Abstract
The cardiovascular disease (CVD) risk of metabolically healthy obesity (MHO) remains controversial. We sought to further characterize the CVD risk profile in MHO by evaluating postprandial triglycerides, vascular function, and systemic inflammatory markers. Control individuals that were normal-weight and metabolically healthy (Con), MHO, and metabolic syndrome (MetS) were recruited (n = 10–11/group). Each participant underwent an abbreviated fat tolerance test, fasting and postprandial flow-mediated dilation (FMD), and had a panel of inflammatory cytokines measured. MHO displayed postprandial triglycerides similar to those in Con and both MHO and Con had lower values than those for MetS (p < 0.01). Fasting FMD was lower in MHO and MetS compared to that of Con (p < 0.01), but during the postprandial period the vasodilatory response of MHO was similar to that while fasting (p = 0.39), while FMD in Con and MetS decreased after the high-fat meal (p values < 0.01). MHO displayed a number of inflammatory cytokines greater than those of Con and MetS (all p values < 0.05), while MetS and MHO had higher TNF-α than did Con (p < 0.05). In conclusion, MHO was associated with lower fasting FMD and a greater inflammatory burden but did not suffer the same negative postprandial effects as did MetS.
Highlights
Obesity continues to represent a major public health issue and is associated with increased risk of developing cardiometabolic diseases, such as cardiovascular disease (CVD)and type 2 diabetes, as well as mortality [1,2,3]
Those with metabolically healthy obesity (MHO) have a largely favorable metabolic profile based on traditional risk factors, mixed evidence suggests that MHO is still associated with increased long-term risk of developing CVD, type 2 diabetes, and mortality; in some cases, risk is similar to individuals considered metabolically unhealthy and obese [7,8,9]
Percent lean mass was significantly lower in MHO and metabolic syndrome (MetS) compared to that of Con (p < 0.01)
Summary
Obesity continues to represent a major public health issue and is associated with increased risk of developing cardiometabolic diseases, such as cardiovascular disease (CVD)and type 2 diabetes, as well as mortality [1,2,3]. MHO refers to individuals who have a body mass index (BMI) in the obese category (BMI ≥ 30 kg/m2 ) yet lack most or all criteria for metabolic syndrome (i.e., abnormal fasting glucose, HDL-C, triglycerides, blood pressure), are not treated with glucose-lowering and/or anti-hypertensive medications, and have no history of CVD [5] This risk profile of MHO has been attributed to a preservation of insulin sensitivity and a greater proportion of body fat being stored subcutaneously rather than viscerally or in ectopic depots in spite of an elevated BMI [6]. Other studies have reported that the CVD and mortality risk for MHO is similar to lean counterparts, further contributing to the debate around this population [10,11]
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