1
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Langroudi AP, Farzi Y, Masinaei M, Varniab ZS, Shahin S, Rashidi MM, Moghaddam SS, Rahimi S, Khalili M, Keykhaei M, Ahmadi N, Kazemi A, Ghasemi E, Azadnajafabad S, Yoosefi M, Fattahi N, Nasserinejad M, Rezaei N, Haghshenas R, Dilmaghani-Marand A, Abdolhamidi E, Djalalinia S, Rezaei N, Larijani B, Farzadfar F. Exploring metabolically healthy obesity: prevalence, characteristics, and cardiovascular risk in the Iranian population based on the STEPS 2021. J Diabetes Metab Disord 2024; 23:881-893. [PMID: 38932890 PMCID: PMC11196437 DOI: 10.1007/s40200-023-01364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/25/2023] [Indexed: 06/28/2024]
Abstract
Background Regarding the rapidly increasing prevalence of obesity throughout the globe, it remains a serious public health concern. A subgroup of obesity that does not meet metabolic syndrome criteria is called metabolically healthy obesity (MHO). However, whether the MHO phenotype increases cardiovascular disease (CVD) risk is controversial. This study aimed to evaluate the prevalence of MHO and its 10-year CVD risk in Iranian populations. Methods Based on the STEPS 2021 project in Iran, we collected data on 18119 Iranians 25 years and older from all 31 provinces after applying many statistical factors. Using the Framingham score, we evaluated the 10-year cardiovascular risk associated with the various MHO definition criteria for Iranian populations. Results The prevalence of MHO was 6.42% (5.93-6.91) at the national level according to the AHA-NHLBI definition, and 23.29% of obese women and 24.55% of obese men were classified as MHOs. Moreover, the MHO group was younger than the metabolically unhealthy obesity (MUO) group based on all definitions (p < 0.001). The odds ratio of MUO individuals being classified as high-risk individuals by the Framingham criteria for CVD was significantly higher than that of MHO individuals by all definitions, with a crude odds ratio of 3.55:1 based on AHA-NHLBI definition. Conclusion This study reveals a significant prevalence of MHO in the Iranian population, with approximately 25% of obese individuals classified as MHO. While MHO is associated with a lower risk of cardiovascular disease compared to MUO, MHO carries the potential for transitioning to an unhealthy state. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01364-5.
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Affiliation(s)
- Ashkan Pourabhari Langroudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shokri Varniab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY USA
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Shakiba Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Khalili
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Kazemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT USA
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology Ministry of Health and Medical Education, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Chen F, Sarver DC, Saqib M, Velez LM, Aja S, Seldin MM, Wong GW. Loss of CTRP10 results in female obesity with preserved metabolic health. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.01.565163. [PMID: 37961647 PMCID: PMC10635050 DOI: 10.1101/2023.11.01.565163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Obesity is a major risk factor for type 2 diabetes, dyslipidemia, cardiovascular disease, and hypertension. Intriguingly, there is a subset of metabolically healthy obese (MHO) individuals who are seemingly able to maintain a healthy metabolic profile free of metabolic syndrome. The molecular underpinnings of MHO, however, are not well understood. Here, we report that CTRP10/C1QL2-deficient mice represent a unique female model of MHO. CTRP10 modulates weight gain in a striking and sexually dimorphic manner. Female, but not male, mice lacking CTRP10 develop obesity with age on a low-fat diet while maintaining an otherwise healthy metabolic profile. When fed an obesogenic diet, female Ctrp10 knockout (KO) mice show rapid weight gain. Despite pronounced obesity, Ctrp10 KO female mice do not develop steatosis, dyslipidemia, glucose intolerance, insulin resistance, oxidative stress, or low-grade inflammation. Obesity is largely uncoupled from metabolic dysregulation in female KO mice. Multi-tissue transcriptomic analyses highlighted gene expression changes and pathways associated with insulin-sensitive obesity. Transcriptional correlation of the differentially expressed gene (DEG) orthologous in humans also show sex differences in gene connectivity within and across metabolic tissues, underscoring the conserved sex-dependent function of CTRP10. Collectively, our findings suggest that CTRP10 negatively regulates body weight in females, and that loss of CTRP10 results in benign obesity with largely preserved insulin sensitivity and metabolic health. This female MHO mouse model is valuable for understanding sex-biased mechanisms that uncouple obesity from metabolic dysfunction.
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Affiliation(s)
- Fangluo Chen
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dylan C. Sarver
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Muzna Saqib
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leandro M Velez
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - Susan Aja
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marcus M. Seldin
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - G. William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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3
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Milano W, Carizzone F, Foia M, Marchese M, Milano M, Saetta B, Capasso A. Obesity and Its Multiple Clinical Implications between Inflammatory States and Gut Microbiotic Alterations. Diseases 2022; 11:diseases11010007. [PMID: 36648872 PMCID: PMC9844347 DOI: 10.3390/diseases11010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
Obesity is a chronic multifactorial disease that has become a serious health problem and is currently widespread over the world. It is, in fact, strongly associated with many other conditions, including insulin resistance, type 2 diabetes, cardiovascular and neurodegenerative diseases, the onset of different types of malignant tumors and alterations in reproductive function. According to the literature, obesity is characterized by a state of low-grade chronic inflammation, with a substantial increase in immune cells, specifically macrophage infiltrates in the adipose tissue which, in turn, secrete a succession of pro-inflammatory mediators. Furthermore, recent studies on microbiota have postulated new possible mechanisms of interaction between obesity and unbalanced nutrition with inflammation. This intestinal "superorganism" complex seems to influence not only the metabolic balance of the host but also the immune response, favoring a state of systemic inflammation and insulin resistance. This review summarizes the major evidence on the interactions between the gut microbiota, energetic metabolism and host immune system, all leading to a convergence of the fields of immunology, nutrients physiology and microbiota in the context of obesity and its possible clinical complications. Finally, possible therapeutic approaches aiming to rebalance the intestinal microbial ecosystem are evaluated to improve the alteration of inflammatory and metabolic states in obesity and related diseases.
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Affiliation(s)
- Walter Milano
- UOSD Eating Disorder Unit, Mental Health Department, ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Francesca Carizzone
- UOSD Eating Disorder Unit, Mental Health Department, ASL Napoli 2 Nord, 80027 Napoli, Italy
| | | | - Magda Marchese
- Clinical Pathology Services, Santa Maria Delle Grazie Hospital Pozzuoli, Asl Napoli 2 Nord, 80027 Napoli, Italy
| | - Mariafrancesca Milano
- UOSD Eating Disorder Unit, Mental Health Department, ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Biancamaria Saetta
- UOSD Eating Disorder Unit, Mental Health Department, ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Anna Capasso
- Department of Pharmacy, University of Salerno, Fisciano, 84084 Salerno, Italy
- Correspondence:
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Mikłosz A, Nikitiuk BE, Chabowski A. Using adipose-derived mesenchymal stem cells to fight the metabolic complications of obesity: Where do we stand? Obes Rev 2022; 23:e13413. [PMID: 34985174 PMCID: PMC9285813 DOI: 10.1111/obr.13413] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 12/15/2022]
Abstract
Obesity is a critical risk factor for the development of metabolic diseases, and its prevalence is increasing worldwide. Stem cell-based therapies have become a promising tool for therapeutic intervention. Among them are adipose-derived mesenchymal stem cells (ADMSCs), secreting numerous bioactive molecules, like growth factors, cytokines, and chemokines. Their unique features, including immunosuppressive and immunomodulatory properties, make them an ideal candidates for clinical applications. Numerous experimental studies have shown that ADMSCs can improve pancreatic islet cell viability and function, ameliorate hyperglycemia, improve insulin sensitivity, restore liver function, counteract dyslipidemia, lower pro-inflammatory cytokines, and reduce oxidative stress in the animal models. These results prompted scientists to use ADMSCs clinically. However, up to date, there have been few clinical studies or ongoing trails using ADMSCs to treat metabolic disorders such as type 2 diabetes mellitus (T2DM) or liver cirrhosis. Most human studies have implemented autologous ADMSCs with minimal risk of cellular rejection. Because the functionality of ADMSCs is significantly reduced in subjects with obesity and/or metabolic syndrome, their efficacy is questioned. ADMSCs transplantation may offer a potential therapeutic approach for the treatment of metabolic complications of obesity, but randomized controlled trials are required to establish their safety and efficacy in humans prior to routine clinical use.
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Affiliation(s)
- Agnieszka Mikłosz
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | | | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
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5
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Fearby N, Penman S, Thanos P. Effects of Δ9-Tetrahydrocannibinol (THC) on Obesity at Different Stages of Life: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063174. [PMID: 35328862 PMCID: PMC8951828 DOI: 10.3390/ijerph19063174] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/04/2022] [Indexed: 12/20/2022]
Abstract
The Cannabis sativa plant has historically been used for both recreational and medical purposes. With the recent surge in recreational use of cannabis among adolescents and adults in particular, there is an increased obligation to determine the short- and long-term effects that consuming this plant may have on several aspects of the human psyche and body. The goal of this article was to examine the negative effects of obesity, and how the use of Δ9-tetrahydrocannibinol (THC) or cannabidiol (CBD) can impact rates of this global pandemic at different timepoints of life. Conflicting studies have been reported between adult and adolescents, as there are reports of THC use leading to increased weight due to elevated appetite and consumption of food, while others observed a decrease in overall body weight due to the regulation of omega-6/omega-3 endocannabinoid precursors and a decrease in energy expenditure. Studies supported a positive correlation between prenatal cannabis use and obesity rates in the children as they matured. The data did not indicate a direct connection between prenatal THC levels in cannabis and obesity rates, but that this development may occur due to prenatal THC consumption leading to low birthweight, and subsequent obesity. There are few studies using animal models that directly measure the effects that prenatal THC administration on obesity risks among offspring. Thus, this is a critical area for future studies using a developmental framework to examine potential changes in risk across development.
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Affiliation(s)
- Nathan Fearby
- Department of Biological Sciences, University at Buffalo, Buffalo, NY 14203, USA;
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY 14203, USA;
| | - Samantha Penman
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY 14203, USA;
| | - Panayotis Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY 14203, USA;
- Department of Psychology, University at Buffalo, Buffalo, NY 14203, USA
- Correspondence: ; Tel.: +1-(716)-881-7520
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6
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Oguoma VM, Coffee NT, Alsharrah S, Abu-Farha M, Al-Refaei FH, Alkandari A, Al-Mulla F, Daniel M. Anthropometric cut-points for discriminating diabetes and the metabolic syndrome among Arabs and Asians: the Kuwait Diabetes Epidemiology Program. Br J Nutr 2022; 127:92-102. [PMID: 33658089 DOI: 10.1017/s0007114521000751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18-60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.
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Affiliation(s)
- Victor M Oguoma
- Health Research Institute, University of Canberra, Canberra, Australia
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City, Kuwait
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Neil T Coffee
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Saad Alsharrah
- Health Research Institute, University of Canberra, Canberra, Australia
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | - Abdullah Alkandari
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mark Daniel
- Health Research Institute, University of Canberra, Canberra, Australia
- Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
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7
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Gómez-Zorita S, Queralt M, Vicente MA, González M, Portillo MP. Metabolically healthy obesity and metabolically obese normal weight: a review. J Physiol Biochem 2021; 77:175-189. [PMID: 33704694 DOI: 10.1007/s13105-020-00781-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023]
Abstract
Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.
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Affiliation(s)
- Saioa Gómez-Zorita
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain. .,BIOARABA Health Research Institute, Vitoria, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain.
| | - Maite Queralt
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain
| | - Maria Angeles Vicente
- BIOARABA Health Research Institute, Vitoria, Spain.,Alava University Hospital (Osakidetza), Vitoria, Spain
| | - Marcela González
- Nutrition and Food Science Department, Faculty of Biochemistry and Biological Sciences, National University of Litoral and National Scientific and Technical Research Council (CONICET), 3000, Santa Fe, Argentina
| | - María P Portillo
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain.,BIOARABA Health Research Institute, Vitoria, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain
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8
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Genua I, Tuneu L, Ramos A, Stantonyonge N, Caimari F, Balagué C, Fernández-Ananin S, Sánchez-Quesada JL, Pérez A, Miñambres I. Effectiveness of Bariatric Surgery in Patients with the Metabolically Healthy Obese Phenotype. Obes Surg 2021; 31:517-522. [PMID: 32915359 DOI: 10.1007/s11695-020-04967-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the effectiveness and safety of bariatric surgery in metabolically healthy obese (MHO) patients. METHODS In this retrospective, observational study, we reviewed the medical records of patients who underwent bariatric surgery at a tertiary care hospital between January 2007 and March 2015. Patients who underwent revisional surgery and patients with type 1 diabetes were excluded from the analysis. MHO patients were defined as those without a previous diagnosis of diabetes or atherogenic dyslipidemia and absence of hypoglycemic treatment or treatment with fibrates. RESULTS A total of 188 patients were included (mean age 48.97 ± 10.32 years, 68.6% of women). Sleeve gastrectomy was performed in 121 patients (64%) and a gastric bypass in 67 patients (36%). Prior to surgery, 36 patients (19%) were MHO. In the second- and third-year post-surgery, MHO patients presented a higher percentage of total weight loss (%TWL) (35.16% vs. 30.34%; p = 0.02 and 33.97% vs. 27.78%; p = 0.013 respectively). Multiple regression analysis showed that MHO was associated with a higher weight loss irrespective of age, sex, baseline BMI, and type of surgery. We did not detect any differences in acute complications between patients with and without MHO after bariatric surgery. CONCLUSIONS Bariatric surgery in MHO patients in our study was associated with higher weight loss than that in MUHO patients. There were no differences between the two groups in respect to acute complications following surgery.
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Affiliation(s)
- Idoia Genua
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Laura Tuneu
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Analía Ramos
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Nicole Stantonyonge
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Francisca Caimari
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Carmen Balagué
- Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Antonio Pérez
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
| | - Inka Miñambres
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
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Abstract
A paradoxical double challenge has emerged in the last decades with respect to nutrition and nutrition-related clinical conditions. Hunger-related undernutrition continues to represent an unacceptable burden, although its prevalence has been encouragingly reduced worldwide. On the other hand, the prevalence of overweight and obesity, defined as fat excess accumulation with negative impact on individual health, has dramatically increased due to increasingly pervasive obesogenic lifestyle changes. Undernutrition and obesity may coexist in world regions, Countries and even smaller communities and households, being referred to as double burden of malnutrition. It is however important to point out that fat accumulation and obesity may also induce additional nutritional derangements in affected individuals, both directly through metabolic and body composition changes and indirectly through acute and chronic diseases with negative impact on nutritional status. In the current narrative review, associations between fat accumulation in obesity and malnutrition features as well as their known causes will be reviewed and summarized. These include risk of loss of skeletal muscle mass and function (sarcopenia) that may allow for malnutrition diagnosis also in overweight and obese individuals, thereby introducing a new clinically relevant perspective to the obesity-related double burden of malnutrition concept.
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Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
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10
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Heinonen S, Jokinen R, Rissanen A, Pietiläinen KH. White adipose tissue mitochondrial metabolism in health and in obesity. Obes Rev 2020; 21:e12958. [PMID: 31777187 DOI: 10.1111/obr.12958] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Abstract
White adipose tissue is one of the largest organs of the body. It plays a key role in whole-body energy status and metabolism; it not only stores excess energy but also secretes various hormones and metabolites to regulate body energy balance. Healthy adipose tissue capable of expanding is needed for metabolic well-being and to prevent accumulation of triglycerides to other organs. Mitochondria govern several important functions in the adipose tissue. We review the derangements of mitochondrial function in white adipose tissue in the obese state. Downregulation of mitochondrial function or biogenesis in the white adipose tissue is a central driver for obesity-associated metabolic diseases. Mitochondrial functions compromised in obesity include oxidative functions and renewal and enlargement of the adipose tissue through recruitment and differentiation of adipocyte progenitor cells. These changes adversely affect whole-body metabolic health. Dysfunction of the white adipose tissue mitochondria in obesity has long-term consequences for the metabolism of adipose tissue and the whole body. Understanding the pathways behind mitochondrial dysfunction may help reveal targets for pharmacological or nutritional interventions that enhance mitochondrial biogenesis or function in adipose tissue.
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Affiliation(s)
- Sini Heinonen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Riikka Jokinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
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11
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Insulin resistance in obesity: an overview of fundamental alterations. Eat Weight Disord 2018; 23:149-157. [PMID: 29397563 DOI: 10.1007/s40519-018-0481-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/12/2018] [Indexed: 12/14/2022] Open
Abstract
Obesity is a major health risk factor, and obesity-induced morbidity and complications account for huge costs for affected individuals, families, healthcare systems, and society at large. In particular, obesity is strongly associated with the development of insulin resistance, which in turn plays a key role in the pathogenesis of obesity-associated cardiometabolic complications, including metabolic syndrome components, type 2 diabetes, and cardiovascular diseases. Insulin sensitive tissues, including adipose tissue, skeletal muscle, and liver, are profoundly affected by obesity both at biomolecular and functional levels. Altered adipose organ function may play a fundamental pathogenetic role once fat accumulation has ensued. Modulation of insulin sensitivity appears to be, at least in part, related to changes in redox balance and oxidative stress as well as inflammation, with a relevant underlying role for mitochondrial dysfunction that may exacerbate these alterations. Nutrients and substrates as well as systems involved in host-nutrient interactions, including gut microbiota, have been also identified as modulators of metabolic pathways controlling insulin action. This review aims at providing an overview of these concepts and their potential inter-relationships in the development of insulin resistance, with particular regard to changes in adipose organ and skeletal muscle.
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12
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Effects of low-fat compared with high-fat diet on cardiometabolic indicators in people with overweight and obesity without overt metabolic disturbance: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2017; 119:96-108. [DOI: 10.1017/s0007114517002902] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractRandomised controlled trials comparing low- v. high-fat diets on cardiometabolic risk factors in people with overweight or obesity have shown inconsistent results, which may be due to the mixed metabolic status of people with excess adiposity. The role of dietary fat manipulation in modifying cardiometabolic indicators in people with overweight or obese without metabolic disturbance is unclear. Thus, meta-analysis was conducted to compare low- v. high-fat diets on cardiometabolic indicators in people who are overweight or obese without metabolic disturbance in the present study. Databases were searched until October 2016. The pooled effects of outcomes with heterogeneity were calculated with a random-effects model, heterogeneities were analysed by subgroup and meta-regression. As a result, twenty studies with 2106 participants were included in the meta-analysis. Total cholesterol and LDL-cholesterol levels were lower following low-fat diets compared with high-fat diets: weighted mean difference (WMD) was −7·05 mg/dl (−0·18 mmol/l; 95 % CI −11·30, −2·80; P=0·001) and −4·41 mg/dl (−0·11 mmol/l; 95 % CI −7·81, −1·00; P=0·011), respectively. Conversely, significant higher level of TAG (WMD: 11·68 mg/dl (0·13 mmol/l), 95 % CI 5·90, 17·45; P<0·001) and lower level of HDL-cholesterol (WMD: −2·57 mg/dl (−0·07 mmol/l); 95 % CI −3·85, −1·28; P<0·001) were found following low-fat diets compared with high-fat diets. In conclusion, dietary fat manipulation has a significant influence on blood lipid levels in people with overweight or obesity without metabolic disturbances.
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Latifi SM, Karandish M, Shahbazian H, Taha JM, Cheraghian B, Moradi M. Prevalence of Metabolically Healthy Obesity (MHO) and its relation with incidence of metabolic syndrome, hypertension and type 2 Diabetes amongst individuals aged over 20 years in Ahvaz: A 5 Year cohort Study (2009-2014). Diabetes Metab Syndr 2017; 11 Suppl 2:S1037-S1040. [PMID: 28781161 DOI: 10.1016/j.dsx.2017.07.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 07/21/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Today, obesity epidemic is one of the major health problems of the present century. One of the phenotypes of obesity is metabolically healthy obesity. It seems that these obese individuals suffer less from cardiovascular disease and metabolically unhealthy obesity. This study aimed to investigate the prevalence of metabolically healthy obesity (MHO) and its relationship with incidence of metabolic syndrome, diabetes and hypertension in individuals over 20 years in the city of Ahvaz. MATERIALS AND METHODS This study was a 5-year cohort study, which was conducted on adults between years 2009 to 2014.Participants who were randomly selected from individuals covered by the health centers in the city of Ahvaz in baseline population, were again recalled by these centers. The subjects completed the question aires, and anthropometric measurements and blood samples were prepared for performing tests based on Phase 1. RESULTS A total of 591 individuals Participated in this study, 281 (47.5%) were males and 310 (52.5%) females with mean age of 42.2±13.3 years. The prevalence of MHO was 19.5% in the baseline population. The cumulative incidence of metabolic syndrome, diabetes and hypertension in MHO individuals were 29.6%, 24.3% and 13%, respectively. CONCLUSION The prevalence of MHO was 19.5% in the baseline population. There was a specific relationship between MHO and incidence of metabolic syndrome and diabetes; however, there was a less significant relationship between MHO and hypertension.
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Affiliation(s)
- Seyed Mahmoud Latifi
- Diabetes Research Center, Health Research Institute,, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hajieh Shahbazian
- Diabetes Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,.
| | - Jalaly Mohammad Taha
- Diabetes Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,.
| | - Bahman Cheraghian
- Department of Biostatistic and Epidemiology, Faculty of Health Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mitra Moradi
- Diabetes Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,.
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Alfadda AA, Masood A, Al-Naami MY, Chaurand P, Benabdelkamel H. A Proteomics Based Approach Reveals Differential Regulation of Visceral Adipose Tissue Proteins between Metabolically Healthy and Unhealthy Obese Patients. Mol Cells 2017; 40:685-695. [PMID: 28927258 PMCID: PMC5638776 DOI: 10.14348/molcells.2017.0073] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 12/16/2022] Open
Abstract
Obesity and the metabolic disorders that constitute metabolic syndrome are a primary cause of morbidity and mortality in the world. Nonetheless, the changes in the proteins and the underlying molecular pathways involved in the relevant pathogenesis are poorly understood. In this study a proteomic analysis of the visceral adipose tissue isolated from metabolically healthy and unhealthy obese patients was used to identify presence of altered pathway(s) leading to metabolic dysfunction. Samples were obtained from 18 obese patients undergoing bariatric surgery and were subdivided into two groups based on the presence or absence of comorbidities as defined by the International Diabetes Federation. Two dimensional difference in-gel electrophoresis coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was carried out. A total of 28 proteins were identified with a statistically significant difference in abundance and a 1.5-fold change (ANOVA, p ≤ 0.05) between the groups. 11 proteins showed increased abundance while 17 proteins were decreased in the metabolically unhealthy obese compared to the healthy obese. The differentially expressed proteins belonged broadly to three functional categories: (i) protein and lipid metabolism (ii) cytoskeleton and (iii) regulation of other metabolic processes. Network analysis by Ingenuity pathway analysis identified the NFκB, IRK/MAPK and PKC as the nodes with the highest connections within the connectivity map. The top network pathway identified in our protein data set related to cellular movement, hematological system development and function, and immune cell trafficking. The VAT proteome between the two groups differed substantially between the groups which could potentially be the reason for metabolic dysfunction.
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Affiliation(s)
- Assim A. Alfadda
- Obesity Research Center, College of Medicine, King Saud University,
Saudi Arabia
- Department of Medicine, College of Medicine, King Saud University,
Saudi Arabia
| | - Afshan Masood
- Obesity Research Center, College of Medicine, King Saud University,
Saudi Arabia
| | | | - Pierre Chaurand
- Department of Chemistry, Université de Montréal, Montreal,
Canada
| | - Hicham Benabdelkamel
- Obesity Research Center, College of Medicine, King Saud University,
Saudi Arabia
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15
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Loprinzi PD, Frith E. Cardiometabolic healthy obesity paradigm and all-cause mortality risk. Eur J Intern Med 2017; 43:42-45. [PMID: 28511849 DOI: 10.1016/j.ejim.2017.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/03/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine the cardiometabolic healthy obesity paradigm as it relates to all-cause mortality risk, with effect moderation evaluated for physical activity and demographic characteristics. METHODS Data from the 1999-2006 NHANES were used. The analytic sample included 7579 dietary fasting adults (20+ yrs). All-cause mortality was linked with participant data from the National Death Index. Metabolic health was based on fasting levels of triglycerides, high-density lipoprotein cholesterol, glucose and blood pressure. Weight status was determined from measured height and weight. Physical activity was assessed via self-report. Six mutually exclusive groups were evaluated, including 1) Metabolically Healthy and Normal Weight (Referent), 2) Metabolically Healthy and Overweight, 3) Metabolically Healthy and Obese, 4) Metabolically Abnormal and Normal Weight, 5) Metabolically Abnormal and Overweight, and 6) Metabolically Abnormal and Obese. A Cox proportional hazards model was used to evaluate the association between these 6 groups and all-cause mortality. RESULTS The unweighted median follow-up was 103months; 770,568 person-months occurred with an incidence rate of 1.18 deaths per 1000 person-months. When compared to those who were metabolically healthy and of normal BMI, all other metabolic and weight configurations had an increased mortality risk. There was no evidence of effect modification by physical activity or demographic characteristics. CONCLUSIONS These findings emphasize the importance of optimizing body habitus and increasing public awareness of the detrimental effects of metabolic abnormalities.
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Affiliation(s)
- Paul D Loprinzi
- The University of Mississippi, Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, MS, United States.
| | - Emily Frith
- The University of Mississippi, Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, MS, United States
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16
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Placental maternal and fetal vascular circulation in healthy non-obese and metabolically healthy obese pregnant women. Atherosclerosis 2017; 260:63-66. [PMID: 28349890 DOI: 10.1016/j.atherosclerosis.2017.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/27/2017] [Accepted: 03/03/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS We investigated placental histopathology for lesions that are associated with maternal and fetal circulation abnormalities in obese pregnant women with and without metabolic alterations. METHODS 332 pregnant women were divided into three groups: Group 1 included 163 non-obese metabolically healthy (NOMH), Group 2 106 obese metabolically healthy (OMH), and Group 3 63 obese metabolically abnormal (OMA) subjects, respectively. RESULTS Fetal vascular supply (FVS) abnormalities and Willous maturation defect (WMD) rate were higher in obese subjects without metabolic abnormalities, compared to NOMH subjects (p < 0.021 and p < 0.018, respectively). In the logistic regression analysis, obesity emerged as a significant independent predictor of FVS abnormalities (OR 1.54, 95% CI 1.193-1.992, p = 0.001) and WMD (OR 2.004, 95% CI 1.173-3.422, p = 0.011). Although maternal vascular supply (MVS) abnormalities differed significantly across groups (31%, 38% and 54% respectively, p < 0.005), in the logistic regression analysis, obesity was not significantly associated with MVS abnormalities. CONCLUSIONS We demonstrated that obesity, per se, is associated with an increased rate of placental vascular supply abnormalities and has a more adverse effect on fetal vascular circulation than on maternal vascular supply.
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17
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Abraham PA, Attipoe S, Kazman JB, Zeno SA, Poth M, Deuster PA. Role of plasma adiponectin /C-reactive protein ratio in obesity and type 2 diabetes among African Americans. Afr Health Sci 2017; 17:99-107. [PMID: 29026382 DOI: 10.4314/ahs.v17i1.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examined relations between fasting plasma adiponectin (ADIP), C-reactive protein (CRP) concentrations and markers of T2D in African Americans (AA). METHODS Fasting plasma ADIP, CRP, Insulin (IN), HOMA-IR, lipid profiles, body fat percent (%BF), waist circumference (WC), body mass index (BMI) and blood pressure measures were determined in AA women (W: n=77) and men (M: n=34). Participants were classified into: 1) Normal fasting glucose (FG) and Normal %BF; 2) Normal FG and High %BF; and 3) High FG. RESULTS Compared to men, women had significantly higher mean ADIP (W: 31.4±2.9 vs. M: 18.0±4.4 ng/L), CRP (W: 3.2±0.3 vs. M: 2.0±0.5 mg/L), %BF (W: 41.2±0.9 vs. M: 27.2±1.3), and BMI (W: 32.3±0.7 vs. M: 29.2±1.1 kg/m2). Women with normal FG and %BF had significantly higher ADIP (64.0±6.0) and lower CRP (1.3±0.6) concentrations than normal FG/ high %BF (ADIP: 37.0±5.0 and CRP: 3.1 ±0.5) and high FG (ADIP: 15.1±4.1 and CRP: 4.0 ± 0.5) groups. Women with high ADIP to CRP ratio had favorable metabolic and anthropometric profiles. CONCLUSION Low ADIP and high CRP are associated with excessive %BF and FG in AA women. ADIP/CRP, may be useful for detecting metabolic dysregulation.
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Affiliation(s)
- Preetha Anna Abraham
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
| | - Selasi Attipoe
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
| | - Josh B Kazman
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
| | - Stacey Anne Zeno
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
| | - Merrily Poth
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
| | - Patricia Anne Deuster
- Department of Military and Emergency Medicine (MEM) Uniformed Services University of Health Sciences (USUHS) 4301 Jones Bridge Rd, Bethesda, MD 20814 (PA, SA, JK, SZ, PD)
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18
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Chen DLT, Brown R, Liess C, Poljak A, Xu A, Zhang J, Trenell M, Jenkins A, Chisholm D, Samocha-Bonet D, Macefield VG, Greenfield JR. Muscle Sympathetic Nerve Activity Is Associated with Liver Insulin Sensitivity in Obese Non-Diabetic Men. Front Physiol 2017; 8:101. [PMID: 28293196 PMCID: PMC5328983 DOI: 10.3389/fphys.2017.00101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 02/07/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction: Muscle sympathetic nerve activity (MSNA) may play a role in insulin resistance in obesity. However, the direction and nature of the relationship between MSNA and insulin resistance in obesity remain unclear. We hypothesized that resting MSNA would correlate inversely with both muscle and liver insulin sensitivity and that it would be higher in insulin-resistant vs. insulin-sensitive subjects. Materials and methods: Forty-five non-diabetic obese subjects were studied. As no significant relationships were found in women, the data presented in on 22 men aged 48 ± 12 years. Two-step (15 and 80 mU/m2/min) hyperinsulinaemic-euglycaemic clamps were performed using deuterated glucose to determine liver and muscle insulin sensitivity. Clinical and metabolic parameters were assessed. MSNA was measured via a microelectrode inserted percutaneously into the common peroneal nerve. Results: MSNA burst frequency correlated inversely with liver insulin sensitivity (r = -0.53, P = 0.02) and positively with the hepatokines C-reactive protein (CRP) and fibroblast growth factor (FGF)-19 (r = 0.57, P = 0.006, and r = -0.47, P = 0.03, respectively). MSNA burst frequency was lower in Liversen compared to Liverres (27 ± 5 vs. 38 ± 2 bursts per minute; P = 0.03). Muscle insulin sensitivity was unrelated to MSNA. Discussion: Sympathetic neural activation is related to liver insulin sensitivity and circulating hepatokines CRP and FGF-19 in non-diabetic obese men. These results suggest a potential hepato-endocrine-autonomic axis. Future studies are needed to clarify the influence of MSNA on liver insulin sensitivity in men.
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Affiliation(s)
- Daniel L. T. Chen
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Rachael Brown
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Carsten Liess
- Philips HealthcareLuebeckertordamm, Hamburg, Germany
| | - Anne Poljak
- Bioanalytical Mass Spectrometry Facility, UNSW SydneySydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | - Jialiang Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | | | - Arthur Jenkins
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Health Science, University of WollongongWollongong, NSW, Australia
| | - Donald Chisholm
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Dorit Samocha-Bonet
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Vaughan G. Macefield
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Jerry R. Greenfield
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- Department of Endocrinology and Diabetes Center, St. Vincent's HospitalSydney, NSW, Australia
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Disability, Physical Inactivity, and Impaired Health-Related Quality of Life Are Not Different in Metabolically Healthy vs. Unhealthy Obese Subjects. Nutrients 2016; 8:nu8120759. [PMID: 27897994 PMCID: PMC5188414 DOI: 10.3390/nu8120759] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/06/2016] [Accepted: 11/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity represents a major health hazard, affecting morbidity, psychological status, physical functionality, quality of life, and mortality. The aim of the present study was to explore the differences between metabolically healthy (MHO) and metabolically unhealthy (MUO) obese subjects with regard to physical activity, disability, and health-related quality of life (HR-QoL). METHODS All subjects underwent a multidimensional evaluation, encompassing the assessment of body composition, metabolic biomarkers and inflammation, physical activity level (IPAQ questionnaire), disability (TSD-OC test), and HR-QoL (SF-36 questionnaire). MHO and MUO were defined based on the absence or the presence of the metabolic syndrome, respectively. RESULTS 253 subjects were included (54 men and 199 women; age: 51.7 ± 12.8 vs. 50.3 ± 11.7 years, p = 0.46; BMI: 38.1 ± 5.7 vs. 38.9 ± 6.7 kg/m², p = 0.37). No significant difference was observed in body composition. There was no difference between MHO and MUO considering inflammation (hs-CRP: 6517.1 ± 11,409.9 vs. 5294.1 ± 5612.2 g/L; p = 0.37), physical inactivity (IPAQ score below 3000 METs-min/week in 77.6% of MHO vs. 80% of MUO subjects; p = 0.36), obesity-related disability (TSD-OC score > 33%, indicating a high level of obesity-related disability, in 20.2% of MHO vs. 26.5% of MUO subjects; p = 0.28), and the HR-QoL (SF-36 total score: 60 ± 20.8 vs. 62.8 ± 18.2, p = 0.27). DISCUSSION AND CONCLUSION The metabolic comorbidity and the impairment of functional ability and psycho-social functioning may have a different timing in the natural history of obesity. Alterations in the physical activity level and mobility disabilities may precede the onset of metabolic abnormalities. (Trial registration 2369 prot 166/12-registered 23 February 2012; Amendment 223/14-registered 13 February 2014).
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20
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Metabolic phenotypes of obesity: frequency, correlates and change over time in a cohort of postmenopausal women. Int J Obes (Lond) 2016; 41:170-177. [PMID: 27748744 DOI: 10.1038/ijo.2016.179] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/12/2016] [Accepted: 09/18/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The possibility that a subset of persons who are obese may be metabolically healthy-referred to as the 'metabolically healthy obese' (MHO) phenotype-has attracted attention recently. However, few studies have followed individuals with MHO or other obesity phenotypes over time to assess change in their metabolic profiles. The aim of the present study was to examine transitions over a 6-year period among different states defined simultaneously by body mass index (BMI) and the presence/absence of the metabolic syndrome (MetS). METHODS We used repeated measurements available for a subcohort of participants enrolled in the Women's Health Initiative (N=3512) and followed for an average of 6 years to examine the frequency of different metabolic obesity phenotypes at baseline, the 6-year transition probabilities to other states and predictors of the risk of different transitions. Six phenotypes were defined by cross-tabulating BMI (18.5-<25.0, 25.0-<30.0, ⩾30.0 kg m-2) by MetS (yes, no). A continuous-time Markov model was used to estimate 6-year transition probabilities from one state to another. RESULTS Over the 6 years of follow-up, one-third of women with the healthy obese phenotype transitioned to the metabolically unhealthy obese (MUO) phenotype. Overall, there was a marked tendency toward increased metabolic deterioration with increasing BMI and toward metabolic improvement with lower BMI. Among MHO women, the 6-year probability of becoming MUO was 34%, whereas among unhealthy normal-weight women, the probability of 'regressing' to the metabolically healthy normal-weight phenotype was 52%. CONCLUSIONS The present study demonstrated substantial change in metabolic obesity phenotypes over a 6-year period. There was a marked tendency toward metabolic deterioration with greater BMI and toward metabolic improvement with lower BMI.
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Zhang T, Li Y, Zhang H, Sun D, Li S, Fernandez C, Harville E, Bazzano L, He J, Chen W. Insulin-sensitive adiposity is associated with a relatively lower risk of diabetes than insulin-resistant adiposity: the Bogalusa Heart Study. Endocrine 2016; 54:93-100. [PMID: 27060004 PMCID: PMC7502025 DOI: 10.1007/s12020-016-0948-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/30/2016] [Indexed: 11/30/2022]
Abstract
Obesity and insulin resistance are both closely associated with type 2 diabetes mellitus (T2DM). It is, however, not clear whether the role of obesity in the development of T2DM is dependent on insulin resistance. This study aims to assess the hypothesis that insulin-sensitive adiposity is associated with a relatively lower risk of T2DM than insulin-resistant adiposity, and the adiposity-T2DM association is modified by insulin resistance in middle-aged black and white adults. The longitudinal study cohort consisted of 1588 middle-aged normoglycemic black and white adults aged 18-44 years at baseline who were followed for 16 years on average. Overweight/obesity at baseline was defined as BMI ≥25, and insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA). The prevalence of incident pre-diabetes and T2DM was compared between the insulin-sensitive and insulin-resistant adiposity groups. The prevalence of both incident pre-diabetes and T2DM was higher in the insulin-resistant adiposity than in the insulin-sensitive adiposity group (11.5 vs. 7.5 %, p = 0.023 for pre-diabetes; 16.7 vs. 2.7 %, p < 0.001 for T2DM). In multivariable logistic analyses, adjusted for baseline age, race, sex, follow-up years, and smoking, baseline insulin-resistant obesity was associated with incident pre-diabetes (odds ratio, OR = 2.07, p = 0.046) and T2DM (OR = 8.19, p < 0.001). ORs did not differ between blacks and whites. The ORs for the association of BMI with pre-diabetes and T2DM significantly increased across increasing quartiles of baseline HOMA (p for trend = 0.032 for pre-diabetes and <0.001 for T2DM). Slopes of increasing follow-up glucose with baseline BMI, measured as regression coefficients (β), were significantly greater in insulin-resistant than in insulin-sensitive individuals (β = 0.86 vs. 0.38, p = 0.009 for difference in slopes). These findings suggest that insulin resistance amplifies the obesity-diabetes association and underscore the importance of preventing both adiposity and insulin resistance in young adults.
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Affiliation(s)
- Tao Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Ying Li
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Huijie Zhang
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
- Department of Endocrinology and Metabolism, The First Hospital of Xiamen, Xiamen University, Xiamen, China
| | - Dianjianyi Sun
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Shengxu Li
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Camilo Fernandez
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Emily Harville
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Jiang He
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University Health Sciences Center, Tulane University, 1440 Canal Street, Room 1504G, New Orleans, LA, 70112, USA.
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22
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Kaur A, Johnston DG, Godsland IF. Does metabolic health in overweight and obesity persist? - Individual variation and cardiovascular mortality over two decades. Eur J Endocrinol 2016; 175:133-43. [PMID: 27412654 DOI: 10.1530/eje-16-0095] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/26/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Overweight and obese individuals may be metabolically healthy, but attention needs to be given to long-term persistence of this trait and any associated variation in cardiovascular risk. DESIGN Cross-sectional and longitudinal variation in metabolic health and associated cardiovascular mortality were analysed in 1099 white European-origin normal-weight and overweight or obese males followed for 20years. METHODS Definitions of metabolic health were based on LDL and HDL cholesterol, triglycerides, blood pressure, fasting glucose and cardiovascular risk. Insulin resistance (e.g. HOMA-IR) and sub-clinical inflammation (ESR and white blood cell count) were explored. Cardiovascular mortality risks and persistence of metabolic health status were evaluated. RESULTS There were 87 cardiovascular deaths. Insulin resistance was increased in metabolically healthy overweight or obese participants (median HOMA-IR 2.63, 95% CI: 1.79-3.65, P<0.001) relative to normal-weight participants (median HOMA-IR 1.67, 95% CI: 1.08-2.67, P<0.001) as was sub-clinical inflammation but metabolically healthy overweight or obese individuals were not at increased risk of cardiovascular mortality compared with the metabolically healthy normal-weight individuals (hazard ratio 1.13, 95% CI: 0.34-3.72, P=0.8). The proportions of initially metabolically healthy overweight or obese who remained metabolically healthy for visits 2, 3 and 4 were 54, 48 and 39% respectively, and for initially normal-weight individuals, 68, 51 and 41%. A lower proportion of metabolically healthy overweight or obese individuals remained metabolically healthy at visit 2 compared with normal-weight individuals (P=0.007), but proportions converged thereafter. CONCLUSIONS Despite being insulin resistant and having greater sub-clinical inflammation, and despite instability in metabolic health status, metabolically healthy overweight or obese individuals were at no greater risk of cardiovascular mortality than their normal-weight equivalents.
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Affiliation(s)
- Akaal Kaur
- Diabetes Endocrinology and Metabolic MedicineFaculty of Medicine, Imperial College London, St Mary's Campus,UK
| | - Desmond G Johnston
- Diabetes Endocrinology and Metabolic MedicineFaculty of Medicine, Imperial College London, St Mary's Campus,UK
| | - Ian F Godsland
- Diabetes Endocrinology and Metabolic MedicineFaculty of Medicine, Imperial College London, St Mary's Campus,UK
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23
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Bala C, Craciun AE, Hancu N. UPDATING THE CONCEPT OF METABOLICALLY HEALTHY OBESITY. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2016; 12:197-205. [PMID: 31149087 PMCID: PMC6535297 DOI: 10.4183/aeb.2016.197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Obesity is a well-recognized risk factor for type 2 diabetes, cardiovascular disease, and several types of cancer. However, a proportion of the obese individuals display a significantly lower risk for metabolic complications than expected for their degree of body mass index, and this subtype of obesity was described as "metabolically healthy obesity" (MHO). No universally accepted criteria for the diagnosis of MHO exists and the prevalence of this subtype of obesity varies largely according to criteria used. Broadly, MHO is characterized by a lower amount of visceral fat, a more favorable inflammatory profile, and less insulin resistance as compared to the metabolically unhealthy obesity. Currently, controversies exist regarding the risk of cardiovascular events and all-cause mortality associated with MHO as compared to metabolically-healthy non-obese individuals. Further research is needed in order to identify the MHO phenotype and if MHO is truly healthy for a long period of time or if it is a transient state from normal metabolic/normal weight to abnormal metabolic/obese state. This review will discuss the MHO definition criteria; the differences between MHO and metabolically unhealthy obesity; the possible underlying mechanisms and clinical implications of MHO.
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Affiliation(s)
| | - A-E. Craciun
- “Iuliu Haţieganu” University of Medicine and Pharmacy, Dept. of Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania
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24
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Ferrer R, Pardina E, Rossell J, Oller L, Viñas A, Baena-Fustegueras JA, Lecube A, Vargas V, Balibrea JM, Caubet E, González O, Vilallonga R, Fort JM, Peinado-Onsurbe J. Morbidly "Healthy" Obese Are Not Metabolically Healthy but Less Metabolically Imbalanced Than Those with Type 2 Diabetes or Dyslipidemia. Obes Surg 2016; 25:1380-91. [PMID: 25515498 DOI: 10.1007/s11695-014-1528-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND We have investigated the differences between metabolically "healthy" morbidly obese patients and those with comorbidities. MATERIALS AND METHODS Thirty-two morbidly obese patients were divided by the absence ("healthy": DM-DL-) or presence of comorbidities (dyslipidemic: DM-DL+, or dyslipidemic and with type 2 diabetes: DM+DL+). We have studied various plasma parameters and gene expression adipose tissue, before and after gastric bypass. RESULTS The group DM+DL+ tends to have lower values than the other two groups for anthropometric parameters. Regarding the satiety parameters, only leptin (p = 0.0024) showed a significant increase with comorbidities. Lipid parameters showed significant differences among groups, except for phospholipids and NEFA. For insulin resistance parameters, only glucose (p < 0.0001) was higher in DM+DL+ patients, but not insulin or homeostasis model assessment of insulin resistance (HOMA-IR). The gene expression of adiponectin, insulin receptor (INSR) and glucose receptor-4 (GLUT4), in the subcutaneous fat, decreased in all groups vs. a non-obese control. Interleukin-6 (IL6) and the inhibitor of plasminogen activator type 1 (PAI-1) genes decreased only in DM-DL+ and DM+DL+, but not in "healthy" patients. Leptin increased in all groups vs. the non-obese control. The visceral fat from DM+DL+ patients showed a sharp decrease in adiponectin, GLUT4, IL6 and PAI-1. All parameters mentioned above improved very significantly by surgery, independent of the occurrence of comorbidities. CONCLUSIONS The morbidly obese "healthy" individual is not really metabolically healthy, but morbidly obese individuals with diabetes and dyslipidemia are more metabolically imbalanced.
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Affiliation(s)
- Roser Ferrer
- Biochemistry Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Barcelona, Spain
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25
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Dankel SJ, Loenneke JP, Loprinzi PD. Mild Depressive Symptoms Among Americans in Relation to Physical Activity, Current Overweight/Obesity, and Self-Reported History of Overweight/Obesity. Int J Behav Med 2016; 23:553-60. [DOI: 10.1007/s12529-016-9541-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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26
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Choe SS, Huh JY, Hwang IJ, Kim JI, Kim JB. Adipose Tissue Remodeling: Its Role in Energy Metabolism and Metabolic Disorders. Front Endocrinol (Lausanne) 2016; 7:30. [PMID: 27148161 PMCID: PMC4829583 DOI: 10.3389/fendo.2016.00030] [Citation(s) in RCA: 672] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 03/31/2016] [Indexed: 12/12/2022] Open
Abstract
The adipose tissue is a central metabolic organ in the regulation of whole-body energy homeostasis. The white adipose tissue functions as a key energy reservoir for other organs, whereas the brown adipose tissue accumulates lipids for cold-induced adaptive thermogenesis. Adipose tissues secrete various hormones, cytokines, and metabolites (termed as adipokines) that control systemic energy balance by regulating appetitive signals from the central nerve system as well as metabolic activity in peripheral tissues. In response to changes in the nutritional status, the adipose tissue undergoes dynamic remodeling, including quantitative and qualitative alterations in adipose tissue-resident cells. A growing body of evidence indicates that adipose tissue remodeling in obesity is closely associated with adipose tissue function. Changes in the number and size of the adipocytes affect the microenvironment of expanded fat tissues, accompanied by alterations in adipokine secretion, adipocyte death, local hypoxia, and fatty acid fluxes. Concurrently, stromal vascular cells in the adipose tissue, including immune cells, are involved in numerous adaptive processes, such as dead adipocyte clearance, adipogenesis, and angiogenesis, all of which are dysregulated in obese adipose tissue remodeling. Chronic overnutrition triggers uncontrolled inflammatory responses, leading to systemic low-grade inflammation and metabolic disorders, such as insulin resistance. This review will discuss current mechanistic understandings of adipose tissue remodeling processes in adaptive energy homeostasis and pathological remodeling of adipose tissue in connection with immune response.
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Affiliation(s)
- Sung Sik Choe
- Department of Biological Sciences, National Creative Research Initiatives Center for Adipose Tissue Remodeling, Institute of Molecular Biology and Genetics, Seoul National University, Seoul, South Korea
| | - Jin Young Huh
- Department of Biological Sciences, National Creative Research Initiatives Center for Adipose Tissue Remodeling, Institute of Molecular Biology and Genetics, Seoul National University, Seoul, South Korea
| | - In Jae Hwang
- Department of Biological Sciences, National Creative Research Initiatives Center for Adipose Tissue Remodeling, Institute of Molecular Biology and Genetics, Seoul National University, Seoul, South Korea
| | - Jong In Kim
- Department of Biological Sciences, National Creative Research Initiatives Center for Adipose Tissue Remodeling, Institute of Molecular Biology and Genetics, Seoul National University, Seoul, South Korea
| | - Jae Bum Kim
- Department of Biological Sciences, National Creative Research Initiatives Center for Adipose Tissue Remodeling, Institute of Molecular Biology and Genetics, Seoul National University, Seoul, South Korea
- *Correspondence: Jae Bum Kim,
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27
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Zhang T, Zhang H, Li S, Li Y, Liu Y, Fernandez C, Harville E, Bazzano L, He J, Chen W. Impact of Adiposity on Incident Hypertension Is Modified by Insulin Resistance in Adults: Longitudinal Observation From the Bogalusa Heart Study. Hypertension 2015; 67:56-62. [PMID: 26573703 DOI: 10.1161/hypertensionaha.115.06509] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/21/2015] [Indexed: 01/29/2023]
Abstract
Adiposity and insulin resistance are closely associated with hypertension. This study aims to investigate whether the association between adiposity and hypertension is modified by insulin resistance. The cohort consisted of 1624 middle-aged normotensive black and white adults aged 18 to 43 years at baseline who followed for 16 years on average. Overweight/obesity at baseline was defined as body mass index (BMI) ≥25, and insulin resistance was measured using homeostasis model assessment of insulin resistance. Prevalence of incident hypertension was compared between the insulin-sensitive adiposity and insulin-resistant adiposity groups. The prevalence of incident hypertension was higher in the insulin-resistant adiposity than in the insulin-sensitive adiposity group (32.1% versus 22.1%, P<0.001). In multivariable logistic analyses, adjusted for baseline age, race, sex, follow-up years, and smoking, baseline insulin-resistant obesity was associated with incident hypertension (odds ratio, 1.9; P=0.008). Odds ratios did not differ between blacks and whites (P=0.238). Of note, the odds ratios of BMI associated with hypertension significantly increased with increasing quartiles of baseline homeostasis model assessment (odds ratio, 1.3, 1.1, 1.5, and 2.5 in quartiles I, II, III, and IV, respectively; P=0.006 for trend). Slopes of increasing follow-up blood pressure with baseline BMI, measured as regression coefficients (β), were significantly greater in insulin-resistant than in insulin-sensitive individuals (β=0.74 versus β=0.35 for systolic blood pressure, P=0.004 for difference; β=0.51 versus β=0.23 for diastolic blood pressure, P=0.001 for difference). These findings suggest that insulin resistance has a synergistic effect on the obesity-hypertension association in young adults, indicating that the role of adiposity in the development of hypertension is modified by insulin resistance.
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Affiliation(s)
- Tao Zhang
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Huijie Zhang
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Shengxu Li
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Ying Li
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Yaozhong Liu
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Camilo Fernandez
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Emily Harville
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Lydia Bazzano
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Jiang He
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li)
| | - Wei Chen
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z.); Departments of Epidemiology (T.Z., H.Z., S.L., C.F., E.H., L.B., J.H., W.C.) and Biostatistics and Bioinformatics (Y. Liu), Tulane University Health Sciences Center, Tulane University, New Orleans, LA; Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China (Y. Li).
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Schmiegelow MD, Hedlin H, Mackey RH, Martin LW, Vitolins MZ, Stefanick ML, Perez MV, Allison M, Hlatky MA. Race and ethnicity, obesity, metabolic health, and risk of cardiovascular disease in postmenopausal women. J Am Heart Assoc 2015; 4:JAHA.114.001695. [PMID: 25994446 PMCID: PMC4599406 DOI: 10.1161/jaha.114.001695] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. Methods and Results We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow-up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity. Conclusions Metabolic abnormalities appeared to convey more cardiovascular risk among black women.
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Affiliation(s)
- Michelle D Schmiegelow
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (M.D.S., M.A.H.) Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.D.S.)
| | - Haley Hedlin
- Department of Medicine, Stanford University School of Medicine, Stanford, CA (H.H., M.L.S., M.V.P., M.A.H.)
| | - Rachel H Mackey
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (R.H.M.)
| | - Lisa W Martin
- Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, DC (L.W.M.)
| | - Mara Z Vitolins
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC (M.Z.V.)
| | - Marcia L Stefanick
- Department of Medicine, Stanford University School of Medicine, Stanford, CA (H.H., M.L.S., M.V.P., M.A.H.)
| | - Marco V Perez
- Department of Medicine, Stanford University School of Medicine, Stanford, CA (H.H., M.L.S., M.V.P., M.A.H.)
| | - Matthew Allison
- Department of Family and Preventive Medicine, University of California, San Diego, CA (M.A.)
| | - Mark A Hlatky
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (M.D.S., M.A.H.) Department of Medicine, Stanford University School of Medicine, Stanford, CA (H.H., M.L.S., M.V.P., M.A.H.)
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29
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Lubrano C, Valacchi G, Specchia P, Gnessi L, Rubanenko EP, Shuginina EA, Trukhanov AI, Korkina LG, De Luca C. Integrated Haematological Profiles of Redox Status, Lipid, and Inflammatory Protein Biomarkers in Benign Obesity and Unhealthy Obesity with Metabolic Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:490613. [PMID: 26090072 PMCID: PMC4451994 DOI: 10.1155/2015/490613] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/11/2015] [Accepted: 04/20/2015] [Indexed: 12/24/2022]
Abstract
The pathogenesis of obesity (OB) and metabolic syndrome (MetS) implies free radical-, oxidized lipid- (LOOH-), and inflammatory cytokine-mediated altered pathways in target organs. Key elements of the transition from benign OB to unhealthy OB+MetS remain unclear. Here, we measured a panel of redox, antioxidant, and inflammation markers in the groups of OB patients (67 with, 45 without MetS) and 90 controls. Both OB groups displayed elevated levels of adipokines and heavy oxidative stress (OS) evidenced by reduced levels of glutathione, downregulated glutathione-S-transferase, increased 4-hydroxynonenal-protein adducts, reactive oxygen species, and membrane-bound monounsaturated fatty acids (MUFA). Exclusively in OB+MetS, higher-than-normal glutathione peroxidase activity, tumor necrosis factor-α, and other proinflammatory cytokines/chemokines/growth factors were observed; a combination of high adipokine plasminogen activator inhibitor-1 and MUFA was consistent with increased cardiovascular risk. The uncomplicated OB group showed features of adaptation to OS such as decreased levels of vitamin E, activated superoxide dismutase, and inhibited catalase, suggesting H2O2 hyperproduction. Proinflammatory cytokine pattern was normal, except few markers like RANTES, a suitable candidate for therapeutic approaches to prevent a setting of MetS by inhibition of LOOH-primed leukocyte chemotaxis/recruitment to target tissues.
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Affiliation(s)
- Carla Lubrano
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Giuseppe Valacchi
- Department of Life Sciences and Biotechnology, University of Ferrara, Via Luigi Borsari 46, 44100 Ferrara, Italy
- Department of Food and Nutrition, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Republic of Korea
| | - Palma Specchia
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Elizaveta P. Rubanenko
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Elena A. Shuginina
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Arseny I. Trukhanov
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Liudmila G. Korkina
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
- Centre of Innovative Biotechnological Investigations (Cibi-NanoLab), 197 Vernadskogo Prospekt, Moscow 119571, Russia
| | - Chiara De Luca
- Centre of Innovative Biotechnological Investigations (Cibi-NanoLab), 197 Vernadskogo Prospekt, Moscow 119571, Russia
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30
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Heianza Y, Kato K, Kodama S, Ohara N, Suzuki A, Tanaka S, Hanyu O, Sato K, Sone H. Risk of the development of Type 2 diabetes in relation to overall obesity, abdominal obesity and the clustering of metabolic abnormalities in Japanese individuals: does metabolically healthy overweight really exist? The Niigata Wellness Study. Diabet Med 2015; 32:665-72. [PMID: 25438871 DOI: 10.1111/dme.12646] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/26/2022]
Abstract
AIMS We investigated the risk of developing diabetes across various metabolic phenotypes by considering the presence of overall adiposity or abdominal adiposity and the number of metabolic abnormalities and aimed to clarify whether a 'healthy overweight' phenotype, that is, overweight with no metabolic abnormalities, was protective of the development of diabetes. METHODS We studied 29 564 Japanese individuals without diabetes. The 5-year incidence of diabetes was assessed according to a combination of either overweight (BMI ≥ 25.0 kg/m(2) ) or abdominal obesity (waist circumference ≥ 90 cm in men and ≥ 80 cm in women) and the number of metabolic factors present (hypertension, elevated triglyceride concentration, low HDL cholesterol concentration and impaired fasting glucose). RESULTS A total of 1188 individuals developed diabetes. Compared with normal weight individuals with none of the four metabolic abnormalities, in overweight individuals with none of the four abnormalities there was an odds ratio (OR) of 2.32 [95% confidence interval (CI) 1.50, 3.59] for diabetes; having any one metabolic abnormality increased the risk of developing diabetes among normal weight individuals [OR 3.23 (2.55, 4.10)] and overweight individuals [OR 5.00 (3.77, 6.63)]. Among overweight individuals, the presence of impaired fasting glucose alone substantially elevated the risk of diabetes by 8.98-fold (5.52, 14.6) in comparison with the absence of the four metabolic factors. CONCLUSIONS Being 'healthy overweight' was associated with a higher OR of developing future diabetes among Japanese individuals than normal weight individuals with no metabolic abnormalities, and being overweight with one or more abnormalities had a further elevated OR compared with 'healthy overweight' people.
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Affiliation(s)
- Y Heianza
- Department of Internal Medicine, Niigata University, Niigata, Japan
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Luo D, Liu F, Li X, Yin D, Lin Z, Liu H, Hou X, Wang C, Jia W. Comparison of the effect of 'metabolically healthy but obese' and 'metabolically abnormal but not obese' phenotypes on development of diabetes and cardiovascular disease in Chinese. Endocrine 2015; 49:130-8. [PMID: 25312689 DOI: 10.1007/s12020-014-0444-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/01/2014] [Indexed: 01/01/2023]
Abstract
The present study was designed to determine the prevalence of 'metabolically healthy but obese' (MHO) and 'metabolically abnormal but not obese' (MANO) phenotypes in Chinese population, and to investigate the association of these two phenotypes with the risk of diabetes and cardiovascular disease (CVD). A total of 2,764 subjects aged 30-90 were followed up over a mean period of 43.80 ± 11.25 months. The metabolic syndrome was defined according to the joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults. Subjects with body fat percentage (BF %) >25 % for men or BF % >35 % for women were defined as being obese. The proportion of MHO and MANO phenotypes were 22.9, 7.6 % in men, and 26.2, 6.0 % in women, respectively. The MANO phenotype was associated with increased risk for diabetes both in men [hazard ratios (HR): 4.44 (1.21-16.26)] and women [HR: 8.68 (2.87-24.96)] after adjustment of age, serum total cholesterol (TC), triglycerides (TG), and family history of diabetes. This association held for CVD in women [HR: 2.87 (1.44-5.73)], but not in men after adjustment of age, serum TC, TG, and family history of CVD. No association was observed between the MHO phenotype and incident diabetes or CVD. MHO and MANO phenotypes are common in Chinese population. Metabolic risk factors appeared to play a more important role in the development of diabetes and CVD than body fat alone.
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Affiliation(s)
- Deng Luo
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, People's Republic of China
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Shargorodsky M. Vascular Impact of Metabolic Syndrome in Subjects with Normal Weight, Overweight, or Obesity: Is Normal Weight Sufficient for Vascular Health? J Am Coll Nutr 2015; 34:515-20. [PMID: 25910192 DOI: 10.1080/07315724.2014.996829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Obesity appears to be one of the major risk factors for metabolic complications. However, no direct relationship between body weight and metabolic abnormalities exists. The present study was designed to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MS) on early vascular atherosclerotic changes, as determined by augmentation index (AI) and pulse wave velocity (PWV). DESIGN AND METHODS The 285 study participants were divided into four groups according to BMI and the presence of MS. Subjects without MS were defined as metabolically normal, while subjects with MS were defined as metabolically obese. Group 1 included 71 metabolically normal, normal-weight subjects (MNNW), Group 2 included 69 metabolically obese, normal-weight subjects (MONW), Group 3 included 66 metabolically obese, overweight subjects (MOOW), and Group 4 included 79 metabolically obese, obese subjects (MOOB). RESULTS AI and PWV differed significantly between groups, such that they increased from Group 1 to Group 4 in a continuous fashion. AI was significantly lower in normal-weight subjects without MS than in normal-weight subjects with MS (p < 0.001). In univariate general linear model (GLM) analysis, significant by-group differences in AI persisted even after adjustment for age, sex, and blood pressure. CONCLUSIONS AI was significantly higher in normal-weight subjects with MS than in normal-weight metabolically benign individuals. Thus, even in patients with normal weight (BMI ≤ 25), presence of metabolic syndrome was associated with significant deterioration in terms of arterial stiffness.
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Affiliation(s)
- Marina Shargorodsky
- a Department of Endocrinology, Wolfson Medical Center, Holon, and Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , ISRAEL
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Smith E, Bailey PE, Crawford J, Samaras K, Baune BT, Campbell L, Kochan N, Menant J, Sturnieks DL, Brodaty H, Sachdev P, Trollor JN. Adiposity estimated using dual energy X-ray absorptiometry and body mass index and its association with cognition in elderly adults. J Am Geriatr Soc 2015; 62:2311-8. [PMID: 25516027 DOI: 10.1111/jgs.13157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine whether obesity, estimated according to body mass index (BMI), waist circumference, and body fat and abdominal fat assessed using dual-energy X-ray absorptiometry (DEXA), was associated with cognitive performance. DESIGN Cross-sectional. SETTING Community based. PARTICIPANTS Individuals aged 74-94 (N = 406). MEASUREMENTS BMI, waist circumference, body fat, and abdominal fat were assessed using DEXA. Cognitive performance was assessed using a comprehensive neuropsychological battery. RESULTS When categorized using BMI, overweight individuals had higher global cognitive function and executive function scores than normal-weight individuals. This relationship did not differ according to sex. When categorized according to DEXA, there were no relationships between body fat and cognitive function in the whole group, but women in the middle and highest tertiles of DEXA body fat had better executive function than those in the lowest tertile. Men in the middle tertile of DEXA body fat had significantly better executive function and memory than those in the lowest tertile. BMI had greater power to predict executive function than DEXA body fat. No significant associations were found between cognition and estimates of abdominal adiposity. CONCLUSION This study found an association between being overweight and better executive function in elderly adults; this association was stronger for the simpler BMI than the more-elaborate DEXA measures.
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Affiliation(s)
- Evelyn Smith
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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Teixeira TFS, Alves RDM, Moreira APB, Peluzio MDCG. Main characteristics of metabolically obese normal weight and metabolically healthy obese phenotypes. Nutr Rev 2015; 73:175-90. [PMID: 26024540 DOI: 10.1093/nutrit/nuu007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In this review, the influence of fat depots on insulin resistance and the main characteristics of metabolically obese normal-weight and metabolically healthy obese phenotypes are discussed. Medline/PubMed and Science Direct were searched for articles related to the terms metabolically healthy obesity, metabolically obese normal weight, adipose tissue, and insulin resistance. Normal weight and obesity might be heterogeneous in regard to their effects. Fat distribution and lower insulin sensitivity are the main factors defining phenotypes within the same body mass index. Although these terms are interesting, controversies about them remain. Future studies exploring these phenotypes will help elucidate the roles of adiposity and/or insulin resistance in the development of metabolic alterations.
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Affiliation(s)
- Tatiana F S Teixeira
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil.
| | - Raquel D M Alves
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Ana Paula B Moreira
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Maria do Carmo G Peluzio
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
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Hashimoto Y, Tanaka M, Okada H, Senmaru T, Hamaguchi M, Asano M, Yamazaki M, Oda Y, Hasegawa G, Toda H, Nakamura N, Fukui M. Metabolically healthy obesity and risk of incident CKD. Clin J Am Soc Nephrol 2015; 10:578-83. [PMID: 25635035 DOI: 10.2215/cjn.08980914] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/06/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Metabolically healthy obesity (MHO) is a unique obesity phenotype that apparently protects people from the metabolic complications of obesity. The association between MHO phenotype and incident CKD is unclear. Thus, this study investigated the association between MHO phenotype and incident CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A total of 3136 Japanese participants were enrolled in an 8-year follow-up cohort study in 2001. Metabolically healthy status was assessed by common clinical markers: BP, triglycerides, HDL cholesterol, and fasting plasma glucose concentrations. Body mass index ≥25.0 kg/m(2) was defined as obesity. CKD was defined by proteinuria or eGFR of <60 ml/min per 1.73 m(2). To calculate the odds ratio for incident CKD, logistic regression analyses were performed. RESULTS The crude incidence proportions of CKD were 2.6% (56 of 2122 participants) in participants with the metabolically healthy nonobesity phenotype, 2.6% (8 of 302) in those with the MHO phenotype, 6.7% (30 of 445) in those with the metabolically abnormal nonobesity phenotype, and 10.9% (29 of 267) in those with the metabolically abnormal obesity phenotype. Compared with metabolically healthy nonobesity phenotype, the odds ratios for incident CKD were 0.83 (95% confidence interval [95% CI], 0.36 to 1.72; P=0.64) for MHO, 1.44 (95% CI, 0.80 to 2.57; P=0.22) for metabolically abnormal nonobesity, and 2.80 (95% CI, 1.45 to 5.35; P=0.02) for metabolically abnormal obesity phenotype after adjustment for confounders, including age, sex, smoking statues, alcohol use, creatinine, uric acid, systolic BP, HDL cholesterol, and impaired fasting glucose or diabetes. CONCLUSION MHO phenotype was not associated with higher risk of incident CKD.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hiroshi Okada
- Division of Metabolism, Nephrology and Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan; and
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yohei Oda
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Goji Hasegawa
- Division of Metabolism, Nephrology and Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan; and
| | - Hitoshi Toda
- Department of Internal Medicine, Oike Clinic, Kyoto, Japan
| | - Naoto Nakamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan;
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Abstract
Obesity and its comorbidities are closely related to the inflammatory environment created by expanded adipose tissue. Several mechanisms trigger inflammation in adipose tissue, including excess fatty acids, hypoxia, and activation of the inflammasome. Inflammation is characterized by the abundance of immune cells, particularly M1 macrophages and T lymphocytes, which have increased secretion of proinflammatory cytokines that act to perpetuate systemic inflammation and induce insulin resistance. The gut microbiota is also involved in obesity-induced inflammation via LPS-related endotoxemia that induces cytokine secretion and insulin resistance. Innate lymphoid type 2 cells, regulatory T cells, and interleukine (IL)-10 counteract the inflammation and insulin resistance, establishing classical or metabolically healthy obesity.
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Affiliation(s)
- Solange S Pereira
- Department Biochemistry and Immunology, Universidade Federal de Minas Gerais, Caixa Postal 486, 30161-970, Belo Horizonte, Brazil
| | - Jacqueline I Alvarez-Leite
- Department Biochemistry and Immunology, Universidade Federal de Minas Gerais, Caixa Postal 486, 30161-970, Belo Horizonte, Brazil.
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Badoud F, Perreault M, Zulyniak MA, Mutch DM. Molecular insights into the role of white adipose tissue in metabolically unhealthy normal weight and metabolically healthy obese individuals. FASEB J 2014; 29:748-58. [PMID: 25411437 DOI: 10.1096/fj.14-263913] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Obesity is a risk factor for the development of type 2 diabetes and cardiovascular disease. However, it is now recognized that a subset of individuals have reduced cardiometabolic risk despite being obese. Paradoxically, a subset of lean individuals is reported to have high risk for cardiometabolic complications. These distinct subgroups of individuals are referred to as metabolically unhealthy normal weight (MUNW) and metabolically healthy obese (MHO). Although the clinical relevance of these subgroups remains debated, evidence shows a critical role for white adipose tissue (WAT) function in the development of these phenotypes. The goal of this review is to provide an overview of our current state of knowledge regarding the molecular and metabolic characteristics of WAT associated with MUNW and MHO. In particular, we discuss the link between different WAT depots, immune cell infiltration, and adipokine production with MUNW and MHO. Furthermore, we also highlight recent molecular insights made with genomic technologies showing that processes such as oxidative phosphorylation, branched-chain amino acid catabolism, and fatty acid β-oxidation differ between these phenotypes. This review provides evidence that WAT function is closely linked with cardiometabolic risk independent of obesity and thus contributes to the development of MUNW and MHO.
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Affiliation(s)
- Flavia Badoud
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Maude Perreault
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Michael A Zulyniak
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Ferrer R, Pardina E, Rossell J, Baena-Fustegueras JA, Lecube A, Balibrea JM, Caubet E, González O, Vilallonga R, Fort JM, Peinado-Onsurbe J. Decreased lipases and fatty acid and glycerol transporter could explain reduced fat in diabetic morbidly obese. Obesity (Silver Spring) 2014; 22:2379-87. [PMID: 25132069 DOI: 10.1002/oby.20861] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/16/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The possible differences were investigated in 32 morbidly obese patients depending on whether they were "healthy" or had dyslipidemia and/or type 2 diabetes. METHODS Lipid metabolism and insulin resistance were analyzed in subcutaneous (SAT) and visceral adipose tissue (VAT) before and during 6 and 12 months after Roux-en-Y gastric bypass. RESULTS Significant differences have been found in lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL) activities in SAT from the different obese group versus normal weight (control) but not between them. The reduced lipase activities in VAT were 43 and 19% smaller (22 and 4% smaller, respectively, vs. control) than the "healthy" obese group for LPL and HSL, respectively, and were accompanied with a reduced expression of these lipases, as well as decreased expression of FAT/CD36, FABP4, and AQ7 in that tissue. In addition, the expression of the other genes measured showed a downregulation not only versus the "healthy" obese but also versus the normal weight group. CONCLUSIONS Being obese is not "healthy," but it is even less so if morbidly obese patients with diabetes and dyslipidemia were considered. The reduced fat accumulation in these patients may be attributed to the decrease of the expression and activity of the lipases of their adipose tissue.
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Affiliation(s)
- Roser Ferrer
- Biochemistry Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
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Heianza Y, Kato K, Kodama S, Suzuki A, Tanaka S, Hanyu O, Sato K, Sone H. Stability and changes in metabolically healthy overweight or obesity and risk of future diabetes: Niigata wellness study. Obesity (Silver Spring) 2014; 22:2420-5. [PMID: 25131796 DOI: 10.1002/oby.20855] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 07/21/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Stability and changes in obesity and metabolic health status from a baseline period and longitudinally investigated their impact on predicting future diabetes were assessed. METHODS Studied were 27,478 Japanese individuals without diabetes. Metabolically healthy (MH) was indicated by having ≤1 among impaired fasting glucose, hypertension, hypertriglyceridemia and low HDL cholesterol concentration. Metabolically abnormal (MA) was indicated by having ≥2 of those metabolic abnormalities. A cut-off value of BMI 25.0 defined overweight or obesity (O) or normal weight (NW). Hazard ratio (HR) for diabetes for a 6-year period was investigated after changes in phenotypes were assessed during the previous 2 years. RESULTS Compared with maintaining MH-NW, transitioning to MH-O from MH-NW resulted in a multivariate-adjusted HR of 1.96 (95% CI: 1.18, 3.25) for diabetes. With a stable MH-O the HR for diabetes was 2.59 (2.00, 3.34) while change from MH-O to MH-NW resulted in an HR of 1.30 (0.61, 2.76). Transitioning to MA-O from MH-O was associated with an HR of 7.09 (5.41, 9.30). With a stable MA-O the risk of diabetes was substantially elevated with an HR of 12.5 (10.5, 14.9). CONCLUSIONS Examining the transitory nature of apparently benign or unhealthy obese phenotypes was effective for differentiating high-risk individuals for future diabetes.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
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Martínez-Larrad MT, Corbatón Anchuelo A, Del Prado N, Ibarra Rueda JM, Gabriel R, Serrano-Ríos M. Profile of individuals who are metabolically healthy obese using different definition criteria. A population-based analysis in the Spanish population. PLoS One 2014; 9:e106641. [PMID: 25198070 PMCID: PMC4157807 DOI: 10.1371/journal.pone.0106641] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 08/06/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Obesity 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. METHODS A 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/m(2). RESULTS The 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. CONCLUSIONS MHO 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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Affiliation(s)
- María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Arturo Corbatón Anchuelo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Náyade Del Prado
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - José María Ibarra Rueda
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Rafael Gabriel
- Clinical Epidemiology Research Unit, Hospital de La Paz, Madrid, Spain
| | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Heianza Y, Arase Y, Tsuji H, Fujihara K, Saito K, Hsieh SD, Tanaka S, Kodama S, Hara S, Sone H. Metabolically healthy obesity, presence or absence of fatty liver, and risk of type 2 diabetes in Japanese individuals: Toranomon Hospital Health Management Center Study 20 (TOPICS 20). J Clin Endocrinol Metab 2014; 99:2952-60. [PMID: 24823457 DOI: 10.1210/jc.2013-4427] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We investigated whether the metabolically healthy obese (MHO) phenotype was associated with an increased risk of the development of diabetes. If so, we aimed to determine what factors could explain this finding. DESIGN, SETTING, AND PARTICIPANTS Studied were 8090 Japanese individuals without diabetes. Metabolic health status was assessed by common clinical markers: blood pressure, triglycerides, high-density lipoprotein-cholesterol, and fasting glucose concentrations. The cutoff value for obesity or normal weight (NW) was a body mass index of 25.0 kg/m(2). RESULTS The 5-year incidence rate of diabetes was 1.2% (n = 58 of 4749) in metabolically healthy NW (MHNW) individuals, 2.8% (n = 20 of 719) in MHO individuals, 6.0% (n = 102 of 1709) in metabolically abnormal NW individuals, and 10.3% (n = 94 of 913) in metabolically abnormal obese individuals. Although MHO individuals had no or one metabolic factor, 47.8% had ultrasonographic fatty liver (FL). The MHO group had a significantly increased risk of diabetes compared with the MHNW group [multivariate adjusted odds ratio (OR) 2.23 (95% confidence interval [CI] 1.33, 3.75)], but this risk was attenuated after adjustment for FL. Compared with the MHNW/non-FL group, the risk of diabetes in the MHO/non-FL group was not significantly elevated [OR 1.01 (95% CI 0.35, 2.88)]. However, the MHO/FL and MHNW/FL groups had similarly elevated risks of diabetes [OR 4.09 (95% CI 2.20, 7.60) and 3.16 (1.78, 5.62), respectively]. CONCLUSIONS Almost half of the MHO participants had FL, which partially explained the increased risk of diabetes among the obese phenotypes. The presence of FL should be evaluated to assess whether an individual was actually in a metabolically benign state for the prediction of diabetes.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951-8510, Japan; Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Okinaka Memorial Institute for Medical Research (Y.A., H.T., S.D.H., S.H.), Toranomon Hospital, Tokyo 105-8470, Japan; Ibaraki Prefectural University of Health Sciences Hospital (K.S.), Ibaraki 300-0394, Japan; and Department of Pharmacoepidemiology (S.T.), Graduate School of Medicine and Public Health, Kyoto University, Kyoto 606-8501, Japan
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Badoud F, Lam KP, DiBattista A, Perreault M, Zulyniak MA, Cattrysse B, Stephenson S, Britz-McKibbin P, Mutch DM. Serum and adipose tissue amino acid homeostasis in the metabolically healthy obese. J Proteome Res 2014; 13:3455-66. [PMID: 24933025 DOI: 10.1021/pr500416v] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A subgroup of obese individuals, referred to as metabolically healthy obese (MHO), have preserved insulin sensitivity and a normal lipid profile despite being obese. The molecular basis for this improved cardiometabolic profile remains unclear. Our objective was to integrate metabolite and gene expression profiling to elucidate the molecular distinctions between MHO and metabolically unhealthy obese (MUO) phenotypes. A subset of individuals were selected from the Diabetes Risk Assessment study and classified into three groups using anthropometric and clinical measurements: lean healthy (LH), MHO, and MUO. Serum metabolites were profiled using gas chromatography coupled to mass spectrometry. Multivariate data analysis uncovered metabolites that differed between groups, and these were subsequently validated by capillary electrophoresis coupled to mass spectrometry. Subcutaneous adipose tissue (SAT) gene expression profiling using microarrays was performed in parallel. Amino acids were the most relevant class of metabolites distinguishing MHO from MUO individuals. Serum levels of glutamic acid, valine, and isoleucine were positively associated (i.e., LH < MHO < MUO) with homeostasis model assessment-insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) values, while leucine was only correlated with HOMA-IR. The glutamine-to-glutamic acid ratio and glycine were inversely correlated (i.e., LH > MHO > MUO) with HbA1c values. Concomitantly, SAT gene expression profiling revealed that genes related to branched-chain amino acid catabolism and the tricarboxylic acid cycle were less down-regulated in MHO individuals compared to MUO individuals. Together, this integrated analysis revealed that MHO individuals have an intermediate amino acid homeostasis compared to LH and MUO individuals.
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Affiliation(s)
- Flavia Badoud
- Department of Human Health and Nutritional Sciences, University of Guelph , Guelph N1G 2W1, ON, Canada
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Fontana L, Hu FB. Optimal body weight for health and longevity: bridging basic, clinical, and population research. Aging Cell 2014; 13:391-400. [PMID: 24628815 PMCID: PMC4032609 DOI: 10.1111/acel.12207] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 12/11/2022] Open
Abstract
Excess body weight and adiposity cause insulin resistance, inflammation, and numerous other alterations in metabolic and hormonal factors that promote atherosclerosis, tumorigenesis, neurodegeneration, and aging. Studies in both animals and humans have demonstrated a beneficial role of dietary restriction and leanness in promoting health and longevity. Epidemiological studies have found strong direct associations between increasing body mass index (BMI) and risks of developing type 2 diabetes, cardiovascular disease, and several types of cancer, beginning from BMI of 20–21 kg m−2. Although a recent meta-analysis suggests that overweight individuals have significantly lower overall mortality than normal-weight individuals, these data are likely to be an artifact produced by serious methodological problems, especially confounding by smoking, reverse causation due to existing chronic disease, and nonspecific loss of lean mass and function in the frail elderly. From a clinical and public health point of view, maintaining a healthy weight through diet and physical activity should remain the cornerstone in the prevention of chronic diseases and the promotion of healthy aging.
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Affiliation(s)
- Luigi Fontana
- Division of Geriatrics and Nutritional Science Washington University St.Louis MO USA
- Department of Clinical and Experimental Sciences Brescia University Medical School Brescia Italy
- CEINGE Biotecnologie Avanzate Napoli Italy
| | - Frank B. Hu
- Departments of Nutrition and Epidemiology Harvard School of Public Health Boston MA USA
- Channing Laboratory Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA
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Green AK, Jacques PF, Rogers G, Fox CS, Meigs JB, McKeown NM. Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham Heart Study. Obesity (Silver Spring) 2014; 22:E157-63. [PMID: 24550031 PMCID: PMC4139414 DOI: 10.1002/oby.20724] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 02/06/2014] [Accepted: 02/14/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship between usual sugar-sweetened beverage (SSB) consumption and prevalence of abnormal metabolic health across body mass index (BMI) categories. METHODS The metabolic health of 6,842 non-diabetic adults was classified using cross-sectional data from the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. Adults were classified as normal weight, overweight or obese and, within these categories, metabolic health was defined based on five criteria-hypertension, elevated fasting glucose, elevated triglycerides, low HDL cholesterol, and insulin resistance. Individuals without metabolic abnormalities were considered metabolically healthy. Logistic regression was used to examine the associations between categories of SSB consumption and risk of metabolic health after stratification by BMI. RESULTS Comparing the highest category of SSB consumers (median of 7 SSB per week) to the lowest category (non-consumers), odds ratios (95% confidence intervals) for metabolically abnormal phenotypes, compared to the metabolically normal, were 1.9 (1.1-3.4) among the obese, 2.0 (1.4-2.9) among the overweight, and 1.9 (1.4-2.6) among the normal weight individuals. CONCLUSIONS In this cross-sectional analysis, it is observed that, irrespective of weight status, consumers of SSB were more likely to display metabolic abnormalities compared to non-consumers in a dose-dependent manner.
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Affiliation(s)
| | - Paul F. Jacques
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts
University, Boston, MA
| | - Gail Rogers
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
| | - Caroline S. Fox
- National Heart, Lung and Blood Institute’s Framingham
Heart Study, Framingham, MA, and the Division of Endocrinology, Metabolism and Diabetes,
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,
Boston, MA
| | - James B. Meigs
- General Medicine Division, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School, Boston, MA
| | - Nicola M. McKeown
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts
University, Boston, MA
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Ferrer R, Pardina E, Rossell J, Baena-Fustegueras JA, Lecube A, Balibrea JM, Caubet E, González O, Vilallonga R, Fort JM, Peinado-Onsurbe J. Haematological parameters and serum trace elements in "healthy" and "unhealthy" morbidly obese patients before and after gastric bypass. Clin Nutr 2014; 34:276-83. [PMID: 24792189 DOI: 10.1016/j.clnu.2014.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/04/2014] [Accepted: 04/06/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND & AIMS We have investigated the differences in plasma parameters and serum trace elements between "healthy" and unhealthy morbidly obese patients before and after Roux-en-Y gastric bypass surgery. METHODS A group of 32 morbidly obese patients undergoing bariatric surgery were divided into three groups. Group 1 subjects were free of dyslipidemia and type II diabetes mellitus (defined as "healthy" obese, DM-DL-); Group 2 subjects had only the presence of dyslipidemia (DM-DL+), while group 3 patients demonstrated the presence of both (DM + DL+). In all patients, we studied haematological, haemostasis, anaemia, coagulation plasma and trace elements parameters before and 1, 6 and 12 months after gastric bypass surgery. RESULTS We found significant differences in some haematological parameters, including haemostasis (e.g., T-Quick, p = 0.0048) and coagulation (e.g., ATIII and PAI-1, p = 0.001 and p < 0.0001, respectively) and in anaemia parameters (e.g., folate, cobalamin and transferrin, p = 0.0002, p < 0.0001 and p = 0.0001, respectively) but also in serum trace elements between the groups. However, the response to bariatric surgery was similar in the three groups. CONCLUSION Any healthy morbid obese subject is really metabolically "unhealthy" because he or she has many other haematologic or serum abnormalities that are often not included in the criteria for the definition of "healthy" in these obese subjects.
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Affiliation(s)
- Roser Ferrer
- Biochemistry Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Eva Pardina
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Diagonal 643, 08028 Barcelona, Spain
| | - Joana Rossell
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Diagonal 643, 08028 Barcelona, Spain
| | | | - Albert Lecube
- Endocrinology and Nutrition Department at Arnau de Vilanova University Hospital (UdL) and Diabetes and Metabolism Research Unit (VHIR, UAB) and CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM) at the Instituto de Salud Carlos III, Spain
| | - José María Balibrea
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Enric Caubet
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Oscar González
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Ramón Vilallonga
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Jose Manuel Fort
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Spain
| | - Julia Peinado-Onsurbe
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Diagonal 643, 08028 Barcelona, Spain.
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van Vliet-Ostaptchouk JV, Nuotio ML, Slagter SN, Doiron D, Fischer K, Foco L, Gaye A, Gögele M, Heier M, Hiekkalinna T, Joensuu A, Newby C, Pang C, Partinen E, Reischl E, Schwienbacher C, Tammesoo ML, Swertz MA, Burton P, Ferretti V, Fortier I, Giepmans L, Harris JR, Hillege HL, Holmen J, Jula A, Kootstra-Ros JE, Kvaløy K, Holmen TL, Männistö S, Metspalu A, Midthjell K, Murtagh MJ, Peters A, Pramstaller PP, Saaristo T, Salomaa V, Stolk RP, Uusitupa M, van der Harst P, van der Klauw MM, Waldenberger M, Perola M, Wolffenbuttel BHR. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocr Disord 2014; 14:9. [PMID: 24484869 PMCID: PMC3923238 DOI: 10.1186/1472-6823-14-9] [Citation(s) in RCA: 372] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 01/27/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies. METHODS Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease. RESULTS Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes. CONCLUSIONS Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.
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Affiliation(s)
- Jana V van Vliet-Ostaptchouk
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
| | - Marja-Liisa Nuotio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Sandra N Slagter
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
| | - Dany Doiron
- Research Institute of the McGill University of Health Centre, Montreal, Canada
| | - Krista Fischer
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Luisa Foco
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
| | - Amadou Gaye
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Martin Gögele
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Tero Hiekkalinna
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Anni Joensuu
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Christopher Newby
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Chao Pang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Genomics Coordination Center, University of Groningen, Groningen Bioinformatics Center, and University Medical Center Groningen, Groningen, The Netherlands
| | - Eemil Partinen
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Eva Reischl
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | | | - Morris A Swertz
- Genomics Coordination Center, University of Groningen, Groningen Bioinformatics Center, and University Medical Center Groningen, Groningen, The Netherlands
| | - Paul Burton
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Isabel Fortier
- Research Institute of the McGill University of Health Centre, Montreal, Canada
| | - Lisette Giepmans
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jennifer R Harris
- Department of Genes and Environment, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway
| | - Hans L Hillege
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Antti Jula
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Jenny E Kootstra-Ros
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kirsti Kvaløy
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Satu Männistö
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Kristian Midthjell
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Madeleine J Murtagh
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter P Pramstaller
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
- Department of Neurology, Central Hospital, Bolzano, Italy
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Timo Saaristo
- Pirkanmaa hospital district and Finnish Diabetes Association, Tampere, Finland
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, and Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Markus Perola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Bruce HR Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
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Zhang M, Tong W, Chen J, Zhang Y, Li S. Metabolically healthy obesity and its associates in Mongolian Chinese adults. Metab Syndr Relat Disord 2014; 12:185-90. [PMID: 24460218 DOI: 10.1089/met.2013.0102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Not all obese individuals show cardiometabolic abnormalities. We examined metabolically healthy obesity (MHO) and its associates in 2530 Mongolian Chinese adults. METHODS MHO was defined by waist circumference, low-density lipoprotein (LDL-C) cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose. RESULTS Only 3.0% of the participants had MHO, with 0.8% of men and 4.5% of women having this condition (P < 0.001 for sex difference). Despite striking differences in obesity measures, MHO individuals had a comparable cardiometabolic profile to that for metabolically healthy, nonobese individuals (MHNO) and an improved cardiometabolic profile, i.e., lower levels of blood pressure, glucose, insulin, LDL-C, TGs, and higher levels of HDL-C compared to metabolically abnormal individuals (all P < 0.01, except for insulin). MHO individuals had lower levels of high-sensitivity C-reactive protein and soluble intercellular adhesion molecule-1, compared to metabolically abnormal individuals, and had comparable levels of these markers to those in MHNO individuals. Furthermore, only 5.3% of MHO individuals had a family history of hypertension, comparable to 5.0% in MHNO individuals, and much lower than 15.9% in metabolically abnormal, nonobese individuals and 12.8% in metabolically abnormal, obese individuals (overall P < 0.001). CONCLUSIONS We conclude that MHO is associated with a low inflammation state, and family history of hypertension may play a role in the MHO phenotype.
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Affiliation(s)
- Mingzhi Zhang
- 1 Department of Epidemiology, School of Public Health, Soochow University , Suzhou, Jiangsu, China
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Abstract
BACKGROUND The effects of bariatric surgery (BS) in metabolically healthy morbidly obese (MO) subjects are not well established. Against this background, we characterized the metabolic and inflammatory profiles of MO subjects with insulin sensitivity (IS) in the normal range, and evaluated the changes on these parameters following BS in this population. METHODS We conducted a retrospective analysis of prospectively collected data in MO women undergoing BS between 2006 and 2010. Anthropometric, metabolic comorbidities, and inflammatory markers were compared at baseline and 12 months after BS, between 52 women (10.4%) presenting with a HOMA-IR < 2.94 (80th percentile reference population) (IS-MO group) and an age- and BMI-matched group of women (n = 52) with HOMA-IR > 2.94. RESULTS The IS-MO women presented a more favorable metabolic and inflammatory profile as compared to the IR-MO group. However, an enlarged waist circumference (WC), a high-sensitivity C-reactive protein (hs-CRP) > 3 mg/dL, and metabolic syndrome (MS) were present in 100%, 90%, and 51.9% of the IS-MO group at baseline. At 12 months after surgery, all the MS components and hs-CRP improved in IS-MO subjects (p < 0.01). The prevalence of the MS in the IS-MO group significantly decreased (11%, p < 0.05) despite WC and hs-CRP being abnormal respectively in 53.3% and 20.0% of women in this group. CONCLUSIONS In MO women, an IS in the normal range is associated with a limited protection from metabolic co-morbidities. Nonetheless, BS results in the amelioration of the altered metabolic and inflammatory profiles also in this group of subjects.
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Phillips CM, Dillon C, Harrington JM, McCarthy VJC, Kearney PM, Fitzgerald AP, Perry IJ. Defining metabolically healthy obesity: role of dietary and lifestyle factors. PLoS One 2013; 8:e76188. [PMID: 24146838 PMCID: PMC3798285 DOI: 10.1371/journal.pone.0076188] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/20/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is a current lack of consensus on defining metabolically healthy obesity (MHO). Limited data on dietary and lifestyle factors and MHO exist. The aim of this study is to compare the prevalence, dietary factors and lifestyle behaviours of metabolically healthy and unhealthy obese and non-obese subjects according to different metabolic health criteria. METHOD Cross-sectional sample of 1,008 men and 1,039 women aged 45-74 years participated in the study. Participants were classified as obese (BMI ≥ 30 kg/m(2)) and non-obese (BMI < 30 kg/m(2)). Metabolic health status was defined using five existing MH definitions based on a range of cardiometabolic abnormalities. Dietary composition and quality, food pyramid servings, physical activity, alcohol and smoking behaviours were examined. RESULTS The prevalence of MHO varied considerably between definitions (2.2% to 11.9%), was higher among females and generally increased with age. Agreement between MHO classifications was poor. Among the obese, prevalence of MH was 6.8% to 36.6%. Among the non-obese, prevalence of metabolically unhealthy subjects was 21.8% to 87%. Calorie intake, dietary macronutrient composition, physical activity, alcohol and smoking behaviours were similar between the metabolically healthy and unhealthy regardless of BMI. Greater compliance with food pyramid recommendations and higher dietary quality were positively associated with metabolic health in obese (OR 1.45-1.53 unadjusted model) and non-obese subjects (OR 1.37-1.39 unadjusted model), respectively. Physical activity was associated with MHO defined by insulin resistance (OR 1.87, 95% CI 1.19-2.92, p = 0.006). CONCLUSION A standard MHO definition is required. Moderate and high levels of physical activity and compliance with food pyramid recommendations increase the likelihood of MHO. Stratification of obese individuals based on their metabolic health phenotype may be important in ascertaining the appropriate therapeutic or intervention strategy.
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Affiliation(s)
- Catherine M. Phillips
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Christina Dillon
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Janas M. Harrington
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Vera J. C. McCarthy
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Patricia M. Kearney
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Anthony P. Fitzgerald
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
- Department of Statistics, University College Cork, Cork, Ireland
| | - Ivan J. Perry
- Health Research Board Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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50
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van Vliet-Ostaptchouk JV, den Hoed M, Luan J, Zhao JH, Ong KK, van der Most PJ, Wong A, Hardy R, Kuh D, van der Klauw MM, Bruinenberg M, Khaw KT, Wolffenbuttel BHR, Wareham NJ, Snieder H, Loos RJF. Pleiotropic effects of obesity-susceptibility loci on metabolic traits: a meta-analysis of up to 37,874 individuals. Diabetologia 2013; 56:2134-46. [PMID: 23827965 DOI: 10.1007/s00125-013-2985-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/12/2013] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Genetic pleiotropy may contribute to the clustering of obesity and metabolic conditions. We assessed whether genetic variants that are robustly associated with BMI and waist-to-hip ratio (WHR) also influence metabolic and cardiovascular traits, independently of obesity-related traits, in meta-analyses of up to 37,874 individuals from six European population-based studies. METHODS We examined associations of 32 BMI and 14 WHR loci, individually and combined in two genetic predisposition scores (GPSs), with glycaemic traits, blood lipids and BP, with and without adjusting for BMI and/or WHR. RESULTS We observed significant associations of BMI-increasing alleles at five BMI loci with lower levels of 2 h glucose (RBJ [also known as DNAJC27], QPTCL: effect sizes -0.068 and -0.107 SD, respectively), HDL-cholesterol (SLC39A8: -0.065 SD, MTCH2: -0.039 SD), and diastolic BP (SLC39A8: -0.069 SD), and higher and lower levels of LDL- and total cholesterol (QPTCL: 0.041 and 0.042 SDs, respectively, FLJ35779 [also known as POC5]: -0.042 and -0.041 SDs, respectively) (all p < 2.4 × 10(-4)), independent of BMI. The WHR-increasing alleles at two WHR loci were significantly associated with higher proinsulin (GRB14: 0.069 SD) and lower fasting glucose levels (CPEB4: -0.049 SD), independent of BMI and WHR. A higher GPS-BMI was associated with lower systolic BP (-0.005 SD), diastolic BP (-0.006 SD) and 2 h glucose (-0.013 SD), while a higher GPS-WHR was associated with lower HDL-cholesterol (-0.015 SD) and higher triacylglycerol levels (0.014 SD) (all p < 2.9 × 10(-3)), independent of BMI and/or WHR. CONCLUSIONS/INTERPRETATION These pleiotropic effects of obesity-susceptibility loci provide novel insights into mechanisms that link obesity with metabolic abnormalities.
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Affiliation(s)
- J V van Vliet-Ostaptchouk
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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