Metabolic Phenotypes Of Obesity Research Articles

Metabolic Features of Individuals with Obesity Referred for Bariatric and Metabolic Surgery: a Cohort Study

The concept of metabolic obesity phenotypes has been proposed, but its relevance to metabolic features is unclear. To determine a new definition of metabolic obesity phenotype, investigate the characteristics of expressing clustered normal and abnormal metabolic parameters, and analyze factors associated with metabolic abnormalities. Characteristics of 600 patients were analyzed. The definition of metabolic obesity phenotype includes elevated blood pressure, glucose, lipid, and uric acid levels and abnormal lipoprotein levels. Independent sample t test and a general linear model with repeated measures were applied to investigate the differences in metabolic parameters. A total of 108 (18.0%) participants were obese yet metabolically healthy, whereas 492 (82.0%) were obese and metabolically unhealthy. Body weight at baseline was significantly higher in metabolically unhealthy phenotype (P < 0.001). For non-phasic oral glucose tolerance test (OGTT) curve shape, 100% glucose, 100% C-peptide, and 95.8% insulin curves were found in the metabolically unhealthy group. Men had an increased risk for elevated lipid level than women (OR = 1.83, 1.21-2.77). Individuals with class II/III obesity had an increased risk for elevated blood pressure, glucose, and UA levels than did those with class I obesity (OR = 2.22, 1.43-3.44; OR = 1.73, 1.11-2.68; OR = 3.61, 2.29-5.69, respectively). Approximately one-fifth of individuals with obesity had a metabolically healthy phenotype, and nearly one-third of individuals with class III obesity had this phenotype. Non-phasic OGTT curve shape is a meaningful predictive factor of metabolically unhealthy phenotype before bariatric surgery. Male sex and class II/III obesity are risk factors associated with specific metabolic abnormalities.

Metabolic Obesity Phenotypes and Risk of Cellulitis: A Cohort Study.

No cohort studies have evaluated the effect of obesity on the risk of cellulitis according to metabolic health status. We investigated an association of BMI and metabolic health status with the development of cellulitis. We conducted a cohort study of 171,322 Korean adults who underwent a health checkup examination and were followed from 2011 to 2016 for cellulitis and hospital admission related to cellulitis, which were ascertained through the linkage to the Health Insurance and Review Agency database. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance <2.5. During 638,240.4 person-years of follow-up, 14,672 cases of incident cellulitis were identified with 225 cases of cellulitis-related admission. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (95% CI) for incident cellulitis comparing BMIs 23–24.9, 25–29.9, and ≥30 with a BMI of 18.5–22.9 kg/m2 as the reference were 1.07 (1.02–1.11), 1.09 (1.04-1.13), and 1.19 (1.08–1.31), respectively, whereas the corresponding multivariable-adjusted hazard ratios (95% CI) for cellulitis-related admission were 1.55 (1.05–2.3), 2.47 (1.73–3.53), and 4.8 (2.86–8.05), respectively. These associations were consistently observed in both metabolically healthy and unhealthy individuals with no significant interaction. In a large cohort of apparently healthy adults, increased BMI was associated with an increased risk of cellulitis and hospitalization for cellulitis in both metabolically healthy and unhealthy individuals. Obesity appears to be an independent risk factor for cellulitis regardless of metabolic phenotype.

2107-P: The Association between Metabolic Syndrome, Obesity Phenotype, and the Risk of Thyroid Cancer

Background: Current evidence suggest that obesity and metabolic unhealthy status may be linked to a higher risk of several cancers. This study investigated whether thyroid cancer risk is increased by metabolic syndrome (MetS) and obesity phenotypes. Methods: A total of 23151947 adults who participated in health screening between 2009-2014 were enrolled from the Korean National Health Insurance Database. Body mass index (BMI), waist circumference, fasting glucose, lipid profiles, and blood pressure were measured. Obesity status was subdivided into being metabolically healthy or unhealthy according to MetS besides BMI. Cox proportional hazards models were used to estimate the risk of thyroid cancer. Results: During the average 5.6-years of follow-up, 158788 cases of thyroid cancer were newly identified. In multivariate models adjusted for age, smoking, drinking, exercise, and income status, the risk of thyroid cancer was increased with increasing BMI and presence of any MetS components. MetS was associated with 1.30-fold higher risk for thyroid cancer in men and 1.12-fold in women. Compared to metabolically healthy non-obese subjects, metabolically unhealthy non-obese subjects had a higher risk of thyroid cancer in both genders. However, metabolically unhealthy obesity versus metabolically healthy obesity were at greater risk for thyroid cancer only in men. Conclusions: Components of Mets, especially obesity, and MetS were significantly associated with increased risk of thyroid cancer in Korean men and women. Moreover, metabolically unhealthy subjects were at higher risk of thyroid cancer despite normal BMI. Management of metabolic disorders may give additional benefit of thyroid cancer prevention. Disclosure E. Kim: None. K. Han: None. H. Kwon: None.

Heterogeneity of obesity phenotypes in relation to cardiovascular risk

Obesity is associated with numerous metabolic disorders, the development and progression of a wide range of conditions and diseases, primarily cardiovascular disease and type 2 diabetes. One of the widely discussed phenomena of the association of obesity with cardiovascular diseases, their complications and mortality is the phenomenon of “heterogeneity of obesity phenotypes in relation to cardiovascular risk”. Currently, two main phenotypes have been identified — metabolically healthy and metabolically unhealthy obesity. At the same time, not only the expediency of separation, but also the existence of this phenotype is widely discussed today. The article provides an overview of existing approaches to the verification of metabolic phenotypes of obesity and data relating to the epidemiology and the association of metabolically healthy obesity with the risk of cardiovascular diseases and death, and also discusses the factors that determine the features of the obesity phenotype.

Heterogeneity of obesity phenotypes in relation to cardiovascular risk

Obesity is associated with numerous metabolic disorders, the development and progression of a wide range of conditions and diseases, primarily cardiovascular disease and type 2 diabetes. One of the widely discussed phenomena of the association of obesity with cardiovascular diseases, their complications and mortality is the phenomenon of “heterogeneity of obesity phenotypes in relation to cardiovascular risk”. Currently, two main phenotypes have been identified — metabolically healthy and metabolically unhealthy obesity. At the same time, not only the expediency of separation, but also the existence of this phenotype is widely discussed today. The article provides an overview of existing approaches to the verification of metabolic phenotypes of obesity and data relating to the epidemiology and the association of metabolically healthy obesity with the risk of cardiovascular diseases and death, and also discusses the factors that determine the features of the obesity phenotype.

Metabolic Obesity Phenotypes and Thyroid Cancer Risk: A Cohort Study.

No cohort studies have evaluated the effect of obesity on the incidence of thyroid cancer according to metabolic health status. Therefore, this study examined the association of body mass index (BMI) and metabolic health status with thyroid cancer risk. A cohort study was performed involving 255,051 metabolically healthy (MH) and metabolically unhealthy (MUH) adults free of thyroid cancer at baseline who were followed for a median of 5.3 years. A parametric proportional hazard model was used to estimate the adjusted hazard ratio (aHR) and confidence interval (CI). During 1,402,426.3 person-years of follow-up, 2927 incident thyroid cancers were identified. Among men, the multivariable aHR for thyroid cancer comparing obesity, defined as a BMI ≥25 kg/m2, with a BMI of 18.5-22.9 kg/m2 was 1.47 [CI 1.12-1.93] in MH individuals, whereas the corresponding HR in MUH individuals was 1.26 [CI 1.03-1.53]. Among women, the corresponding HR in MH individuals was 1.05 [CI 0.80-1.36], whereas the corresponding HR in MUH individuals was 1.43 [CI 1.22-1.69]. Increasing quartiles of waist circumference were positively associated with risk of thyroid cancer in MUH men and women (p for trend <0.005) but not in MH individuals. In both MH and MUH men, obesity was associated with an increased risk of incident thyroid cancer, indicating excessive adiposity per se as an independent risk factor for thyroid cancer. Conversely, women with MUH obesity but not MH obesity were found to have an increased risk of thyroid cancer, indicating that obesity with accompanying metabolic abnormalities may affect thyroid cancer risk in women.

Prevalence of different metabolic phenotypes of obesity in Iranian children and adolescents: the CASPIAN V study.

Pediatric metabolic disorders are a major health problem. The prevalence of child and adolescent metabolic disorders particularly obesity has globally shown a growing pattern. The aims of this study were to estimate the prevalence of different metabolic phenotypes of obesity in children and adolescents. This multi-centric cross-sectional study was conducted in 2015 in 30 provinces of Iran. Participants consisted of 4200 school students aged 7-18years, studied in a national school-based surveillance program (CASPIAN- V) in Iran. Metabolic syndrome (MetS) and obesity was defined according to ATP III and WHO criteria respectively. Subjects were classified into four different metabolic phenotypes of obesity; metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically non-healthy non-obese (MNHNO) and metabolically non-healthy obese (MNHO). Moreover students were classified in four different phenotypes of obesity; normal; only abdominal obesity (AO), only generalized obesity (GO) and combined obesity (CO). The prevalence (95% confidence interval) of different metabolic phenotypes of obesity, MHO 10.35 (9.1, 11.8), MNHNO 3.31 (2.6, 4.2) and MNHO 2.19 (1.6, 2.9) was found in boys, while the prevalence of these phenotypes was significantly lower in girls (7.74 (6.6, 9.1), 3.11 (2.4,5.1) and 1.41 (0.9,2.1) respectively). The prevalence of only AO, only GO and CO was 12.17% (11.6, 12.7), 2.51% (2.3,2.8), and 8.86% (8.4,9.3), respectively. Based on gender differences, the prevalence of AO was significantly higher among girls than boys (12.4% of girls vs. 11.9% of boys). Healthy lifestyle education and program interventions are necessary for children with different metabolic phenotypes of obesity, as there is a high probability that they may suffer from poor health in the future.

Maternal diet-induced obesity during suckling period programs offspring obese phenotype and hypothalamic leptin/insulin resistance

During the early post-natal period, offspring are vulnerable to environmental insults, such as nutritional and hormonal changes, which increase risk to develop metabolic diseases later in life. Our aim was to understand whether maternal obesity during lactation programs offspring to metabolic syndrome and obese phenotype, in addition we aimed to assess the peripheral glucose metabolism and hypothalamic leptin/insulin signaling pathways. At delivery, female Wistar rats were randomly divided in two groups: Control group (CO), mothers fed a standard rodent chow (Nuvilab); and Diet-induced obesity group (DIO), mothers who had free access to a diet performed with 33% ground standard rodent chow, 33% sweetened condensed milk (Nestlé), 7% sucrose and 27% water. Maternal treatment was performed throughout suckling period. All offspring received standard rodent chow from weaning until 91-day-old. DIO dams presented increased total body fat and insulin resistance. Consequently, the breast milk from obese dams had altered composition. At 91-day-old, DIO offspring had overweight, hyperphagia and higher adiposity. Furthermore, DIO animals had hyperinsulinemia and insulin resistance, they also showed pancreatic islet hypertrophy and increased pancreatic β-cell proliferation. Finally, DIO offspring showed low ObRb, JAK2, STAT-3, IRβ, PI3K and Akt levels, suggesting leptin and insulin hypothalamic resistance, associated with increased of hypothalamic NPY level and decreased of POMC. Maternal obesity during lactation malprograms rat offspring to develop obesity that is associated with impairment of melanocortin system. Indeed, rat offspring displayed glucose dyshomeostasis and both peripheral and central insulin resistance.

EPICARDIAL OBESITY AS ONE OF THE BASIC CRITERIA FOR METABOLICALLY UNHEALTHY OBESITY PHENOTYPE AND THE PREDICTOR OF SUBCLINICAL ATHEROSCLEROSIS

Aim. To assess the effect of epicardial obesity on the development of dyslipidemia and polyvascular subclinical atherosclerosis, and to assess the prognostic significance of various obesity criteria in the development of cardiovascular risk. Methods. Male patients with arterial hypertension and without clinical symptoms of atherosclerosis of any localization and type 2 diabetes were included in the study. All the patients were enrolled into two groups, depending on the metabolic phenotypes of obesity assessed by epicardial fat thickness and body mass index. Both groups were comparable in waist circumference. All patients in both groups had abdominal obesity (AO≥94 cm). The study groups underwent a comparative assessment of parameters of lipid metabolism and levels of Apo-proteins. Coronary atherosclerosis was measured with multispiral computed tomography. Atherosclerotic lesions of brachiocephalic arteries were assessed by duplex scanning was performed. Epicardial fat thickness was measured by echocardiography. Results. Significant relationships between epicardial obesity and the development of dyslipidemia and polyvascular subclinical atherosclerosis have been determined. Waist circumference and body mass index have low prognostic significance for developing cardiovascular risk. Conclusion. Epicardial obesity significantly affects the development of subclinical atherosclerosis of the coronary and brachiocephalic arteries. The assessment of cardiovascular risk in patients with arterial hypertension and without other diagnosed cardiovascular diseases reported that it is necessary to measure epicardial fat thickness along with traditional risk factors. Epicardial fat thickness is considered to be a criterion for visceral obesity, contributing to the development of cardiometabolic disorders.

Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women

Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-<25.0, 25.0-<30.0 and ≥30.0 kg/m2 ) and presence of the metabolic syndrome into 6 phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Neither BMI nor presence of the metabolic syndrome was associated with risk of colorectal cancer, whereas waist circumference showed a robust positive association. Relative to the MHNW phenotype, the MUNW phenotype was associated with increased risk, whereas no other phenotype showed an association. Furthermore, HOMA-IR was not associated with increased risk. Overall, our results do not support a direct role of metabolic dysregulation in the development of colorectal cancer; however, they do suggest that higher waist circumference is a risk factor, possibly reflecting the effects of increased levels of cytokines and hormones in visceral abdominal fat on colorectal carcinogenesis.

Lack of association between FTO gene variations and metabolic healthy obese (MHO) phenotype: Tehran Cardio-metabolic Genetic Study (TCGS).

Obesity is currently an international epidemic and metabolic derangements pose these individuals at greater risk for future morbidity and mortality. Genetics and environmental factors have undeniable effects and among genetic risk factors, FTO/CETP genes are important. The current study examines the interaction between obesity phenotypes and FTO/CETP SNPs and their effects on lipid profile changes. We selected 954 adult subjects from TCGS (47.9% male). Participants were stratified according to their BMI and presence of metabolic syndrome according to the Joint Interim Statement (JIS) definition. Nine selected polymorphisms from FTO/CETP genes were genotyped using Tetra ARMS-PCR method. After age and sex adjustment the interaction of 9 markers with lipid profiles among phenotypes were tested by PASW. In three main groups, HDL_C level had a strong significant association with CETP markers: (rs3764261, β(95% CI) - 0.48(- 0.61 to - 0.35), P = 1.0 × 10-11), (rs1800775, β(95% CI) 0.5(0.36;0.65), P = 1.0 × 10-6) and (rs1864163, β(95% CI) 0.3(0.16;0.43), P = 9.1 × 10-5). This association was also seen in rs7202116 within the total population. In only unhealthy metabolic obese (MUHO) subgroups four new FTO markers (rs1421085, rs1121980, rs1558902 and rs8050136) (P value < 0.01) demonstrated significant association, even after lipid profile adjustment. In the present study, we investigated the association between obesity phenotypes and some variations in FTO/CETP genes for the first time. Our study showed that four markers in the first intron of the FTO gene should be the risk marker in MUHO participants. Level III, case-control study.

Metabolic syndrome and different obesity phenotypes in the elderly women population: Iran's Health System on aging.

Background: Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS).Methods: A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index.Results:The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p<0.001) and high density lipoprotein (HDL-C) (OR=2.15,p<0.01) was independently related to metabolically healthy and normal weight(MHNW) phenotype. Moreover, TG (OR=3.92,p<0.001), HDL-C (OR=2.18,p<0.001), fasting blood glucose(FBG) (OR=1.73,p<0.01) and waist circumference(WC) (OR=3.18,p<0.001) are correlated significantly with metabolically unhealthy and overweight/obese (MUO) and also TG (OR=2.88,p<0.001) and WC (OR=2.67,p<0.001) with metabolically unhealthy and overweight/obese(MHO).WC followed by %body fat (BF) showed to be highly correlated with the prognosis of MetS components.Conclusions:There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI.

Metabolic Obesity Phenotypes and Risk of Breast Cancer in Postmenopausal Women.

Background: Obesity and the metabolic syndrome (MetS) have both been linked to increased risk of postmenopausal breast cancer; however, their relative contributions are poorly understood.Methods: We examined the association of metabolic phenotypes of obesity defined by presence of the MetS (yes and no) and body mass index (BMI; normal, overweight, obese) with risk of postmenopausal breast cancer in a prospective analysis of a cohort of postmenopausal women (n ∼ 21,000) with baseline measurements of blood glucose, triglycerides, HDL-cholesterol, blood pressure, waist circumference, and BMI. Women were classified into 6 metabolic obesity phenotypes according to their BMI (18.5-<25.0, 25.0-<30.0, ≥30.0 kg/m2) and presence of the MetS (≥3 of the following: waist circumference ≥88 cm, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, glucose ≥100 mg/dL, and systolic/diastolic blood pressure ≥130/85 mmHg or treatment for hypertension). HRs for incident breast cancer and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards models.Results: Over 15 years of follow-up, 1,176 cases of invasive breast cancer were diagnosed. Obesity, regardless of metabolic health, was associated with increased risk of breast cancer. Being obese and metabolically unhealthy was associated with the highest risk: HR, 1.62; 95% CI, 1.33-1.96. These associations were stronger in women who had never used hormone therapy.Conclusions: Our findings suggest that both obesity and metabolic dysregulation are associated with breast cancer risk.Impact: Beyond BMI, metabolic health should be considered a clinically relevant and modifiable risk factor for breast cancer. Cancer Epidemiol Biomarkers Prev; 26(12); 1730-5. ©2017 AACR.

Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes

Visceral adiposity index (VAI) is a novel sex-specific index for visceral adipose function; however the association between VAI and hyperuricemia in China is unknown. We aimed to investigate this association, also whether it was independent of metabolic health and obesity phenotypes. 7632 adult subjects from the China Health and Nutrition Survey 2009 were retained. Subjects were categorized into four obesity phenotypes based on a cross-classification of BMI and metabolic health status by two representative criteria. VAI was the best predictors for hyperuricemia irrespective of obesity phenotypes, with area under curve (AUC) ranging 0.665–0.719. The odd ratio (OR) for hyperuricemia in the highest quartile of the VAI were 6.93 (95% CI 5.79–8.29) after adjusting for age and gender. Following further adjustments for metabolic obesity phenotypes and lifestyle confounders, the ORs were 4.88 (3.92–6.09) and 5.65 (4.68–6.82) according to these two criteria, respectively. A similar significant pattern was still found even after adjustment for blood pressure and other cardiovascular risks. Within each metabolic obesity phenotype, the significant association between VAI and hyperuricemia was consistently evident. In conclusion, the association of the VAI with hyperuricemia was significant, especially this association was independent of metabolic health and obesity phenotypes in the Chinese population.

Haplotypes on pig chromosome 3 distinguish metabolically healthy from unhealthy obese individuals.

We have established a pig resource population specifically designed to elucidate the genetics involved in development of obesity and obesity related co-morbidities by crossing the obesity prone Göttingen Minipig breed with two lean production pig breeds. In this study we have performed genome wide association (GWA) to identify loci with effect on blood lipid levels. The most significantly associated single nucleotide polymorphisms (SNPs) were used for linkage disequilibrium (LD) and haplotype analyses. Three separate haploblocks which influence the ratio between high density lipoprotein cholesterol and total cholesterol (HDL-C/CT), triglycerides (TG) and low density lipoprotein cholesterol (LDL-C) levels respectively were identified on Sus Scrofa chromosome 3 (SSC3). Large additive genetic effects were found for the HDL-C/CT and LDL-C haplotypes. Haplotypes segregating from Göttingen Minipigs were shown to impose a positive effect on blood lipid levels. Thus, the genetic profile of the Göttingen Minipig breed seems to support a phenotype comparable to the metabolic healthy obese (MHO) phenotype in humans.

Lack of Association between FTO Gene Variations and Metabolic Healthy Obese (MHO) Phenotype: Tehran Cardio-Metabolic Genetic Study (TCGS)

Background: Obesity is currently an international epidemic and metabolic derangements pose these individuals at greater risk for future morbidity and mortality. Genetics and environmental factors have undeniable effects and among genetic risk factors, FTO/CETP genes are important. The current study examines the interaction between obesity phenotypes and FTO/CETP SNPs and their effects on lipid profile changes. Material and methods: We selected 954 adult subjects from TCGS (47.9% male). Participants were stratified according to their BMI and presence of metabolic syndrome according to the Joint Interim Statement (JIS) definition. Nine selected polymorphisms from FTO/CETP genes were genotyped using Tetra ARMS-PCR method. After age and sex adjustment the interaction of 9 markers with lipid profiles among phenotypes were tested by PASW. Results: In three main groups, HDL-C level had a strong significant association with CETP markers: (rs3764261, β(95%CI) -0.48(-0.61-0.35), P=1.0 × 10-11), (rs1800775, β(95%CI) 0.5(0.36;0.65), P=1.0 × 10-6) and (rs1864163, β(95%CI) 0.3(0.16;0.43), P=9.1 × 10-5). This association was also seen in rs7202116 within the total population. In only unhealthy metabolic obese (MUHO) subgroups four new FTO markers (rs1421085, rs1121980, rs1558902 and rs8050136) (P-value<0.01) demonstrated significant association, even after lipid profile adjustment. Conclusion: In the present study, we investigated the association between obesity phenotypes and some variations in FTO/CETP genes for the first time. Our study showed that four markers in the first intron of the FTO gene should be the risk marker in MUHO participants.

The Prevalence of Metabolic Syndrome and Different Obesity Phenotype in Iranian Male Military Personnel.

Obesity, especially when concentrated in the abdominal area, is often associated with the presence of metabolic syndrome. Stress, particularly occupational stress, is one of the most important factors contributing to the increased prevalence of metabolic syndrome components among different populations. This study aimed to investigate the prevalence of overweight and obesity as well as the criteria for metabolic syndrome and its risk factors and different obesity phenotype in a population of military personnel aged 20 to 65 years. This study is a retrospective cross-sectional study in which data are extracted from the database of a military hospital (2,200 participants). The records of participants contained information such as age, marital status, educational level, weight, height, body mass index, blood pressure, waist circumference, history of drug use and smoking, as well as the results of tests including lipid profile and fasting blood glucose. The Adult Treatment Panel III criteria as well as two national criteria were used to identify metabolic syndrome among participants. Data analysis was p1erformed using SPSS version 16. The average age of participants was 33.37 (7.75) years. The prevalence of metabolic syndrome according to Iranian cutoff was 26.6% for the waist circumference >90 cm (585 persons) and 19.6% for the waist circumference >95 cm (432 persons). The rate of metabolic syndrome was identified as 11.1% (432 cases) according to Adult Treatment Panel III criteria. Results of the current study identified that the prevalence of metabolic syndrome among military individuals is less than other populations, but the prevalence of the syndrome is higher than other military personnel in other countries.

THE RELEVANCE OF METABOLIC PHENOTYPES OF OBESITY IN CHILDHOOD AND ADOLESCENCE

Rationale: The study on specifics of metabolic phenotypes of obesity in children and adolescents seems be highly relevant for a comprehensive assessment of causal and pathophysiological roles of obesity in the atherogenesis. Aim: To identify particulars of metabolic phenotypes of obesity in the population of the school children in the city of Arkhangelsk. Materials and methods: We examined 102 patients aged from 10 to 15 years with obesity, abdominal type (boys, 44.6%, girls, 55.4%). According to the results of a comprehensive clinical and laboratory assessments, the patients were divided into the group of metabolically healthy obese (children and adolescents with obesity, but without any metabolic abnormalities) and the group of metabolically unhealthy obese (having at least 1 metabolic abnormality). The list of metabolic abnormalities included high triglyceride levels, low levels of high density lipoprotein cholesterol (HDL-C), high blood pressure, impaired fasting glucose, increased C-reactive protein levels. Results: The group comparison showed that the mean levels of all studied parameters of pro-atherogenic metabolic abnormalities were significantly higher in the patients with metabolically active obesity (the mean triglyceride levels in the groups of metabolically active and metabolically healthy obesity were 1.31 vs 0.74 mmol/L, glucose levels, 4.92 vs 4.54 mmol/L, C-reactive protein, 3.15 vs 2.30 mg/mL, systolic and diastolic blood pressure, 118.97 vs 110.23 mmHg and 72.90 vs 68.58 mmHg, respectively; p < 0.001), with the exclusion of the mean level of anti-atherogenic HDL-C, which was lower (1.27 vs 1.49 mmol/L; p < 0.001). Also, in addition to abdominal obesity, 21.43% of school children with metabolically active obesity had ≥ 2 atherogenic factors, as well as some pro-inflammatory abnormalities (C-reactive protein levels were higher in one third of children and adolescents of this group, with a borderline significance level). Sixty percent of children and adolescents with obesity and metabolic abnormalities had abnormal lipid parameters. Pro-atherogenic metabolic abnormalities were found in all children and adolescents with increased C-reactive protein levels. Conclusion: Distinctly different phenotypes of obesity with various degrees of metabolic abnormalities were found in the pediatric population. Formation of combination of atherogenic clinical and metabolic abnormalities (dyslipidemia, impaired glucose tolerance, high blood pressure) is possible already in children and adolescents with metabolically active obesity. They can be associated with chronic inflammation, and as such could be the first stage of development of atherosclerosis, metabolic syndrome and cardiovascular disease.

A RESISTANCE TO LEPTIN IN DEVELOPMENT OF DIFFERENT OBESITY PHENOTYPES

The underlying process of visceral obesity (VO) is frequently the resistance to regulating action of leptin on the patients food related behavior. There is ongoing research on the role of soluble leptin receptors (SLR) in the leptin signal transmittance and leptin resistance development (LR). Aim. To study the relation of leptin metabolism parameters with insulin resistance (IR) in men with various obesity phenotypes. Material and methods. Totally, 110 males included of the age 44-67 y.o., with arterial hypertension, absence of atherosclerosis of any area signs, and diabetes. The participants were selected to two groups according to metabolic obesity phenotype by the value of epicardial fat thickness (EFT) and body mass index. In groups we assessed the levels of insulin, HOMA-IR, serum leptine (SL), SLR and free leptin index (FLI) calculated as SL/SLR, lipid profile including apoproteines A1 and B (ApoA1, ApoB). EFT was measured via echocardiography. Results. It has been shown, that leptin metabolism disorders and LR might lead to metabolically stout phenotype (MSP) and its main complication — IR. The regression equation is formulated that links FLI with HOMA-IR. Conclusion. Leptin metabolism disorder is related to the development of VO and IR. FLI can be used as laboratory marker of LR, as an early marker of IR risk and, possibly, further cardiometabolic complications.

Circulating Unsaturated Fatty Acids Delineate the Metabolic Status of Obese Individuals

BackgroundObesity is not a homogeneous condition across individuals since about 25–40% of obese individuals can maintain healthy status with no apparent signs of metabolic complications. The simple anthropometric measure of body mass index does not always reflect the biological effects of excessive body fat on health, thus additional molecular characterizations of obese phenotypes are needed to assess the risk of developing subsequent metabolic conditions at an individual level. MethodsTo better understand the associations of free fatty acids (FFAs) with metabolic phenotypes of obesity, we applied a targeted metabolomics approach to measure 40 serum FFAs from 452 individuals who participated in four independent studies, using an ultra-performance liquid chromatograph coupled to a Xevo G2 quadruple time-of-flight mass spectrometer. FindingsFFA levels were significantly elevated in overweight/obese subjects with diabetes compared to their healthy counterparts. We identified a group of unsaturated fatty acids (UFAs) that are closely correlated with metabolic status in two groups of obese individuals who underwent weight loss intervention and can predict the recurrence of diabetes at two years after metabolic surgery. Two UFAs, dihomo-gamma-linolenic acid and palmitoleic acid, were also able to predict the future development of metabolic syndrome (MS) in a group of obese subjects. InterpretationThese findings underscore the potential role of UFAs in the MS pathogenesis and also as important markers in predicting the risk of developing diabetes in obese individuals or diabetes remission after a metabolic surgery.