001) and diastolic (p<0.01) blood pressure z-score and triglycerides (p<0.01), but higher HDL-C (p<0.001), total cholesterol (p<0.05), and apo-A1 (p<0.05) compared to those with MUO. Compared to controls, both children with MHO and MUO showed higher fasting insulin (p<0.05), HOMA-IR (p<0.05) and QUICKI (p<0.001). Similarly, both groups had higher hsCRP, fibrinogen, uric acid, and leptin compared to controls (for all, p<0.001), while their adiponectin was lower (p<0.05). Visfatin was higher in children with MUO compared to controls (p<0.01), and it showed a trend to be lower in children with MHO compared to those with MUO (p=0.1).Conclusion: This study provides evidence that children identified as having MHO by the consensus-based criteria had better metabolic profile than youth with MUO, but worse than NW. Further research is needed in pediatric populations both regarding MHO criteria and the nature of the MHO phenotype per se.

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Metabolic health and weight: Understanding metabolically unhealthy normal weight or metabolically healthy obese patients

Metabolism ◽

10.1016/j.metabol.2015.10.019 ◽

2016 ◽

Vol 65 (1) ◽

pp. 73-80 ◽

Cited By ~ 69

Author(s):

Hannah Mathew ◽

Olivia M. Farr ◽

Christos S. Mantzoros

Keyword(s):

Normal Weight ◽

Metabolic Health ◽

Obese Patients ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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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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Metabolic Health, Obesity, and the Risk of Developing Open-Angle Glaucoma: Metabolically Healthy Obese Patients versus Metabolically Unhealthy but Normal Weight Patients

Diabetes & Metabolism Journal ◽

10.4093/dmj.2019.0048 ◽

2020 ◽

Vol 44 (3) ◽

pp. 414 ◽

Cited By ~ 4

Author(s):

Younhea Jung ◽

Kyungdo Han ◽

Hae-Young L. Park ◽

Seung Hoon Lee ◽

Chan Kee Park

Keyword(s):

Open Angle Glaucoma ◽

Normal Weight ◽

Metabolic Health ◽

Obese Patients ◽

Open Angle ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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Changes in Body Size Phenotypes From Childhood to Adulthood and the Associated Cardiometabolic Outcomes, a Prospective Cohort Study

10.21203/rs.3.rs-805316/v1 ◽

2021 ◽

Author(s):

Tingting Du ◽

Vivian Fonseca ◽

Wei Chen ◽

Lydia Bazzano

Keyword(s):

Body Size ◽

Left Ventricular ◽

Normal Weight ◽

Bogalusa Heart Study ◽

Metabolically Healthy Obese ◽

Heart Study ◽

Healthy Obese ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

Abstract Background: Cardiometabolic outcomes associated with changes between body size phenotypes (defined by body mass index [BMI] together with metabolic status) over time have attracted attention recently. It remains unclear how metabolic health change from childhood to adulthood across different BMI categories and how such dynamic changes from childhood to adulthood might affect risk of cardiometabolic outcomes in adulthood. Therefore, we aimed to examine the effects of changes in body size phenotypes between childhood and adulthood on risks of diabetes and left ventricular hypertrophy (LVH) in adulthood.Methods: We included 3,351 individuals who participated as both children and adults in the Bogalusa Heart Study. The mean follow-up period was 36 years. Body size phenotypes for both children and adults were defined by harmonized criteria.Results: Compared with participants with persistently metabolically healthy normal weight (MHNW) from childhood to adulthood, MHNW children who became metabolically unhealthy in adulthood had increased diabetes burden and LVH risk in adulthood; Metabolically unhealthy normal weight (MUNW) children who became MHNW or metabolically healthy obese (MHO) as adults and individuals with persistent MHO from childhood to adulthood were not at increased risks of diabetes or LVH. The risks were increased if MHO during childhood transitioned to metabolically unhealthy obesity (MUO) by adulthood or MUO stayed from childhood to adulthood. MUO children who became MHO or MHNW as adults had decreased diabetes burden and LVH risk in adulthood.Conclusions: Individuals maintained MHO from childhood to adulthood and MUNW children who became MHO as adults had a diabetes burden and LVH risk similar to individuals with persistent MHNW. Progression to metabolically unhealthy status and maintenance of metabolically unhealthy status, regardless of childhood BMI status, were associated with increased cardiometabolic outcomes.

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