Prevalence and determinants of metabolically healthy obesity in Spain

López-Garcı́a, Esther; Guallar-Castillón, Pilar; León‐Muñoz, Luz M.; Rodríguez‐Artalejo, Fernando

doi:10.1016/j.atherosclerosis.2013.09.003

Cited by 49 publications

(42 citation statements)

References 25 publications

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“…About 35% of obese adults display normal intrahepatic TG content [4], and 2%-50% of obese adults are "metabolically normal" [144][145][146][147][148][149][150]. Molecular mechanisms for these observations are largely unknown.…”

Section: Unanswered Questionsmentioning

confidence: 94%

Molecular mechanisms of fatty liver in obesity

Xiang

Xie

2015

Front. Med.

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Nonalcoholic fatty liver disease (NAFLD) covers a spectrum of liver disorders ranging from simple steatosis to advanced pathologies, including nonalcoholic steatohepatitis and cirrhosis. NAFLD significantly contributes to morbidity and mortality in developed societies. Insulin resistance associated with central obesity is the major cause of hepatic steatosis, which is characterized by excessive accumulation of triglyceride-rich lipid droplets in the liver. Accumulating evidence supports that dysregulation of adipose lipolysis and liver de novo lipogenesis (DNL) plays a key role in driving hepatic steatosis. In this work, we reviewed the molecular mechanisms responsible for enhanced adipose lipolysis and increased hepatic DNL that lead to hepatic lipid accumulation in the context of obesity. Delineation of these mechanisms holds promise for developing novel avenues against NAFLD.

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Section: Unanswered Questionsmentioning

confidence: 94%

Molecular mechanisms of fatty liver in obesity

Xiang

Xie

2015

Front. Med.

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“…Since then, a series of studies have used the components of the metabolic syndrome or some measure of insulin sensitivity to identify a subset of obese people who are metabolically normal. However, there is no consensus as to how metabolic normality should be defined, so the reported prevalence of MNO ranges from 2% to 50%, depending on the specific criteria used and the population studied (9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In the present study, we used IHTG content to identify obese people who have already demonstrated either a propensity for or a resistance to accumulating triglycerides in organs other than adipose tissue.…”

Section: Discussionmentioning

confidence: 99%

“…However, not all obese persons develop NAFLD, insulin resistance, and cardiometabolic disease. About 35% of obese adults have normal IHTG content (8), and 2%-50% of obese adults are "metabolically normal," depending on the criteria used to define metabolic normality and the sex and age of the study cohort (9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Moreover, the risk of developing diabetes and future cardiovascular events is much lower in metabolically normal obese (MNO) people than in metabolically abnormal obese (MAO) people (19,20).…”

Section: Introductionmentioning

confidence: 99%

Metabolically normal obese people are protected from adverse effects following weight gain

Fabbrini¹,

Yoshino²,

Yoshino³

et al. 2015

J. Clin. Invest.

145

150

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BACKGROUND.Obesity is associated with insulin resistance and increased intrahepatic triglyceride (IHTG) content, both of which are key risk factors for diabetes and cardiovascular disease. However, a subset of obese people does not develop these metabolic complications. Here, we tested the hypothesis that people defined by IHTG content and insulin sensitivity as "metabolically normal obese" (MNO), but not those defined as "metabolically abnormal obese" (MAO), are protected from the adverse metabolic effects of weight gain. METHODS.Body composition, multiorgan insulin sensitivity, VLDL apolipoprotein B100 (apoB100) kinetics, and global transcriptional profile in adipose tissue were evaluated before and after moderate (~6%) weight gain in MNO (n = 12) and MAO (n = 8) subjects with a mean BMI of 36 ± 4 kg/m 2 who were matched for BMI and fat mass. RESULTS.Although the increase in body weight and fat mass was the same in both groups, hepatic, skeletal muscle, and adipose tissue insulin sensitivity deteriorated, and VLDL apoB100 concentrations and secretion rates increased in MAO, but not MNO, subjects. Moreover, biological pathways and genes associated with adipose tissue lipogenesis increased in MNO, but not MAO, subjects.CONCLUSIONS. These data demonstrate that MNO people are resistant, whereas MAO people are predisposed, to the adverse metabolic effects of moderate weight gain and that increased adipose tissue capacity for lipogenesis might help protect MNO people from weight gain-induced metabolic dysfunction.TRIAL REGISTRATION. ClinicalTrials.gov NCT01184170.

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“…However, a proportion between 20 and 30% of obese individuals may be free of metabolic comorbidities during an unknown variable period of time [3]–[5]. The existence of a metabolically healthy obese (MHO) phenotype was first proposed by Sims in 2001 [3].…”

Section: Introductionmentioning

confidence: 99%

Profile of Individuals Who Are Metabolically Healthy Obese Using Different Definition Criteria. A Population-Based Analysis in the Spanish Population

et al. 2014

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BackgroundObesity is associated with numerous metabolic complications such as diabetes mellitus type 2, dyslipidemia, hypertension, cardiovascular diseases and several forms of cancer. Our goal was to compare different criteria to define the metabolically healthy obese (MHO) with metabolically unhealthy obese (MUHO) subjects. We applied Wildman (W), Wildman modified (WM) with insulin resistance (IR) with cut-off point ≥3.8 and levels of C- Reactive Protein (CRP) ≥3 mg/l; and Consensus Societies (CS) criteria. In these subjects cardiovascular-risk (CV-risk) was estimated by Framingham score and SCORE for MHO and MUHO.MethodsA cross-sectional study was conducted in Spanish Caucasian adults. A total of 3,844 subjects completed the study, 45% males, aged 35–74 years. Anthropometric/biochemical variables were measured. Obesity was defined as BMI: ≥30 Kg/m2.ResultsThe overall prevalence of obesity in our population was 27.5%, (23.7%/males and 30.2%/females). MHO prevalence according to W, WM, and CS definition criteria were: 9.65%, 16.29%, 39.94% respectively in obese participants. MHO has lower waist circumference (WC) measurements than MUHO. The estimated CV-risks by Framingham and SCORE Project charts were lower in MHO than MUHO subjects. WC showed high specificity and sensitivity in detecting high estimated CV risk by Framingham. However, WHR showed high specificity and sensitivity in detecting CV risk according to SCORE Project. MHO subjects as defined by any of the three criteria had higher adiponectin levels after adjustment by sex, age, WC, HOMA IR and Framingham or SCORE risks. This relationship was not found for CRP circulating levels neither leptin levels.ConclusionsMHO prevalence is highly dependent on the definition criteria used to define those individuals. Results showed that MHO subjects had less WC, and a lower estimated CV-risk than MUHO subjects. Additionally, the high adiponectin circulating levels in MHO may suggest a protective role against developing an unhealthy metabolic state.

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Prevalence and determinants of metabolically healthy obesity in Spain

Cited by 49 publications

References 25 publications

Molecular mechanisms of fatty liver in obesity

Molecular mechanisms of fatty liver in obesity

Metabolically normal obese people are protected from adverse effects following weight gain

Profile of Individuals Who Are Metabolically Healthy Obese Using Different Definition Criteria. A Population-Based Analysis in the Spanish Population

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