Morbidly “Healthy” Obese Are Not Metabolically Healthy but Less Metabolically Imbalanced Than Those with Type 2 Diabetes or Dyslipidemia

Ferrer, Roser; Pardina, Eva; Rossell, Joana; Oller, Laura; Viñas, Anna; Baena‐Fustegueras, Juan Antonio; Lecube, Albert; Vargas, Vı́ctor; Caubet, Enric; González, O.; Vilallonga, Ramón; Fort, José Manuel; Peinado-Onsurbe, Júlia

doi:10.1007/s11695-014-1528-z

Cited by 15 publications

(12 citation statements)

References 36 publications

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“…In fact, marked deficiencies in several haematological parameters have been observed in “theoretically healthy obese” individuals [16] . Additionally, patients with dyslipidaemia and type 2 diabetes exhibit decreases in adipose tissue lipase expression and activity, which are not observed in “healthy” MO or normal-weight patients [17] .…”

Section: Introductionmentioning

confidence: 94%

Diabetic and dyslipidaemic morbidly obese exhibit more liver alterations compared with healthy morbidly obese

et al. 2016

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Background & aimsTo study the origin of fat excess in the livers of morbidly obese (MO) individuals, we analysed lipids and lipases in both plasma and liver and genes involved in lipid transport, or related with, in that organ.MethodsThirty-two MO patients were grouped according to the absence (healthy: DM − DL −) or presence of comorbidities (dyslipidemic: DM − DL +; or dyslipidemic with type 2 diabetes: DM + DL +) before and one year after gastric bypass.ResultsThe livers of healthy, DL and DM patients contained more lipids (9.8, 9.5 and 13.7 times, respectively) than those of control subjects. The genes implicated in liver lipid uptake, including HL, LPL, VLDLr, and FAT/CD36, showed increased expression compared with the controls. The expression of genes involved in lipid-related processes outside of the liver, such as apoB, PPARα and PGC1α, CYP7a1 and HMGCR, was reduced in these patients compared with the controls. PAI1 and TNFα gene expression in the diabetic livers was increased compared with the other obese groups and control group. Increased steatosis and fibrosis were also noted in the MO individuals.ConclusionsHepatic lipid parameters in MO patients change based on their comorbidities. The gene expression and lipid levels after bariatric surgery were less prominent in the diabetic patients. Lipid receptor overexpression could enable the liver to capture circulating lipids, thus favouring the steatosis typically observed in diabetic and dyslipidaemic MO individuals.

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Section: Introductionmentioning

confidence: 94%

Diabetic and dyslipidaemic morbidly obese exhibit more liver alterations compared with healthy morbidly obese

et al. 2016

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“…A growing area of research focuses on persons with obesity who, despite excess adiposity, are considered to be metabolically healthy due to an absence of comorbidities [17,18,19]. In order to prevent weight gain and development of chronic disease, lifestyle modifications, such as changes in diet and exercise habits, are often the first recommendations given by health care professionals [20].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Dietary Replacement of Saturated Fatty Acids with Unsaturated Fat Sources in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Control Trials

Hannon¹,

Thompson²,

An³

et al. 2017

Ann Nutr Metab

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Background: Obesity and dyslipidemia are frequently treated with dietary interventions before pharmacotherapy is given. Diets high in unsaturated fat have proven advantageous to disease treatment. Aims: The purpose of this systematic review and meta-analysis was to assess the evidence of the effect of saturated fatty acids (SFA) replacement with unsaturated fatty acids (UFA) in metabolically healthy adults with overweight and obesity on markers of dyslipidemia and body composition. Methods: Keyword search was performed in PubMed, CINAHL, and Cochrane Library for randomized controlled trials (RCTs) evaluating the effects of fatty acid substitution in adults with overweight and obesity. Meta-analysis was performed on interventions assessing lipoprotein levels and body composition. Publication bias was assessed by funnel plot inspection, Begg's, and Egger's test. Results: Eight RCTs enrolling 663 participants were included in the review, with intervention durations between 4 and 28 weeks. Although nonsignificant (p = 0.06), meta-analysis found UFA replacement to reduce total cholesterol concentrations by 10.68 mg/dL (95%CI -21.90 to 0.53). Reductions in low-density lipoprotein cholesterol and triglycerides were statistically nonsignificant. Conclusions: Due to null results and a small number of studies included, there is no strong evidence that replacement of SFA with UFA may benefit lipid profiles in this population.

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“…It should be noted, however, that studies [11] that provided that scientific basis of this concept have often included only a limited number of subjects displaying severe (i. e. a body mass index (BMI) greater than 35 kg m − 2 ) obesity. It is also important to note in this context that even severely obese subjects can display a relative good metabolic health state, an observation that has brought forward the term "metabolically healthy obesity" during recent years [13,14]. Putting this forward, we suggest that the degree of cardiorespiratory fitness plays a role in determining the degrees of metabolic alterations in severely obese subjects.…”

Section: Introductionmentioning

confidence: 77%

Cardiorespiratory Fitness is Associated with Glycated Hemoglobin and Triglyceride Levels in Severely Obese Men: A Retrospective Clinical Data Analysis

Wilms

Keppler

Ernst

et al. 2018

Exp Clin Endocrinol Diabetes

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Morbidly “Healthy” Obese Are Not Metabolically Healthy but Less Metabolically Imbalanced Than Those with Type 2 Diabetes or Dyslipidemia

Abstract: The morbidly obese "healthy" individual is not really metabolically healthy, but morbidly obese individuals with diabetes and dyslipidemia are more metabolically imbalanced.

Cited by 15 publications

References 36 publications

Diabetic and dyslipidaemic morbidly obese exhibit more liver alterations compared with healthy morbidly obese

Diabetic and dyslipidaemic morbidly obese exhibit more liver alterations compared with healthy morbidly obese

Clinical Outcomes of Dietary Replacement of Saturated Fatty Acids with Unsaturated Fat Sources in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Control Trials

Cardiorespiratory Fitness is Associated with Glycated Hemoglobin and Triglyceride Levels in Severely Obese Men: A Retrospective Clinical Data Analysis

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