Study on clinical characteristics of metabolic-based obesity classification

Abstract

Objective This study aimed to explore clinical characteristics of four types of obesity based on metabolic classification. Methods Forty-eight obese patients were divided according to their clinical characteristics into 4 groups including metabolic healthy obesity (MHO), hypometabolic obesity (LMO), hypermetabolic obesity (HMO), and metabolic obesity with inflammation (IMO). 20 normal weight individuals were also recruited as a control group. Body fat, body weight, visceral index, and basal metabolism were measured by Omron body fat meter. Fat content and its distribution were measured by dual energy X-ray absorptiometry. All participating patients underwent various tests for 75 g oral glucose tolerance, blood glucose, insulin, C peptide. Lipid profile, thyroid function and sex hormones levels, and inflammation factors were also measured. Results (1)Patients in MHO group had higher body fat content, but had no metabolic disorder and inflammation. Their hormones levels were normal. (2)Lower metabolic rate and lower hormones levels were found in the patients in LMO group with increasing visceral fat. Trunk/subcutaneous fat mass was significantly higher than that in MHO group(1.19±0.25 vs 0.97±0.32, P<0.05). There were abnormal lipid and glucose metabolism in LMO group. The insulin action index was significantly lower than that in MHO group(0.006 6±0.002 7 vs 0.012 1±0.009 5, P<0.05). The area under the curve of glucose concentration was significantly higher in LMO group than that in MHO group[(18.71±8.68 vs 12.70±4.63)mmol/L, P<0.05]. (3)Heart rate and blood pressure were higher in HMO group. The heart rate was significantly increased compared with that in MHO group [(90.50±8.24 vs 73.20±14.11) beat/min, P<0.05]. The waist circumference was significantly larger than that in MHO group [(111.88±10.54 vs 98.05±15.56)cm, P<0.05]. (4)In IMO group, insulin action index was significantly lower than MHO group (0.007 0±0.003 3 vs 0.012 1±0.009 5, P<0.05). The trunk fatmass and uric acid levels were significantly higher than MHO group [(17 236.38±4 610.60 vs 15 816.10±5 453.42)g and (468.28±121.32 vs 376.84±97.14) μmol/L, both P<0.05]. Patients in IMO group had acanthosis nigricans, but their glucose level was relatively normal. Conclusion The metabolic-based obese diagnosis is essential for understanding the obesity etiology and providing individualized treatment. (Chin J Endocrinol Metab, 2015, 31: 678-683) Key words: Obesity; Classification; Metabolism; Characteristics