Can we identify metabolically healthy but obese individuals (MHO)?

Abstract

A unique subset of obese individuals termed, Metabolically Healthy but Obese (MHO), has been described in the literature. However, there is no agreed upon method to identify MHO individuals for research protocols or in clinical practice. Therefore, we examined a large cohort of obese older women to attempt to develop a first set of clinical markers that may identify MHO individuals. We studied 154 obese postmenopausal women (age: 57.0 +/- 5.3 years and BMI: 34.3 +/- 5.5 kg/m2). Selection criteria for MHO individuals were partially based on the National Cholesterol Education Program's Adult Treatment Panel III report (ATP III) for lipid profiles (triglycerides: < or =1.7 mmol/l, total cholesterol: < or =5.2 mmol/l, HDL-cholesterol: > or =1.3 mmol/l and LDL-cholesterol: < or =2.6 mmol/l) and from the study of Brochu et al. (2001) for insulin sensitivity (HOMA<=1.95). When 4 out of 5 criteria are met, we suggest that a diagnosis of the MHO individual could be made. Based on the proposed criteria, 19 out of 154 (12.3%) postmenopausal women subjects were identified as MHO. By design, MHO individuals showed a favourable lipid profile and higher insulin sensitivity values. We suggest a potential new set of clinical markers to identify MHO individuals. Identifying MHO individuals could have important implications for therapeutic medical decision making, subject characterization in research protocols and in medical education.