Abstract
Few studies have described the characteristics of metabolically healthy individuals with excess fat in the Chinese population. This study aimed to prospectively investigate the natural course of metabolically healthy overweight/obese (MH-OW/OB) adults, and to assess the impact of weight change on developing metabolic abnormalities. During 2009–2010, 525 subjects without any metabolic abnormalities or other obesity-related diseases were evaluated and reevaluated after 5 years. The subjects were categorized into two groups of overweight/obese and normal weight based on the criteria of BMI by 24.0 at baseline. At follow-up, the MH-OW/OB subjects had a significantly increased risk of developing metabolically abnormalities compared with metabolically healthy normal-weight (MH-NW) individuals (risk ratio: 1.35, 95% confidence interval: 1.17–1.49, p value < 0.001). In the groups of weight gain and weight maintenance, the MH-OW/OB subjects was associated with a larger increase in fasting glucose, triglycerides, systolic blood pressure, diastolic blood pressure and decrease in high-density lipoprotein cholesterol comparing with MH-NW subjects. In the weight loss group, no significant difference of changes of metabolic parameters was observed between MH-OW/OB and MH-NW adults. This study verifies that MH-OW/OB are different from MH-NW subjects. Weight management is needed for all individuals since weight change has a significant effect on metabolic health without considering the impact of weight change according to weight status.
Highlights
Obesity is a key risk factor for various diseases, including type 2 diabetes, cardiovascular disease (CVD), certain cancers, and musculoskeletal diseases [1]
We checked for withdrawal bias by testing for differences in baseline variables between the participants who participated in follow-up measurements and those who did not participated in follow-up examinations
We found that the MH-OW/OB subjects had higher incidences of metabolic derangements compared with metabolically healthy normal-weight (MH-NW) counterparts as time passed
Summary
Obesity is a key risk factor for various diseases, including type 2 diabetes, cardiovascular disease (CVD), certain cancers, and musculoskeletal diseases [1]. It has been appreciated for many years that about 20% to 30% of obese adults exhibit fewer of these complications and do not meet all the criteria for metabolic syndrome [2]. Nutrients 2016, 8, 430 for defining MHO phenotype, longitudinal studies have suggested that this subtype of obesity are still at increased risk of diabetes and cardiovascular diseases [4,5,6,7]. It has been speculated that the MHO subjects are not protected, but require additional time to develop adverse metabolic outcomes
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