Does Inflammation Determine Metabolic Health Status in Obese and Nonobese Adults?

Abstract

Favorable inflammatory status is positively associated with metabolic health in obese and nonobese individuals. These findings are of public health and clinical significance in terms of screening and stratification based on metabolic health phenotype to identify those at greatest cardiometabolic risk for whom appropriate therapeutic or intervention strategies should be developed.

Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes

“…These pro-inflammatory markers also positively correlated with insulin resistance and the features of the metabolic syndrome, in most cases, independently of the degree of obesity [6,7,[12][13][14].…”

“…This phenotype is referred in the literature as "metabolically healthy obesity" (MHO) and may account for around 30% of the obese population [60]. Interestingly, the MHO phenotype is characterized by a more favourable body fat distribution with lower visceral fat and greater subcutaneous fat [42], by a lower ectopic fat depot in the liver [61], and by a less inflammatory profile with lower levels of circulating inflammatory markers [14,42] compared to unhealthy obese phenotype. We have recently reported that the visceral adipose tissue of MHO phenotype is associated with lower activation of the NLRP3 inflammasome in infiltrating macrophages, and with a more favourable inflammatory and immunological profile compared to that of unhealthy obese phenotype [33] (Figure 3).…”

Metabolic syndrome and the seminal cytokine network in morbidly obese males

“…These data highlight a specific low-grade inflammation in obesity/MetS, with the majority of cytokine levels tested not being increased in blood. However, the reports show some variation related to gender (Saltevo et al, 2008), ethnicity (Morimoto et al, 2014), sample size (Schipper et al, 2010;Phillips & Perry, 2013), clinical heterogeneity of MetS (Phillips & Perry, 2013), and different definitions of MetS (Surendar et al, 2011;Tisato et al, 2013). Specifically, increased waist circumference is mandatory in the IDF definition, while being just one facultative parameter in the NCEP definition (Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001;Alberti et al, 2009).…”

Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity

“…However, in our study the difference in 117 liver triglyceride did not reach statistical significance and we did not measure cardiac 118 triglyceride. Metabolically unhealthy individuals have increased levels of inflammatory 119 markers (interleukins, tumour necrosis factor-alpha and high sensitivity CRP), which can 120 result in cardiac fibrosis and myocardial stiffening 45,46 and increased circulating levels of the 121 liver-secreted glycoprotein fetuin A which further induces subclinical inflammation and 122 perturbs lipid and glucose metabolism 6,47 . Hyperinsulinaemia and/or insulin resistance may 123 also be implicated through abnormal LV energy metabolism 41 ; indeed the cardiovascular 124 benefit derived from bariatric surgery was strongly associated with reduced fasting insulin 125 concentration 48 .…”