Abstract
Aims: Obesity is the major contributor of the metabolic syndrome (MetS), but a unique phenotype of obesity known as metabolically healthy obese (MHO) shows healthier metabolic profile; however understanding of their biochemical correlates is poorly understood. Obesity is defined by Body mass index (BMI), but controversy exists regarding ethnic-specific BMI cut-offs. The present study used the Asian Indian BMI cut-offs to assess relationships of MHO phenotypes with oxidative stress (OS) and inflammation. Methods: In this case-control study, 299 metabolically-healthy (MH) respondents were divided into four groups as per Asian criteria for obesity: MH non-obese (MHNO), MH overweight (MHOW), MHO and MH severely obese (MHSO). Their oxidative stress and pro-inflammatory markers were measured. Results: Levels of hydroxyl radicals (·OH), fluorescent oxidation products (FLOP), MDA, PCO and inflammatory markers CRP, TNF-α, IL-6 were highest in MHSO phenotype followed by the MHO, MHOW and MHNO groups (p > 0.0001), whereas antioxidant markers, CuZn-SOD, catalase, glutathione peroxidase and total antioxidant activity followed the reverse trend. The MHNO and MHOW groups showed significant difference with regard to (·OH) radicals and FLOP. Moreover, ·OH radicals, FLOP and inflammatory markers were significantly correlated to BMI in MHSO and MHO but not in MHNO and MHOW group. Conclusion: The MHO and MHSO phenotype display differences in terms of OS and inflammatory markers at lower BMI cut-offs, indicating that they may be on the way to becoming “unhealthy” obese. The lower BMI cut-offs proposed by Indian Consensus Group would help in understanding of manifestation of metabolic syndrome.
Highlights
Obesity has been recognized as the major contributor to the global epidemic of metabolic syndrome, which has been defined as a cluster of conditions that occur together to increase the risk of heart disease, stroke and type 2 diabetes
The biochemical parameters including fasting plasma glucose, triglyceride, blood pressure were found to be significantly higher (p < 0.05), and HDL-cholesterol, lower in MH severely obese (MHSO) and metabolically healthy obese (MHO) phenotype as compared to MH overweight (MHOW) and MH non-obese (MHNO), who did not differ from each other (Table 2)
The concentrations of plasma/serum/erythrocytic oxidative stress markers and antioxidant markers were assessed in various phenotypes of obesity and again all OS markers, serum OH radicals and fluorescent oxidation products (FLOP), Erythrocytic MDA and protein carbonyl (PCO) were significantly higher at p < 0.0001, and antioxidant enzymes, CuZn-SOD, CAT, and total antioxidant capacity (FRAP) low as obesity became more pronounced, based on one-way analysis of variance (ANOVA)
Summary
Obesity has been recognized as the major contributor to the global epidemic of metabolic syndrome, which has been defined as a cluster of conditions that occur together to increase the risk of heart disease, stroke and type 2 diabetes. The issue is under more active investigation and those who are obese but are not affected by metabolic disturbances have been designated as “metabolically healthy obese” (MHO) phenotype [1] They are, by definition, insulin sensitive, have normal blood pressure, favorable lipid profile, a lower proportion of visceral fat, less liver fat and normal glucose metabolism despite having an excessive amount of body fat [2] [3], and are reported to be associated with substantially lower risk of metabolic complications [4] and account for about 10% 25% of obese people [5]. The most acceptable criterion to define MHO in clinical practice is the absence of Metabolic Syndrome [3] [6], as defined by the NCEP-ATP III criteria [7] in overweight/obese subjects
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