Metabolic health and weight: Understanding metabolically unhealthy normal weight or metabolically healthy obese patients

Mathew, Hannah; Farr, Olivia M.; Mantzoros, Christos S.

doi:10.1016/j.metabol.2015.10.019

Cited by 136 publications

(122 citation statements)

References 91 publications

(96 reference statements)

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“…Surprisingly, MHO individuals frequently represent a high fitness level, which is associated with less visceral and intrahepatic fat content [6]. This may explain the fact that the lifestyle and diet change have no effect on BMI modifications in these subjects [32,37]. Other studies suggest that the occurrence of the MHO phenotype is not related to physical activity, alcohol consumption, or diet.…”

Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 98%

“…Some researchers evaluate that 23.5% of normal-weight adults represent the metabolically obese normal-weight subgroup, when metabolic syndrome criteria are used. However other data suggest that this phenotype prevalence is 3-28%, depending on the used definition of metabolic risk [26,32,33]. Regarding race, there have been distinctions in prevalence of MONW phenotype -some studies have shown that Asians are more likely to be MONW than typically obese.…”

Section: Metabolically Obese Normal-weight (Monw)mentioning

confidence: 99%

“…Regarding race, there have been distinctions in prevalence of MONW phenotype -some studies have shown that Asians are more likely to be MONW than typically obese. According to Mathew et al, Chinese people have a higher risk of intra-abdominal obesity and ectopic accumulation of fat, even if they tend to be lean [32].…”

Section: Metabolically Obese Normal-weight (Monw)mentioning

confidence: 99%

“…Moreover, Samocha-Bonet et al suggest that 30% of MHO people may be transitioned to the metabolically unhealthy obese group, while others propose as many as 50% [8]. Thus, longitudinal studies seem to be crucial to evaluate the possibility of developing metabolic complications typical of obesity [32]. Surprisingly, MHO individuals frequently represent a high fitness level, which is associated with less visceral and intrahepatic fat content [6].…”

Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 99%

“…Other studies suggest that the occurrence of the MHO phenotype is not related to physical activity, alcohol consumption, or diet. However, some researches point out smoking and lower education levels as potential risk factors [32,38].…”

Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 99%

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Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese

Cembrowska

Stefańska

Odrowąż-Sypniewska

2017

Medical Research Journal

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According to recent studies, adipose tissue secretes a large number of bioactive proteins, which affect the whole body metabolism. The amount of adipose tissue is the main factor that explains metabolic disorders; however, obesity is not necessarily the result of increased body weight. Interestingly, there is a subgroup of patients with normal weight and high-risk metabolic profile. Consequently, they are significantly more likely to have metabolic disorders or cardiovascular disease (CVD). Conversely, some individuals, called metabolically healthy obese (MHO), demonstrate a favourable metabolic profile despite having high BMI index and excessive adipose tissue.The aim of this paper is to review recent studies about obesity phenotypes. Better understanding of differences between metabolically obese normal-weight (MONW) and MHO may improve the therapy and treatment of metabolic health in all obese patients. Equally importantly, it may lead to an increase in early detection of individuals with metabolic disorders, regardless of their body mass value or BMI.

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Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 98%

Section: Metabolically Obese Normal-weight (Monw)mentioning

confidence: 99%

Section: Metabolically Obese Normal-weight (Monw)mentioning

confidence: 99%

Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 99%

Section: Metabolically Healthy Obese (Mho)mentioning

confidence: 99%

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Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese

Cembrowska

Stefańska

Odrowąż-Sypniewska

2017

Medical Research Journal

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Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight

Agius,

Pace,

Fava

2023

Diabetes Metabolism Res

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Over the past 4 decades, research has shown that having a normal body weight does not automatically imply preserved metabolic health and a considerable number of lean individuals harbour metabolic abnormalities typically associated with obesity. Conversely, excess adiposity does not always equate with an abnormal metabolic profile. In fact, evidence exists for the presence of a metabolically unhealthy normal weight (MUHNW) and a metabolically healthy obese (MHO) phenotype. It has become increasingly recognised that different fat depots exert different effects on the metabolic profile of each individual by virtue of their location, structure and function, giving rise to these different body composition phenotypes. Furthermore, other factors have been implicated in the aetiopathogenesis of the body composition phenotypes, including genetics, ethnicity, age and lifestyle/behavioural factors. Even though to date both MHO and MUHNW have been widely investigated and documented in the literature, studies report different outcomes on long‐term cardiometabolic morbidity and mortality. Future large‐scale, observational and population‐based studies are required for better profiling of these phenotypes as well as to further elucidate the pathophysiological role of the adipocyte in the onset of metabolic disorders to allow for better risk stratification and a personalised treatment paradigm.

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Abnormal Metabolic Phenotypes Among Urban Chinese Children: Epidemiology and the Impact of DXA‐Measured Body Composition

Chen

Liu

Yan

et al. 2019

Obesity

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Objective This study aimed to describe the prevalence rates of abnormal metabolic phenotypes among urban Chinese children and to explore the impact of body composition as measured by dual‐energy x‐ray absorptiometry (DXA) on metabolic disorders. Methods A total of 7,926 children aged 6 to 17 years from seven cities across China were involved. Metabolically unhealthy was defined as having ≥ 2 risk factors (elevated blood pressure, high triglyceride levels, low levels of high‐density lipoprotein cholesterol, and impaired fasting glucose [IFG]). Abnormal metabolic phenotypes were defined as metabolically unhealthy with normal weight (MUNW) and metabolically healthy with overweight or obesity (MHO). Results Overall prevalence rates of MUNW and MHO were 10.6% and 15.3%, respectively. The prevalence of MUNW increased with age in boys, whereas the prevalence in girls was statistically higher in 11‐ to 15‐year‐olds than in other age groups. The prevalence of MHO decreased with age in both genders. Among children with normal weight, the levels of body composition indices were positively correlated with metabolically unhealthy phenotype. Fat‐free mass had a protective effect on IFG in children with normal weight. Among children with overweight or obesity, body composition was related to elevated blood pressure and dyslipidemia but not to IFG. Conclusions The prevalence rates of abnormal metabolic phenotypes differed between genders and ages. Body composition could partly explain the different metabolic phenotypes at the same BMI status among children.

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Metabolic health and weight: Understanding metabolically unhealthy normal weight or metabolically healthy obese patients

Cited by 136 publications

References 91 publications

Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese

Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese

Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight

Abnormal Metabolic Phenotypes Among Urban Chinese Children: Epidemiology and the Impact of DXA‐Measured Body Composition

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