Abstract
Increasing evidences support that metabolically healthy obese (MHO) is a transient state. However, little is known about the early markers associated with the development of metabolic abnormalities in MHO individuals. Serum free fatty acids (FFAs) profile is highlighted in its association with obesity-related insulin resistance, type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). To examine the association of endogenous fatty acid metabolism with future development of metabolic abnormalities in MHO individuals, we retrospectively analyzed 24 [product FFA]/[precursor FFA] ratios in fasting sera and clinical data from 481 individuals who participated in three independent studies, including 131 metabolic healthy subjects who completed the 10-year longitudinal Shanghai Diabetes Study (SHDS), 312 subjects cross-sectionally sampled from the Shanghai Obesity Study (SHOS), and 38 subjects who completed an 8-week very low carbohydrate diet (VLCD) intervention study. Results showed that higher baseline level of oleic acid/stearic acid (OA/SA), and lower levels of stearic acid/palmitic acid (SA/PA) and arachidonic acid/dihomo-γ-linolenic acid (AA/DGLA) ratios were associated with higher rate of MHO to MUO conversion in the longitudinal SHDS. Further, the finding was validated in the cross-sectional and interventional studies. This panel of FFA ratios could be used for identification and early intervention of at-risk obese individuals.
Highlights
Table 1. 10-year longitudinal study: baseline clinical characteristics of MH-NW and metabolically healthy obese (MHO) groups and four subgroups categorized by follow-up metabolic outcomes
The subjects selected from the Shanghai Diabetes Study (SHDS) consisted of 69 MH-NW and 62 MHO at baseline, with clinical data and sera collected at both baseline and 10-year follow-up
The data were used in the present study to investigate whether MHO had higher risk of developing metabolic abnormalities than MH-NW, and to explore the potential role of FFA ratios as early metabolic markers to predict the development of metabolic abnormalities in MHO
Summary
Table 1. 10-year longitudinal study: baseline clinical characteristics of MH-NW and MHO groups and four subgroups categorized by follow-up metabolic outcomes. 10-year longitudinal study: baseline clinical characteristics of MH-NW and MHO groups and four subgroups categorized by follow-up metabolic outcomes. Compared with concentrations of individual FFAs, the ratios of [product FFA/[precursor FFA] may better reflect the status of endogenous fatty acid metabolism. This study examined samples collected from participants in 3 independent studies, including a 10-year longitudinal cohort of 131 metabolically healthy individuals from the Shanghai Diabetes Study (SHDS)[17], a cross-sectional cohort of 312 subjects from the Shanghai Obesity Study (SHOS)[18], and a controlled dietary intervention study of 38 obese subjects who completed 8-week of very low carbohydrate diet (VLCD)[19]
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