Metabolically Healthy versus Unhealthy Morbidly Obese: Chronic Inflammation, Nitro-Oxidative Stress, and Insulin Resistance.

Adriana Cӑtoi,Andra Andreicuț,Alina Pârvu,Cornel Cӑtoi,Ioana Pop,Aurel Mironiuc,Alexandra Crӑciun

doi:10.3390/nu10091199

Abstract

Metabolically heathy obesity is characterised by the presence of obesity in the absence of metabolic disturbances. The aim of our study was to analyse pro-inflammatory, nitro-oxidative stress, and insulin-resistance (IR) markers in metabolically healthy morbidly obese (MHMO) with respect to metabolically unhealthy morbidly obese (MUHMO) with metabolic syndrome (MS) and to identify the potential predictors of MS in the MHMO group. Two groups of MHMO and MUHMO with MS were analysed. We evaluated serum high sensitivity C reactive protein (hsCRP), tumor necrosis factor alpha (TNF-α), chemerin, nitrite and nitrate (NOx), total oxidant status (TOS), total antioxidant response (TAR), fasting blood glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR.) MHMO have similar hsCRP and TNF-α values as the MUHMO with MS, while chemerin was significantly lower in MHMO. NOx was higher in MUHMO with MS patients, while no difference regarding TOS and TAR was found between the two groups. HOMA-IR and insulin values were lower in MHMO as compared to the MUHMO with MS group. Insulin, HOMA-IR, and chemerin were identified predictors of MS in MHMO. In conclusion, MHMO and MUHMO display similarities and differences in terms of chronic inflammation, nitro-oxidative stress, and IR. Markers of IR and chemerin are possible predictors of MS in MHMO.

Highlights

Obesity is one of the most important burdens of the health care systems worldwide [1]
In the present study we found no significant differences of the high sensitivity C reactive protein (hsCRP) and TNF-α values between metabolically healthy morbidly obese (MHMO) and metabolically unhealthy morbidly obese (MUHMO) with metabolic syndrome (MS)
We showed that chemerin level was significantly lower in MHMO as compared with MUHMO with MS, opposite to Alfadda who found no differences between the two groups [42]

Summary

Introduction

Obesity is one of the most important burdens of the health care systems worldwide [1]. It is often associated with type 2 diabetes, cardiovascular diseases, dyslipidemia, metabolic syndrome, a reduced life expectancy, and it is considered a metabolically unhealthy obese (MUHO). While most studies use as criteria for defining MHO less than 2 conditions of metabolic syndrome (MS), others use a more strict definition, i.e., the absence of type 2 diabetes, dyslipidemia, and hypertension [4,5,6], and some include markers of homeostasis model assessment of insulin resistance (HOMA-IR) and systemic inflammation markers such as C reactive protein (CRP) [7,8,9]. An obesity low grade inflammatory state has been confirmed by the elevated levels of pro-inflammatory marker CRP a well-known harbinger of type 2 diabetes [13]

Objectives

Methods

Results

Discussion

Conclusion