Evolution of Metabolic Phenotypes of Obesity in Coronary Patients after 5 Years of Dietary Intervention: From the CORDIOPREV Study

Background: Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. Methods: The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Results: Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p < 0.05). Most of the MUO (92%) patients maintained unhealthy phenotypes (MUO-Non-Responders), but 8% became metabolically healthy (MUO-Responders) after a significant decrease in their BMI and FLI-score, with improvement in all metabolic criteria. No differences were found among dietary groups. Conclusions: A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.

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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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The prevalence of metabolically healthy obesity according to the sample of the Moscow region

Obesity and metabolism ◽

10.14341/omet2017451-56 ◽

2017 ◽

Vol 14 (4) ◽

pp. 51-56 ◽

Cited By ~ 2

Author(s):

Elena V. Ostrovskaya ◽

Tatiana I. Romantsova ◽

Andrei N. Gerasimov ◽

Tamara E. Novoselova

Keyword(s):

Metabolic Syndrome ◽

Carbohydrate Metabolism ◽

Medical Records ◽

Density Lipoprotein ◽

Homa Index ◽

Obese Patients ◽

Hip Circumference ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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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Should we wait for metabolic complications before operating on obese patients? Gastric bypass outcomes in metabolically healthy obese individuals

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2015.04.024 ◽

2016 ◽

Vol 12 (1) ◽

pp. 49-56 ◽

Cited By ~ 11

Author(s):

Elise Pelascini ◽

Emmanuel Disse ◽

Arnaud Pasquer ◽

Gilles Poncet ◽

Christian Gouillat ◽

...

Keyword(s):

Gastric Bypass ◽

Obese Patients ◽

Metabolic Complications ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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Effectiveness of bariatric surgery in metabolically healthy obese patients

Endocrine Abstracts ◽

10.1530/endoabs.56.p533 ◽

2018 ◽

Author(s):

Laura Tuneu ◽

Analia Ramos ◽

Idoia Genua ◽

Nicole Stantonyonge ◽

Francisca Caimari ◽

...

Keyword(s):

Bariatric Surgery ◽

Obese Patients ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

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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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