Metabolically Healthy But Obese Research Articles

Differences in the levels of inflammatory markers between metabolically healthy obese and other obesity phenotypes in adults: A systematic review and meta-analysis

AimsThe aim of this study was to systematically review and analyze differences in the levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) comparing metabolically healthy but obese (MHO) with metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO) subjects. Data synthesisWe searched PubMed, Embase, Web of Science, and Scopus for studies that matched the relevant search terms. Differences in inflammatory marker levels between MHO and the other three phenotypes were pooled as standardized mean differences (SMD) or differences of medians (DM) using a random-effects model. We included 91 studies reporting data on 435,007 individuals. The CRP levels were higher in MHO than in MHNO subjects (SMD = 0.63, 95% CI: 0.49, 0.76; DM = 0.83 mg/L, 95% CI: 0.56, 1.11). The CRP levels were higher in MHO than in MUNO subjects (SMD = 0.16, 95% CI: 0.05, 0.28; DM = 0.39 mg/L, 95% CI: 0.09, 0.69). The CRP levels were lower in MHO than in MUO individuals (SMD = −0.43, 95% CI: −0.54, −0.31; DM = −0.82 mg/L, 95% CI: −1.16, −0.48). The IL-6 levels in MHO were higher than in MHNO while lower than in MUO subjects. The TNF-α levels in MHO were higher than in MHNO individuals. ConclusionsThis review provides evidence that CRP levels in MHO are higher than in MHNO and MUNO subjects but lower than in MUO individuals. Additionally, IL-6 levels in MHO are higher than in MHNO but lower than in MUO subjects, and TNF-α levels in MHO are higher than in MHNO individuals. Systematic review registrationPROSPERO number: CRD42021234948.

Differences in the Impact of Obesity and Metabolic Unhealthiness on the Risk of Gallbladder Polyp.

Differences in the impact of obesity and metabolic health status on the risk of gallbladder polyp (GBP) remain uncertain. Herein, we aimed to compare the risk of GBP ≥5 mm among individuals with different phenotypes based on obesity and metabolic health status. A cohort of 253485 asymptomatic adults who underwent abdominal ultrasonography screening were categorized into the following four groups according to obesity and metabolic health status: 1) metabolically healthy non-obese (MHNO), 2) metabolically unhealthy and non-obese (MUNO), 3) metabolically healthy but obese (MHO), and 4) metabolically unhealthy obese (MUO). The prevalences of GBP ≥5 mm were 2.4%, 3.1%, 3.7%, and 4.0% in the MHNO, MUNO, MHO, and MUO groups, respectively. The multivariable-adjusted odds ratio (OR) values for prevalence of GBP ≥5 mm by comparing the MUNO, MHO, and MUO with the MHNO group were 1.11 [95% confidence interval (CI), 1.04-1.19], 1.30 (95% CI, 1.15-1.47), and 1.37 (95% CI, 1.28-1.45), respectively. The risk of GBP ≥5 mm in the MHO group was significantly higher than that in the MUNO group, but not significantly different from that in the MUO group. Obesity and metabolic unhealthiness appear to be independent risk factors for the prevalence of GBP, and the impact of obesity is greater than that of metabolic unhealthiness, suggesting that maintaining both normal weight and metabolic health may help reduce the risk of GBP.

Metabolically obese phenotype and its dynamic change are associated with increased carotid intima-media thickness: Results from a cohort study

Background and aimsTo examine associations between metabolically obese phenotypes or their changes and increased carotid intima-media thickness (CIMT). Methods and resultsThis prospective cohort included 13,681 Chinese adults aged 20–80 years who completed follow-up health examination with carotid ultrasound and were divided according to metabolic and weight status: metabolically healthy and normal weight (MHNW); metabolically obese but normal weight (MONW); metabolically healthy but obese (MHO); metabolically abnormal and obese (MAO). Cox and logistic regression were used to evaluate the associations of the phenotypes or their changes with increased CIMT.During a mean follow-up of 33 months, 1927 participants developed increased CIMT. After adjusting for age, sex and potential biochemical confounders, MAO was significantly associated with increased CIMT (HR 1.22, 95% CI [1.07, 1.4]); the association remained significant in those 40 years or older. Compared with stable MHNW, increased CIMT risk was higher for stable MAO (OR 1.35 [1.16, 1.57]), transitional MAO from MONW (OR 1.44 [1.04, 1.97]), and transitional MHO from MHNW (OR 1.59 [1.10, 2.26]) in demographic adjusted models; only stable MAO remained significant in the multivariate adjusted model (OR 1.23 [1.05, 1.45]). ConclusionMAO significantly elevated the risk of increased CIMT. Stable MAO and obese transitions also promoted CIMT progression.

Metabolically Healthy, but Obese Individuals and Associations with Echocardiographic Parameters and Inflammatory Biomarkers: Results from the CARLA Study.

IntroductionThe research on heterogeneity among obese individuals has identified the metabolically healthy, but obese (MHO) phenotype as a distinct group that does not experience the typical cardiovascular-related diseases (CVD). It is unclear if this group differs with regard to preconditions for CVDs. Our aim was to assess differences in echocardiographic parameters and inflammatory biomarkers between MHO and metabolically healthy, normal weight individuals (MHNW).MethodsThe analyses used data from 1412 elderly participants from a German population-based cohort study (CARLA), which collected detailed information on demographic, biochemical, and echocardiographic variables. Participants were subdivided into four groups (MHNW, MHO, MUNW (metabolically unhealthy, normal weight) and MUO (metabolically unhealthy, obese)) based on BMI≥30 kg/m2 (obese or normal weight) and presence of components of the metabolic syndrome. The clinical characteristics of the 4 groups were compared with ANOVA or Chi-Square test, in addition to two linear regression models for 16 echocardiographic parameters. The difference in inflammatory biomarkers (hsCRP, IL-6 and sTNF-RI) between the groups was examined with a multinomial logistic regression model.ResultsThe MHO individuals were on average 64.2±8.4 years old, with a higher proportion of women (71.6%), low percentage of smokers, larger waist circumference (109.3±10.5 cm vs 89.1±10.8 cm, p<0.0001) and higher odds ratios for hsCRP, IL-6 and sTNF-RI compared to MHNW individuals. Linear regression models revealed greater left atrial (LA) diameter (2.73 (95% CI: 1.35–4.11) mm), LA volume (7.86 (95% CI: 2.88–12.83) mL), and left ventricular mass index (LVMI) (11.82 (95% CI: 4.43–19.22) g/m1.7) in the MHO group compared to the MHNW group.ConclusionThe MHO phenotype is associated with echocardiographic markers of cardiac remodeling (LA diameter, volume and LVMI) and higher odds ratios for inflammatory biomarkers.

Interactive effect of obesity and metabolic profile on renal risk in hypertensive patients

Obesity and metabolic disorders are known risk factors for impaired renal function. The objective of this study is to determine the nature of the interactive effect between obesity and metabolic profile on the increase in urinary albumin excretion and the decrease in estimated glomerular filtration rate (eGFR) in hypertensive patients. This is a prospective cross-sectional study, which involved a population of 499 hypertensive subjects. Based on BMI values and metabolic profile, subjects were classified into four metabolic phenotype groups: group I: metabolically healthy non-obese (MHNO), group II: metabolically healthy but obese (MHO), Group III: metabolically unhealthy non-obese (MUHNO) and group IV: metabolically unhealthy obese (MUHO). The effect of the biological interaction between obesity and metabolic profile on impaired renal function was tested on both scales: multiplicative and additive. A significant difference in renal function was noted between the four groups. After adjustment for confounding factors, patients who are both obese and at metabolic risk (MUHO) have the highest risk of microalbuminuria and decreased eGFR (OR = 6; 95 CI%[2.7–13], OR = 5.4; 95 CI%[1.1–26] respectively). Analysis of the additive biological interaction shows that 51% and 53% of the risk of elevated ACR and high ACR-low DFGe association respectively is explained by the obesity-metabolic disorder association. The interaction mechanism is synergistic (SI = 2.6; 95 CI%[1.2–5.3]). The decline in renal function in hypertensive subjects is significantly associated with the interaction of obesity and metabolic disorders. The management of these at-risk subjects must include, in addition to the therapeutic regimen, a dietary and physical program to preserve glomerular function.

Strong association between metabolically-abnormal obesity and gallstone disease in adults under 50\u2009years

BackgroundAge, obesity, and metabolic syndrome are known risk factors for gallstones; however, the combined impact of these different risk factors on gallstone formation has not yet been examined.MethodsThis retrospective, cross-sectional study involved 3190 participants, including 207 participants (6.5%) with gallstones and 986 (30.9%) with metabolic syndrome. Participants were divided into four phenotypes according to metabolic syndrome and obesity status: 1378 participants were metabolically healthy and non-obese (MHNO); 826 were metabolically healthy but obese (MHO); 185 were metabolically abnormal but not obese (MANO); and 801 participants were metabolically abnormal and obese (MAO).ResultsThe MAO and MANO phenotypes had more gallstones than the MHO and MHNO phenotypes, regardless of age (< 50 or ≥ 50 years old). Multivariate analyses showed that phenotype was an independent risk factor for gallstones in participants < 50 years old (odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.32–2.28). Younger participants also had a higher risk of gallstones in the MAO (OR = 5.41, 95% CI = 2.31–12.66), MANO (OR = 3.18, 95% CI = 0.86–11.75), and MHO (OR = 2.17, 95% CI = 0.90–5.22) phenotypes than the MHNO phenotype.ConclusionsOur retrospective results demonstrate an increased association of gallstones in younger people (< 50 years old) with metabolic syndrome and obesity.

Prevalence of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) in Chinese Beijing urban subjects.

The aim of this study was to assess the prevalence of metabolic syndrome (MetS) in non-obese adults (body mass index (BMI) < 25 kg/m2) and the prevalence of obese adults (body mass index (BMI) ≥ 25 kg/m2) without MetS in Chinese Beijing urban subjects. A cross-sectional study was conducted and the subjects who came to the hospital to receive a health examination were enrolled randomly. Regardless of age stratification, men have a higher prevalence of MetS than women. Among the urban Beijing population, prevalence of metabolically obese but normal weight (MONW) is lower than metabolically healthy but obese (MHO) regardless of gender. Except for the underweight group, participants exhibit significant differences between MetS and non-MetS subgroups in all tested variables in normal weight and overweight groups, whereas MONW and MHO participants exhibit significant differences in all variables except for creatinine (CR), aspartate aminotransferase (AST), uric acid (UAC) and high-density lipoprotein cholesterol (HDL-C). Women tend to have a higher MONW prevalence but lower MHO prevalence than men. Accordingly, MetS happens more frequently among those 40-59 yr. Besides, sex, age, WC, SBP, DBP, ALT, FG, UAC, TG, HDL-C and LDL-C are risk factors for MetS after multivariate adjustment. In conclusion, the prevalence of MONW is lower than MHO regardless of gender. Women tend to have a higher MONW prevalence but lower MHO prevalence than men.

Peripheral invariant natural killer T cell deficiency in metabolically unhealthy but normal weight versus metabolically healthy but obese individuals.

ObjectiveTo investigate the proportion of circulating invariant natural killer T (iNKT) cells in four body health types.MethodsIn this cross-sectional study, participants were classified into four body health types according to the body mass index and metabolic status: metabolically healthy and normal weight (MHNW), metabolically unhealthy but normal weight (MUNW), metabolically healthy but obese (MHO), or metabolically unhealthy and obese (MUO). Demographic and clinical characteristics were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) and visceral adiposity index (VAI) were calculated. The proportion of circulating iNKT cells was also evaluated by flow cytometry.ResultsThe study enrolled 41 MHNW, 37 MUNW, 30 MHO, and 43 MUO participants. Compared with the MHNW group, the MUNW, MHO, and MUO groups had significantly lower iNKT cell proportions. The iNKT cell proportion was significantly higher in the MHO group than the MUNW and MUO groups. The iNKT cell proportion was inversely correlated with high-sensitivity C-reactive protein, HOMA-IR, and VAI values.ConclusionThe proportion of iNKT cells was lower in people (lean or obese) with excessive visceral fat accumulation, suggesting that iNKT cell deficiency may be involved in the pathophysiology of obesity-related metabolic disorders.

Characterization of the metabolically healthy phenotype in overweight and obese British men

We calculated the prevalence of the metabolically healthy but obese (MHO) phenotype in (n=9177) British men (age 48.9±7.4years) attending preventive health screening between 2000 and 2009. We examined differences in cardiorespiratory fitness (Fitness) and self-reported physical activity levels, according to whether the men were metabolically healthy (<2 components of the metabolic syndrome), and by BMI category (normal-weight, overweight, obese). Fitness was estimated from treadmill exercise as VO2peak and classified as: Low, Moderate, or High using age-specific cut-offs. We identified 21.6% of our sample as obese, of whom 83.1% were metabolically healthy. Compared with the metabolic unhealthy obese (MUO; 3.7% of sample), MHO phenotypes were fitter (effect size d=0.21) and were more physically active (d=0.31). Logistic regression showed high fitness (OR=2.40, 95% CI 1.38–4.19), and being physically active (OR=1.71, 95% CI 1.14–2.56) to be independently associated with the MHO phenotype. Our findings agree with US data suggesting that higher cardiorespiratory fitness is a characteristic of the MHO phenotype. Our finding that meeting physical activity guidelines was associated with the MHO phenotype independent of fitness is, however, novel. If confirmed, our findings indicate that public health messages that encourage active lifestyles to promote fitness should be encouraged regardless of weight status.

Clinical implication of body size phenotype on heart rate variability

We compared heart rate variability (HRV) values according to the following body size phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy but normal weight (MUNW), metabolically healthy but obese (MHO), and metabolically unhealthy obese (MUO). We retrospectively analyzed a dataset from 1200 participants who had visited the Cardiovascular Center at Korea University Guro Hospital between March 2009 and February 2014 and underwent Holter monitoring for 24h. HRV was calculated from standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), and root mean square of successive differences (rMSSD) measurements, and study subjects were classified according to body mass index (BMI) and presence or absence of metabolic syndrome. Various HRV indices, including SDNN, SDANN, and rMSSD, were significantly lower in MUNW subjects than in MHNW or MHO subjects, while there were no significant differences between MUNW and MUO subjects. Although BMI had no significant correlation with any HRV indices, SDNN, SDANN, and rMSSD values had significant negative correlations with waist circumference and levels of C-reactive proteins, AST, ALT, fasting glucose, and HOMA-IR. A significant positive correlation was observed between HRV index and HDL level. Furthermore, the SDNN value significantly decreased with an increase in the number of metabolic syndrome components after adjusting for other covariates. Compared to MHNW or MHO subjects, Korean men and women with the MUNW phenotype exhibited decreased HRV, suggesting that low HRV is related to adverse cardiovascular outcomes in MUNW individuals.

Obese But Fit: The Relationship of Fitness to Metabolically Healthy But Obese Status among Sexual Minority Women

PurposeThe purpose of this study was to describe fitness characteristics of metabolically healthy sexual minority women who are obese. MethodsAs part of the Healthy Weight in Lesbian and Bisexual Women Initiative funded by the U.S. Office on Women's Health, one site enrolled self-identified lesbian or bisexual women age 40 and older in a randomized controlled trial that evaluated interventions to improve health. Women with waist-to-height ratio of 0.5 or greater were classified as obese. Women without diabetes or cardiovascular disease and with normal range fasting blood level measurements of glucose, triglycerides, high-density cholesterol, and blood pressure were classified as metabolically healthy but obese (MHO). Otherwise, women were classified as metabolically unhealthy obese (MUHO). Fitness measurements included predicted VO2 maximum, 1-minute heart rate recovery, and strength (single maximal leg lift and chest press). Self-reported demographic and physical activity level data were obtained by standardized questionnaires. ResultsOf the 53 participants who completed the eligibility screener in Columbia, Missouri, 47 were enrolled in the study (89% participation proportion) with 45 categorized as obese. Approximately one-third (38%) were MHO. The majority of MHO and MUHO participants ranked poor or very poor on a composite fitness score that included measures of strength, flexibility, and aerobic fitness (75.0% and 77.8%, respectively). In the logistic regression models, better 1-minute heart rate recovery after peak exercise performance was significantly associated with MHO individuals (odds ratio, 2.92; 95% CI, 1.13–9.10) compared with MUHO. No other fitness measure was significantly different between the two groups. ConclusionConsistent with other studies, we identified more than one-third of our obese sexual minority women as MHO. Fitness measures may be potential predictors of MHO status because one measure, heart rate recovery, was significantly associated with MHO status. With the population prevalence of obesity high and even higher among lesbian or bisexual women, sexual minority women are an ideal population for a longitudinal study to better understand MHO characteristics.

Metabolically Obese Individuals of Normal Weight Have a High Risk of 25-Hydroxyvitamin D Deficiency

BackgroundVitamin D status is related to obesity-related metabolic disorders. We investigated the risk of 25-hydroxyvitamin D [25(OH)D] deficiency among different metabolic phenotypes. MethodsThis prospective cross-sectional study evaluated 1,292 individuals who were ≥40 years old. Participants were classified as metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese (MHO) or metabolically unhealthy and obese (MUO). The demographic and clinical characteristics, as well as plasma 25(OH)D levels, were compared between the 4 groups. ResultsThe prevalences of MHNW, MONW, MHO and MUO were 32.1%, 19.3%, 17.9% and 30.7%, respectively. Approximately 58.5% participants had vitamin D deficiency, and vitamin D deficiency was more common in the MONW (68.7%) and MUO (73.6%) groups (MHNW, 42.7 and MHO, 50.2%). The MONW and MUO groups had lower 25(OH)D levels (versus the MHNW and the MHO groups). Among vitamin D-deficient participants, the MONW group exhibited increased risks of abdominal obesity (odds ratio [OR]: 3.28, P = 0.005), hypertension (OR: 3.08, P = 0.003) and elevated C-reactive protein (OR: 1.97, P = 0.03). In addition, the MUO group exhibited increased risks of hypertriglyceridemia (OR: 2.57, P = 0.001), insulin resistance (OR: 2.37, P = 0.001) and elevated C-reactive protein level (OR: 2.09, P = 0.003). ConclusionsIndividuals who were MONW and MUO had increased risks of vitamin D deficiency (versus MHNW and MHO), and individuals with vitamin D deficiency had worse metabolic status. Vitamin D supplementation may improve the metabolic status of individuals who are MONW or MUO.

Obesity and Cardiovascular Disease.

The prevalence of obesity has increased worldwide over the past few decades. In 2013, the prevalence of obesity exceeded the 50% of the adult population in some countries from Oceania, North Africa, and Middle East. Lower but still alarmingly high prevalence was observed in North America (≈30%) and in Western Europe (≈20%). These figures are of serious concern because of the strong link between obesity and disease. In the present review, we summarize the current evidence on the relationship of obesity with cardiovascular disease (CVD), discussing how both the degree and the duration of obesity affect CVD. Although in the general population, obesity and, especially, severe obesity are consistently and strongly related with higher risk of CVD incidence and mortality, the one-size-fits-all approach should not be used with obesity. There are relevant factors largely affecting the CVD prognosis of obese individuals. In this context, we thoroughly discuss important concepts such as the fat-but-fit paradigm, the metabolically healthy but obese (MHO) phenotype and the obesity paradox in patients with CVD. About the MHO phenotype and its CVD prognosis, available data have provided mixed findings, what could be partially because of the adjustment or not for key confounders such as cardiorespiratory fitness, and to the lack of consensus on the MHO definition. In the present review, we propose a scientifically based harmonized definition of MHO, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis.

Are metabolically healthy obese patients also hemorheologically healthy?

We examined whether "metabolically healthy obesity" (MHO) is associated or not with hemorheologic alterations. We studied 110 subjects: 32 normal weight; 40 overweight; 38 obese. Overweight and obese subjects were divided into two subgroups according to the occurrence or not of a metabolic syndrome (METS). Subjects were thus categorized as follows: (1) metabolically healthy and normal weight (MHNW); (2) metabolically healthy but overweight (MHOW); (3) metabolically abnormally overweight (MAOW); (4) metabolically healthy but obese (MHOB); and (5) metabolically abnormally obese (MAOB). Across those various subgroups whole blood viscosity and plasma viscosity were not statistically different, although there was a tendency to higher values in the subgroups with METS compared to those without METS. RBC aggregation "M" was higher in all obese than MHNW (7.25 ± 0.64 vs 4.31 ± 0.44 p < 0.001 and was also higher in MHOB than MHNW (8.22 ± 1.07 vs 4.31 ± 0.44 vs 8.22 ± 1.07 p < 0.02). It was higher in all obese subjects than in all overweight subjects (7.25 ± 0.64 vs 5.22 ± 0.40 p < 0.01) but the difference between overweight and MHNW was not significant. M was negatively correlated with insulin sensitivity (r =-0.457 p = 0.0008). On the whole increased RBC aggregability "M" seems to be more related to fatness by its own than to the occurrence of metabolic abnormalities. MHO is not associated with alterations of blood viscosity at high shear rate, but exhibits a slight increase in RBC aggregability. These data are consistent with the assumption that MHO is on the whole a "hemorheologically healthy" situation, but that RBC aggregability is proportional to fatness even in "healthy" conditions, as already observed in samples of normal weight athletes.

Association between thyroid hormones, thyroid antibodies and insulin resistance in euthyroid individuals: A population-based cohort

AimThe association between insulin resistance and thyroid function in euthyroid subjects has not yet been clarified. This study aimed to investigate the association between thyroid function within the normal reference range and insulin resistance in participants of the Tehran Thyroid Study (TTS). MethodsThis cross-sectional study was conducted within the framework of the TTS. Of 5786subjects aged≥20 years, 2758euthyroid subjects free of thyroid disorders, diabetes, chronic kidney disease and cardiovascular disease, and not taking steroids and lipid-lowering agents, were included. Serum concentrations of free thyroxine (FT4) and TSH were measured. The homoeostasis model assessment index for insulin resistance (HOMA-IR) was used to evaluate IR. ResultsOn linear regression analysis, a negative association was found between serum FT4 levels and HOMA-IR in the model with age, smoking and physical activity (B=−0.09, P<0.001) and in the WC-adjusted model with age, smoking and physical activity for men (B=−0.06, P<0.01). In addition, there was a positive association between serum TSH levels and HOMA-IR in both models [with age, smoking and physical activity (B=0.07, P=0.006), and age, smoking, physical activity and adjusted for WC (B=0.05, P=0.01)] that was not more significant on logistic regression analysis. In women, neither serum FT4 nor TSH levels were associated with HOMA-IR; the prevalence of IR decreased from 27.2 to 19.1 with increasing tertiles of FT4 only in men (P=0.01). No significant differences were observed in HOMA-IR and its components between thyroid peroxidase antibody (TPOAb)-negative and -positive groups. Also, it was found that metabolically healthy but obese (MHO) subjects had higher levels of TSH than individuals who were MONW (metabolically obese but normal weight; P<0.01). ConclusionLow FT4 was independently associated with IR in healthy euthyroid Iranian men.

Role of Fitness in the Metabolically Healthy but Obese Phenotype: A Review and Update

Despite the strong and consistent evidence supporting that a high physical fitness (PF) level at any age is a major predictor of a healthier metabolic profile, major studies focused on the metabolically healthy but obese (MHO) phenotype have ignored the role of PF when examining this phenotype and its prognosis. Particularly, the role of its main health-related components such as higher cardiorespiratory fitness (CRF) and muscular fitness in the MHO phenotype needs to be reviewed in depth. The present review aimed to: 1) contribute to the characterization of the MHO phenotype by examining whether MHO individuals are fitter than metabolically abnormal obese (MAO) individuals in terms of CRF and other PF components; 2) review the role of CRF and other PF components in the prognosis of MHO. The studies reviewed suggest that a higher CRF level should be considered a characteristic of the MHO phenotype. Likewise, CRF seems to play a key role in the prognosis of the MHO individuals, yet this statement is based on a single study and future studies need to confirm or contrast these findings. Comparability of studies is difficult due to the different definitions used for MHO; consequently, the present review makes a proposal for harmonizing this definition in adults and in youth. Obesity is still related to an important number of comorbidities; therefore, the public health message remains to fight against both obesity and low CRF in both adult and pediatric populations.

Association between body size phenotype and sleep duration: Korean National Health and Nutrition Examination Survey V (KNHANES V)

ObjectiveRecent studies reported the presence of unique subsets of body size phenotypes that are more susceptible or more resistant to the development of obesity-associated metabolic disorders, although the underlying mechanism is not yet fully elucidated. We investigated the association between body size phenotypes and sleep duration after adjusting potential confounding factors. Materials and methodsWe analyzed data from the Korean National Health and Nutrition Examination Survey V (KNHANES V), a nation-wide, population-based health survey including 9077 Korean adults. The average amount of sleep per night was categorized as: ≤6, 7, 8, and ≥9h. Body size phenotypes were classified based on body mass index (BMI) and presence of metabolic syndrome; metabolically healthy and normal weight (MHNW), metabolically abnormal but normal weight (MANW), metabolically healthy but obese (MHO), and metabolically abnormal obese (MAO). ResultsAccording to sleep duration, there were significant differences in age, gender, BMI, waist circumference, and blood pressure (all P <0.05). Multivariate analysis showed that obese groups (MHO and MAO) had significantly shorter sleep durations than non-obese groups (MHNW and MANW) (6.78±0.04 vs. 6.93±0.03, P <0.001). Sleep duration was significantly different according to body size phenotype, irrespective of confounding factors, such as age, gender, smoking status, alcohol consumption, physical activity, income, and education (MHO; 6.73±0.05, MAO; 6.82±0.05, MHNW; 6.94±0.04, and MANW; 6.91±0.05; P <0.001). ConclusionSleep duration is independently associated with body size phenotype after adjusting for confounding factors in the Korean population.

Risk of maternal condition among obese and non-obese women

Obesity is a growing global health problem. In India, more than half of the adult women are overweight and almost 30% are obese. The problems which are associated with obesity are Type 2 diabetes, coronary heart disease, high LDL (bad) cholesterol, stroke, hypertension, nonalcoholic fatty liver disease, gallbladder disease, osteoarthritis ( degeneration of cartilage and bone of joints), sleep apnea and other breathing problem, some forms of cancer (breast, colorectal, endometrial and kidney). Obesity represents a major risk factor in pregnant and lactating women and has documented maternal effects on both pregnancy and the fetus. Alarmingly 35% of the women died from maternal death had a BMI >30. According to the results and discussion of the study following broad conclusion was drawn according to anthropometrics measurement. The majority of maternal women belonging to this phase showed the maternal obesity in obese and non-obese women in the study by using previous WHO criteria and proposed Asian criteria. The anthropometric measurement obese and non-obese problem in Lucknow city was assessed on body mass index, the objective of the study was to know nature and extent of maternal condition during the study, to determine obese and non-obese women according to anthropometry measurement. To assess metabolic aberrations in women through biochemical parameters and investigation of the risk of maternal obesity condition women. The study was carried out in urban area of Lucknow city using retrospective study (case-control study) after applying screening technique to drawn the sample size (n=120). For this study, 120 women belonging to reproductive age group (15 to 49 years) in four mohalla of Lucknow city by adopting multistage random sampling procedure. The tools in the study were pre- designed and pre-tested schedule comprising of family and individual schedule, body mass index (BMI), waist circumference/ hip circumference. Metabolic syndrome (MS) 10.00 per cent, metabolically healthy but obese (MHO) 41.67 per cent, metabolically obese normal weight (MONW) 48.33 per cent women and results are given 120 women according to her age (55.81%) women were metabolically normal weight (BMI>18.5) according to (BMI>30).

A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype.

BackgroundLower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness.Methods and resultsMetabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (P<0.05) transitioned to metabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; P<0.05) and 7.5 (95% confidence interval: 1.5–37.5; P<0.05) times more likely to transition from MAO to MHO, respectively.ConclusionCommunity-based exercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease.

Prevalence and characteristics of individuals without diabetes and hypertension who underwent bariatric surgery: lessons learned about metabolically healthy obese

BackgroundRecent studies describe a unique subset of obese individuals with normal metabolic profiles despite having excess weight called “metabolically healthy but obese (MHO)”. Our aim was to determine the prevalence of individuals without diabetes and hypertension and risk factors associated with the MHO phenotype among bariatric surgery patients. MethodsWe conducted a retrospective study of 710 adults who underwent bariatric surgery at Johns Hopkins between 2008 and 2010. In the first analysis of 523 individuals, we identified 150 individuals without diabetes and hypertension; in the second analysis of 260 individuals, we identified 44 individuals without diabetes, hypertension and hypertriglyceridemia. We used multivariable logistic regression to examine the association between each group and potential risk factors including age, sex, race, body mass index, and presence of liver disease on liver biopsy. ResultsThe prevalence of individuals without diabetes and hypertension was 28.7%; among these individuals 88.7% had liver steatosis, 7.3% nonalcoholic steatohepatitis (NASH), and 19.3% liver fibrosis. These individuals were significantly more likely to be white OR = 1.9 (95% CI: 1.1–3.1), younger OR = 4.1 (95% CI = 2.6–6.3), and female OR = 2.1, (95% CI = 1.2–3.6) and less likely to have liver steatosis OR = 0.4 (95% CI = 0.2–0.9) or NASH OR = 0.3 (95% CI = 0.2–0.6). ConclusionAmong bariatric surgery patients, almost a third of patients do not have diabetes and hypertension and could be probably considered “MHO” and were more likely to be white, young, female, and have less liver injury. The high prevalence of liver steatosis in MHO individuals among bariatric surgery patients challenges the notion of MHO as a truly metabolically healthy entity.