Are metabolically normal but obese individuals at lower risk for all-cause mortality?

Kuk, Jennifer L.; Ardern, Chris I.

doi:10.14341/2071-8713-5284

Cited by 69 publications

(118 citation statements)

References 10 publications

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“…Importantly, when patients were categorized as insulin resistant or insulin sensitive according to the HOMA-IR≥2.5 cut-off criteria [5,40], 18.0% of regainers exhibited worsened insulin sensitivity from a state of insulin sensitivity at T0 to insulin resistance at T2, and only 16.4% of regainers improved their insulin sensitivity during the therapy program (Fig. 3B).…”

Section: Resultsmentioning

confidence: 99%

“…Insulin resistance was indirectly determined by the homeostatic model assessment index (HOMA-IR), which was calculated following the formula [fasting plasma glucose (mg/mL) x fasting plasma insulin (μU/mL)/405], as described elsewhere [39]. Furthermore, patients were divided into two categories according to estimated insulin resistance (insulin sensitive: HOMA-IR<2.5; insulin resistant HOMA-IR≥2.5) following previously reported data [5,40].…”

Section: 3biochemical and Hormonal Analysismentioning

confidence: 99%

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Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients

et al. 2014

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Objective. Weight regain is associated with the promotion of insulin resistance. The newly discovered myokine irisin, which was proposed to be involved in the management of insulin sensitivity, could play a role in this process. This study aimed to investigate the association between irisin and reduced insulin sensitivity induced by weight regain.Materials/Methods. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) in 136 obese patients who followed an eight-week hypocaloric diet (30% reduced energy expenditure) to lose weight and were reevaluated four or six months after treatment. Irisin plasma levels, as well as the levels of leptin, adiponectin, ghrelin and TNF-α, were quantified in a sub-cohort (n=73) from the initially studied patients at baseline (T0), at the diet endpoint (T1) and after the follow-up period (T2).Results. After a successful dietary intervention to lose weight, 50% of the patients who regained the lost weight during the follow-up period were categorized as insulin resistant (HOMA-IR≥2.5) compared with only 25% of patients who maintained the weight loss (p=0.018). Importantly, in addition to the well-studied hormones leptin and adiponectin, irisin plasma levels were statistically associated with several risk factors for insulin resistance.Indeed, the increased risk of insulin resistance during the follow-up period was related to high irisin levels at baseline (odds ratio=4.2; p=0.039).Conclusions. Circulating irisin predicts the insulin resistance onset in association with weight regain. Therefore, irisin could be secreted as an adaptive response to counteract the deleterious effect of excess adiposity on glucose homeostasis.

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Section: Resultsmentioning

confidence: 99%

Section: 3biochemical and Hormonal Analysismentioning

confidence: 99%

Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients

et al. 2014

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“…9,10 Other studies observed that the MHO subset had an intermediate cardiovascular risk between healthy non-obese subjects and insulin resistant subjects. 11,12 Furthermore, recent intervention studies showed that lifestyle-induced weight loss among MHO individuals was associated with improved insulin sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

et al. 2011

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OBJECTIVES: Although the existence of metabolically healthy obese (MHO) individuals has been recognized, little is known regarding metabolic health status in these subjects over time. Thus, we evaluated longitudinal changes in metabolic parameters among MHO subjects compared with metabolically healthy, normal-weight (MHNW) subjects. METHODS: A cohort study was performed on 2599 Korean men, 30 --59 years of age, with no evidence of fatty liver disease on ultrasound and no traits of metabolic syndrome at baseline. BMI was categorized based on criteria for Asian population. Study participants were followed annually or biennially between 2002 and 2009. At each visit, the fatty liver on ultrasound was assessed and metabolic abnormalities were measured. Parametric Cox models and a pooled logistic regression models were used to evaluate the relationships of BMI with incident metabolic abnormalities. RESULTS: During 9647.1 person-years of follow-up, 1673 participants developed metabolic abnormalities. After adjusting for age, smoking, alcohol intake and exercise, higher baseline BMI categories predicted increased incidences of metabolic abnormalities in a dose-response manner. The hazard ratios (95% confidence intervals) for hypertriglyceridemia, prediabetes, pre-hypertension, low high-density lipoprotein-cholesterol, fatty liver, elevated high sensitivity-C reactive protein, elevated homeostasis model assessment of insulin resistance, any metabolic abnormality and metabolic syndrome among the MHO subjects compared with the MHNW subjects were 1.51 (1. Keywords: body mass index; risk factors; insulin resistance; metabolic syndrome X; follow-up studies INTRODUCTIONObesity is a risk factor for cardiometabolic disorders such as type 2 diabetes mellitus and cardiovascular disease. 1,2 However, the incidence of obesity-related metabolic disturbances varies widely among obese individuals. 3,4 A unique subset of obese individuals that appears to be protected from obesity-related metabolic abnormalities has been identified. 3,5 These individuals, referred to as metabolically healthy but obese (MHO), are relatively insulin sensitive and have a favorable cardiovascular risk profile despite excessive body fat. 6 Previous studies indicate that MHO individuals, regardless of body mass index, are not at increased risk for cardiovascular diseases compared with normal-weight subjects without insulin resistance. 7,8 Therefore, weight loss may not be deemed necessary among these individuals.Recent longitudinal studies have observed that obese men without metabolic syndrome were at an increased risk for cardiovascular events or death compared with normal-weight individuals without metabolic syndrome. 9,10 Other studies observed that the MHO subset had an intermediate cardiovascular risk between healthy non-obese subjects and insulin resistant subjects. 11,12 Furthermore, recent intervention studies showed that lifestyle-induced weight loss among MHO individuals was associated with improved insulin sensitivity. 13,14

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“…BDP offspring showed high risk for males i.e.14.35%, 37.50% for females, and SDP offspring had 23.1% in males and 30.4% in females, whereas offspring of NDP had a normal WHR(Waist hip ratio) ( Table 1). BMI and WHR were calculated by Asian Pacific cutoffs [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Serum Insulin and Insulin Resistance in the Off-Springs of Type 2 Diabetes Mellitus

Rahim¹,

Rahim²

2014

J Diabetes Metab

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Are metabolically normal but obese individuals at lower risk for all-cause mortality?

Cited by 69 publications

References 10 publications

Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients

Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients

Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

Serum Insulin and Insulin Resistance in the Off-Springs of Type 2 Diabetes Mellitus

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