1
|
Guzmán-García JM, Romero-Saldaña M, Molina-Recio G, Álvarez-Fernández C, Jiménez-Mérida MDR, Molina-Luque R. Relationship between commonly defined metabolic health phenotypes and obesity with lung function in a working population: A cross-sectional study. Heart Lung 2024; 67:62-69. [PMID: 38703640 DOI: 10.1016/j.hrtlng.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/10/2024] [Accepted: 04/20/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Four phenotypes relate metabolism and obesity: metabolically healthy (MHO) and unhealthy (MUO) people with obesity and metabolically healthy (MHNO) and unhealthy (MUNO) people without obesity. No studies have addressed the association between these categories and lung function in the working population. OBJECTIVES The aim was to determine the relationship of phenotypes to lung ageing as measured by lung age and its relationship to lung dysfunction. METHODS A descriptive cross-sectional study was conducted in a working population. The outcome variable was lung function assessed by lung age. The four phenotypes of obesity and metabolic health (MHNO, MHO, MUO and MUNO) were determined using NCEP-ATP III criteria. Lung dysfunctions were classified into restrictive, obstructive, and mixed patterns. RESULTS The mean age of the participants was 43.7 years, ranging from 18 to 67 years. Of the 1860 workers, 51.3 % were women. The prevalences found were 71.4 %, 12 %, 10.6 % and 6 % for MHNO, MUO, MHO, and MUNO, respectively. MHO (β = 0.66; p = 0.591) was not associated with increased lung ageing compared with MHNO, but MUO (β = 7.1; p < 0.001) and MUNO (β = 6.6; p < 0.001) were. Concerning pulmonary dysfunctions, MUNO (OR = 1.93; p < 0.001) and MUO (OR = 2.91; p < 0.001) were found to be related to the presence of a restrictive pattern, and MUNO (OR = 2.40; p = 0.028) to the mixed pattern. CONCLUSION The results show that metabolic abnormalities, not obesity, are responsible for premature lung ageing and, therefore, lung function decline. In our study, having obesity without metabolic abnormality was not significantly associated with the presence of dysfunctional respiratory patterns.
Collapse
Affiliation(s)
- José-Miguel Guzmán-García
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Manuel Romero-Saldaña
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain.
| | - Guillermo Molina-Recio
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| | - Carlos Álvarez-Fernández
- Department of Occupational Health and Safety, Cordoba City Council, Huerto de San Pedro el Real, Cordoba, Spain
| | - María Del Rocío Jiménez-Mérida
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Rafael Molina-Luque
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
| |
Collapse
|
2
|
Zhang Y, Xue J, Li S, Yang H, Kang C. Impact of bariatric surgery on carotid intima-media thickness and arterial stiffness in metabolically healthy obesity: a prospective study. Hormones (Athens) 2024:10.1007/s42000-024-00568-5. [PMID: 38819742 DOI: 10.1007/s42000-024-00568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Cardiovascular disease is one of the leading causes of mortality in patients with obesity. Metabolically healthy obesity (MHO), in which people do not have metabolic disorders, is a transient state of obesity. However, over the long term, a proportion of individuals with MHO develop metabolic syndrome (MetS). We aimed to investigate the effect of substantial weight loss following bariatric surgery in MHO on carotid intima-media thickness (CIMT) and pulse-wave velocity (PWV), which are independent predictors of subclinical atherosclerosis. METHODS This prospective study included 38 patients (34 women, four men) undergoing bariatric surgery who had severe obesity but without comorbidities (hypertension, diabetes, and hyperlipidemia), and 28 control individuals who were matched for age and sex. CIMT and PWV of the left common carotid artery were measured. At 12-month follow-up after bariatric surgery, measurements were repeated in the 38 patients with obesity. RESULTS Mean baseline body mass index (BMI) in the MHO group was 40.55 ± 3.59 kg/m2, which decreased by 33.1% after bariatric surgery. Compared with controls, CIMT and PWV were increased in MHO (543.53 ± 55.29 vs. 407.82 ± 53.09 μm, 6.70 ± 1.22 vs. 5.45 ± 0.74 m/s, respectively; all P < 0.001). At 12 months post-bariatric surgery, CIMT in MHO was lower than baseline (466.79 ± 53.74 vs. 543.53 ± 55.29 μm, P = 0.009), but PWV was not significantly different from baseline (6.27 ± 0.86 vs. 6.70 ± 1.22 m/s, P = 0.132). Multivariate regression showed that BMI was an independent predictor of CIMT (β = 0.531, P < 0.001). CONCLUSION Carotid artery structure and function were impaired in MHO, and improved carotid artery structure was associated with weight loss in MHO after bariatric surgery.
Collapse
Affiliation(s)
- Yanxia Zhang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Jiping Xue
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Shuai Li
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Hongyu Yang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Chunsong Kang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China.
| |
Collapse
|
3
|
Romero-Becera R, Santamans AM, Arcones AC, Sabio G. From Beats to Metabolism: the Heart at the Core of Interorgan Metabolic Cross Talk. Physiology (Bethesda) 2024; 39:98-125. [PMID: 38051123 DOI: 10.1152/physiol.00018.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/26/2023] [Accepted: 12/01/2023] [Indexed: 12/07/2023] Open
Abstract
The heart, once considered a mere blood pump, is now recognized as a multifunctional metabolic and endocrine organ. Its function is tightly regulated by various metabolic processes, at the same time it serves as an endocrine organ, secreting bioactive molecules that impact systemic metabolism. In recent years, research has shed light on the intricate interplay between the heart and other metabolic organs, such as adipose tissue, liver, and skeletal muscle. The metabolic flexibility of the heart and its ability to switch between different energy substrates play a crucial role in maintaining cardiac function and overall metabolic homeostasis. Gaining a comprehensive understanding of how metabolic disorders disrupt cardiac metabolism is crucial, as it plays a pivotal role in the development and progression of cardiac diseases. The emerging understanding of the heart as a metabolic and endocrine organ highlights its essential contribution to whole body metabolic regulation and offers new insights into the pathogenesis of metabolic diseases, such as obesity, diabetes, and cardiovascular disorders. In this review, we provide an in-depth exploration of the heart's metabolic and endocrine functions, emphasizing its role in systemic metabolism and the interplay between the heart and other metabolic organs. Furthermore, emerging evidence suggests a correlation between heart disease and other conditions such as aging and cancer, indicating that the metabolic dysfunction observed in these conditions may share common underlying mechanisms. By unraveling the complex mechanisms underlying cardiac metabolism, we aim to contribute to the development of novel therapeutic strategies for metabolic diseases and improve overall cardiovascular health.
Collapse
Affiliation(s)
| | | | - Alba C Arcones
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Guadalupe Sabio
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| |
Collapse
|
4
|
Hajmir MM, Shiraseb F, Hosseininasab D, Aali Y, Hosseini S, Mirzaei K. The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study. Front Nutr 2023; 10:1226162. [PMID: 38162517 PMCID: PMC10754978 DOI: 10.3389/fnut.2023.1226162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Background Diet and inflammation both play important roles in the occurrence of obesity. We aimed to investigate the role of inflammation in the development of both metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals. Methods This cross-sectional study included 221 overweight and obese women aged 18-56 years. The study assessed the metabolic health phenotypes of the participants using the Karelis criterion score. Additionally, dietary intakes were evaluated using a 147-item semi-quantitative questionnaire and the NOVA classification system (comprising 37 food groups and beverages). The study also collected and analyzed the blood parameters, as well as biochemical and anthropometric indices, for all participants. Results Among the women included in the study, 22.9% had MHO phenotypes but 77.1% had MUHO phenotypes. A significant association between the third quartile of the NOVA classification system and the increased likelihood of having the MUHO phenotype was observed (OR = 1.40, 95% CI = 1.09-4.92, p = 0.04). Regarding the potential role of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) (p = 0.84), transforming growth factor-β (TGF-β) (p = 0.50), monocyte chemoattractant protein-1 (MCP-1) (p = 0.49), plasminogen activator inhibitor-1 (PAI-1) (p = 0.97), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.92) were found to be mediators. Conclusion We observed a significant positive association between ultra-processed food (UPF) consumption and the MUHO phenotype in overweight and obese women. This association appeared to be mediated by some inflammatory markers, such as hs-CRP, TGF-β, MCP-1, PAI-1, and HOMA-IR. Additional studies are needed to validate these findings.
Collapse
Affiliation(s)
- Mahya Mehri Hajmir
- Students’ Scientific Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Hosseininasab
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Hosseini
- School of Human Nutrition, McGill University, Quebec, QC, Canada
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Zhang S, You Y, Li Y, Yuan H, Zhou J, Tian L, Liu Y, Wang B, Zhu E. Foxk1 stimulates adipogenic differentiation via a peroxisome proliferator-activated receptor gamma 2-dependent mechanism. FASEB J 2023; 37:e23266. [PMID: 37889840 DOI: 10.1096/fj.202301153r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Adipogenesis is a tightly regulated process, and its dysfunction has been linked to metabolic disorders such as obesity. Forkhead box k1 (Foxk1) is known to play a role in the differentiation of myogenic precursor cells and tumorigenesis of different types of cancers; however, it is not clear whether and how it influences adipocyte differentiation. Here, we found that Foxk1 was induced in mouse primary bone marrow stromal cells (BMSCs) and established mesenchymal progenitor/stromal cell lines C3H/10T1/2 and ST2 after adipogenic treatment. In addition, obese db/db mice have higher Foxk1 expression in inguinal white adipose tissue than nonobese db/m mice. Foxk1 overexpression promoted adipogenic differentiation of C3H/10T1/2, ST2 cells and BMSCs, along with the enhanced expression of CCAAT/enhancer binding protein-α, peroxisome proliferator-activated receptor γ (Pparγ), and fatty acid binding protein 4. Moreover, Foxk1 overexpression enhanced the expression levels of lipogenic factors during adipogenic differentiation in both C3H/10T1/2 cells and BMSCs. Conversely, Foxk1 silencing impaired these cells from fully differentiating. Furthermore, adipogenic stimulation induced the nuclear translocation of Foxk1, which depended on the mTOR and PI3-kinase signaling pathways. Subsequently, Foxk1 is directly bound to the Pparγ2 promoter, stimulating its transcriptional activity and promoting adipocyte differentiation. Collectively, our study provides the first evidence that Foxk1 promotes adipocyte differentiation from progenitor cells by promoting nuclear translocation and upregulating the transcriptional activity of the Pparγ2 promoter during adipogenic differentiation.
Collapse
Affiliation(s)
- Shan Zhang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Yanru You
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Yachong Li
- Department of Endodontics, School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Hairui Yuan
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Jie Zhou
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Lijie Tian
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Ying Liu
- Department of Endodontics, School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Baoli Wang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Endong Zhu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| |
Collapse
|
6
|
Yildirim V, Sheraton VM, Brands R, Crielaard L, Quax R, van Riel NA, Stronks K, Nicolaou M, Sloot PM. A data-driven computational model for obesity-driven diabetes onset and remission through weight loss. iScience 2023; 26:108324. [PMID: 38026205 PMCID: PMC10665812 DOI: 10.1016/j.isci.2023.108324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/22/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Obesity is a major risk factor for the development of type 2 diabetes (T2D), where a sustained weight loss may result in T2D remission in individuals with obesity. To design effective and feasible intervention strategies to prevent or reverse T2D, it is imperative to study the progression of T2D and remission together. Unfortunately, this is not possible through experimental and observational studies. To address this issue, we introduce a data-driven computational model and use human data to investigate the progression of T2D with obesity and remission through weight loss on the same timeline. We identify thresholds for the emergence of T2D and necessary conditions for remission. We explain why remission is only possible within a window of opportunity and the way that window depends on the progression history of T2D, individual's metabolic state, and calorie restrictions. These findings can help to optimize therapeutic intervention strategies for T2D prevention or treatment.
Collapse
Affiliation(s)
- Vehpi Yildirim
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Vivek M. Sheraton
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, 1100 DD Amsterdam, the Netherlands
| | - Ruud Brands
- AMRIF B.V., Agro Business Park, 6708 PW Wageningen, the Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CL Utrecht, the Netherlands
| | - Loes Crielaard
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Rick Quax
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
| | - Natal A.W. van Riel
- Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, the Netherlands
- Department of Experimental and Vascular Medicine, Amsterdam University Medical Centers, 1100 DD Amsterdam, the Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Peter M.A. Sloot
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
| |
Collapse
|
7
|
Ding Y, Deng Q, Yang M, Niu H, Wang Z, Xia S. Clinical Classification of Obesity and Implications for Metabolic Dysfunction-Associated Fatty Liver Disease and Treatment. Diabetes Metab Syndr Obes 2023; 16:3303-3329. [PMID: 37905232 PMCID: PMC10613411 DOI: 10.2147/dmso.s431251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
Obesity,and metabolic dysfunction-associated fatty liver disease (MAFLD) have reached epidemic proportions globally. Obesity and MAFLD frequently coexist and act synergistically to increase the risk of adverse clinical outcomes (both hepatic and extrahepatic). Type 2 diabetes mellitus (T2DM) is the most important risk factor for rapid progression of steatohepatitis and advanced fibrosis. Conversely, the later stages of MAFLD are associated with an increased risk of T2DM incident. According to the proposed criteria, MAFLD is diagnosed in patients with liver steatosis and in at least one in three: overweight or obese, T2DM, or signs of metabolic dysregulation if they are of normal weight. However, the clinical classification and correlation between obesity and MAFLD is more complex than expected. In addition, treatment for obesity and MAFLD are associated with a reduced risk of T2DM, suggesting that liver-based treatments could reduce the risk of developing T2DM. This review describes the clinical classification of obesity and MAFLD, discusses the clinical features of various types of obesity and MAFLD, emphasizes the role of visceral obesity and insulin resistance (IR) in the development of MAFLD,and summarizes the existing treatments for obesity and MAFLD that reduce the risk of developing T2DM.
Collapse
Affiliation(s)
- Yuping Ding
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| | - Quanjun Deng
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| | - Mei Yang
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| | - Haiyan Niu
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| | - Zuoyu Wang
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| | - Shihai Xia
- Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China
- Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis & Treatment, Tianjin, 300162, People’s Republic of China
| |
Collapse
|
8
|
Aisike G, Kuerbanjiang M, Muheyati D, Zaibibuli K, Lv MX, Han J. Correlation analysis of obesity phenotypes with leptin and adiponectin. Sci Rep 2023; 13:17718. [PMID: 37853077 PMCID: PMC10584881 DOI: 10.1038/s41598-023-43550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023] Open
Abstract
Obesity can be categorized as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). However, individuals with MHO are characterized by the absence of metabolic syndrome (MS) and appear to have lower inflammation levels compared to MUO. This study aimed to investigate the association of obesity phenotypes with leptin (LEP) and adiponectin (ADP). According to the inclusion and exclusion criteria, we selected 178 subjects from the previous cross-sectional survey. Based on the body mass index (BMI) and diagnostic criteria of MS, we divided the individuals into three groups, including healthy control group (HC group), metabolically healthy obesity group (MHO group) and metabolically unhealthy obesity group (MUO group). The concentrations of LEP and ADP in serum were measured, and the association of these two cytokines with different obesity phenotypes were subsequently analyzed. Compared to both the HC and MHO groups, the MUO group showed significantly higher BMI, waist circumference (WC), waist-hip ratio (WHR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (Homa-IR) and blood pressure (P < 0.05). In contrast, serum high-density lipoprotein cholesterol (HDL-C) was notably lower in the MUO group (P < 0.05). ADP was found to have a positive correlation with systolic blood pressure (SBP) and a negative correlation with FPG in the MHO group. In the MUO group, LEP demonstrated a positive correlation with fasting insulin (FINS) and Homa-IR, while ADP showed a positive correlation with TC and SBP. Linear regression analysis further indicated that SBP (β = 0.234, P = 0.043), TG (β = - 0.292, P = 0.001) and LDL-C (β = 0.626, P = 0.000) were independently correlated with ADP, and BMI (β = 0.398, P = 0.002) was independently correlated with LEP in obese individuals. In conclusion, ADP and LEP were closely related with glucose and lipid metabolism in obese individuals, these two cytokines might play critical roles in obesity-associated metabolic disorders.
Collapse
Affiliation(s)
- Guliqiekeran Aisike
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Maierheba Kuerbanjiang
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Dina Muheyati
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Kaibinuer Zaibibuli
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Mei-Xia Lv
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Jia Han
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China.
| |
Collapse
|
9
|
Yu B, Hu M, Jiang W, Ma Y, Ye J, Wu Q, Guo W, Sun Y, Zhou M, Xu Y, Wu Z, Wang Y, Lam SM, Shui G, Gu J, Li JZ, Fu Z, Gong Y, Zhou H. Ceramide d18:1/24:1 as a potential biomarker to differentiate obesity subtypes with unfavorable health outcomes. Lipids Health Dis 2023; 22:166. [PMID: 37794463 PMCID: PMC10548646 DOI: 10.1186/s12944-023-01921-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The criteria for metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) remain controversial. This research aimed to identify a potential biomarker to differentiate the subtypes of obesity. METHODS The study conducted a lipidomic evaluation of ceramide in the serum of 77 Chinese adults who had undergone hyperinsulinemic-euglycemic clamps. These adults were divided into three groups according to the clinical data: normal weight control group (N = 21), MHO (N = 20), and MUO (N = 36). RESULTS The serum Cer d18:1/24:1 level in the MHO group was lower than that in the MUO group. As the Cer d18:1/24:1 level increased, insulin sensitivity decreased, and the unfavorable parameters increased in parallel. Multivariate logistic regression analysis revealed that serum Cer d18:1/24:1 levels were independently correlated with MUO in obesity. Individuals with higher levels of Cer d18:1/24:1 also had an elevated risk of cardiovascular disease. Most ceramide subtype levels increased in obesity compared to normal-weight individuals, but the levels of serum Cer d18:0/18:0 and Cer d18:1/16:0 decreased in obesity. CONCLUSIONS The relationships between ceramide subtypes and metabolic profiles might be heterogeneous in populations with different body weights. Cer d18:1/24:1 could be a biomarker that can be used to differentiate MUO from MHO, and to better predict who will develop unfavorable health outcomes among obese individuals. TRIAL REGISTRATION The First Affiliated Hospital of Nanjing Medical University's Institutional Review Board authorized this study protocol, and all participants provided written informed consent (2014-SR-003) prior to study entry.
Collapse
Affiliation(s)
- Baowen Yu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Moran Hu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wanzi Jiang
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yizhe Ma
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jingya Ye
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qinyi Wu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen Guo
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Sun
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Zhou
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yiwen Xu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhoulu Wu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yiwen Wang
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Sin Man Lam
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Guanghou Shui
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Jingyu Gu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - John Zhong Li
- Department of Biochemistry and Molecular Biology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhenzhen Fu
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Yingyun Gong
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Hongwen Zhou
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Biochemistry and Molecular Biology, Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
10
|
Chan KE, Ng CH, Fu CE, Quek J, Kong G, Goh YJ, Zeng RW, Tseng M, Aggarwal M, Nah B, Chee D, Wong ZY, Zhang S, Wang JW, Chew NWS, Dan YY, Siddiqui MS, Noureddin M, Sanyal AJ, Muthiah M. The Spectrum and Impact of Metabolic Dysfunction in MAFLD: A Longitudinal Cohort Analysis of 32,683 Overweight and Obese Individuals. Clin Gastroenterol Hepatol 2023; 21:2560-2569.e15. [PMID: 36202348 DOI: 10.1016/j.cgh.2022.09.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/08/2022] [Accepted: 09/19/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Metabolic associated fatty liver disease (MAFLD) was recently proposed as an alternative name change for better encapsulation of disease. However, there exists a spectrum of MAFLD where both metabolically healthy (MH) and metabolically unhealthy (MU) individuals are included. In view of limited evidence, we sought to examine the prevalence, clinical characteristics, and differences in outcomes of MH-MAFLD at the population level. METHODS Data were used from the United States National Health and Nutrition Examination Survey 1999 to 2018. Multivariate logistic regression analysis was used to obtain odds ratios for the estimation of events. Survival analysis was conducted with Cox regression and the Fine-Gray subdistribution model. RESULTS There were 32,683 overweight and obese individuals included in the analysis. In MAFLD patients, the prevalence of MH-MAFLD was 6.92% (95% confidence interval [CI], 6.58%-7.27%), and 93.08% (95% CI, 92.73%-93.42%) were considered as MU-MAFLD. Multivariate analysis found a significantly higher risk of MACE (odds ratio, 1.38; 95% CI, 1.28-1.49; P < .01), all-cause (hazard ratio, 1.24; 95% CI, 1.17-1.32; P < .01), cardiovascular disease (SHR, 1.20; 95% CI, 1.02-1.42; P = .03), and cancer mortality (SHR, 1.24; 95% CI, 1.07-1.44; P < .01) in MU-MAFLD relative to non-MAFLD. However, MH-MAFLD individuals were not associated with a statistically significant increased risk of these adverse outcomes compared with non-MAFLD. MU-MAFLD diabetics were also at a higher risk of adverse events compared with non-diabetics. CONCLUSIONS This study reports on the heterogeneity and spectrum of metabolic dysfunction that exists in overweight and obese MAFLD. Although MAFLD may potentially be advantageous in improving awareness and patient outcomes, there remains substantial heterogeneity within patients included in MAFLD on the basis of the underlying metabolic burden.
Collapse
Affiliation(s)
- Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Clarissa Elysia Fu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi Jie Goh
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | | | - Michael Tseng
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Manik Aggarwal
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Benjamin Nah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | - Douglas Chee
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | - Zhen Yu Wong
- Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Sitong Zhang
- Department of Surgery, Cardiovascular Research Institute (CVRI), National University Heart Centre, Singapore; Nanomedicine Translational Research Programme, Centre for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiong-Wei Wang
- Department of Surgery, Cardiovascular Research Institute (CVRI), National University Heart Centre, Singapore; Nanomedicine Translational Research Programme, Centre for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas W S Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore
| | - Yock Young Dan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | | | - Arun J Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore.
| |
Collapse
|
11
|
Mohamadi A, Shiraseb F, Mirzababaei A, Barekzai AM, Clark CCT, Aali Y, Mirzaei K. Inflammatory markers may mediate the relationship between processed meat consumption and metabolic unhealthy obesity in women: a cross sectional study. Sci Rep 2023; 13:9261. [PMID: 37286588 DOI: 10.1038/s41598-023-35034-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 05/11/2023] [Indexed: 06/09/2023] Open
Abstract
Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) are known to be affected by diet and inflammatory factors (such as TGF-β1, IL-β1, MCP1). We sought to survey that consume of processed meat could effect on MHO and MUHO phenotypes, mediated through inflammatory markers, in overweight and obese Iranian women. The current cross-sectional study was done on 224 women 18-48 years, with a body mass index (BMI) ≥ 25 kg/m2. A 147- item food frequency questionnaire (FFQ) was used to evaluate dietary intake. In all participants, anthropometric indices and biochemical factors, as well as metabolic health phenotypes based on Karelis score, were evaluated. According to results, 22.6% of participants had MHO and 75.7% had MUHO phenotypes. There was an association between higher adherence to processed meats and increasing odds of MUHO phenotype in Iranian women (OR:2.54; 95% CI 0.009, 7.51; P = 0.05). Moreover, we found that the relation can be affected by agents such as TGF-β1, IL-β1, and MCP1; however, more research is needed to confirm these results and finding.
Collapse
Affiliation(s)
- Azam Mohamadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6117, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6117, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6117, Tehran, Iran.
| | - Ahmad Mujtaba Barekzai
- Department of Public Health, Spinghar Institute of Higher Education, Kabul Campus, Kabul, Afghanistan
- Spinghar Institute of Higher Education, Kabul Campus, Kabul, Afghanistan
- World FoodProgram, KIC, Kabul, Afghanistan
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6117, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6117, Tehran, Iran.
| |
Collapse
|
12
|
Tanriover C, Copur S, Gaipov A, Ozlusen B, Akcan RE, Kuwabara M, Hornum M, Van Raalte DH, Kanbay M. Metabolically healthy obesity: Misleading phrase or healthy phenotype? Eur J Intern Med 2023; 111:5-20. [PMID: 36890010 DOI: 10.1016/j.ejim.2023.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
Collapse
Affiliation(s)
- Cem Tanriover
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Abduzhappar Gaipov
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan; Clinical Academic Department of Internal Medicine, CF "University Medical Center", Astana, Kazakhstan
| | - Batu Ozlusen
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Rustu E Akcan
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | | | - Mads Hornum
- Department of Nephrology, Rigshospitalet, Inge Lehmanns Vej 7, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel H Van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Loaction VUMC, Amsterdam, the Netherlands
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul 34010, Turkey.
| |
Collapse
|
13
|
Khadem A, Shiraseb F, Mirzababaei A, Noori S, Mirzaei K. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolically unhealthy overweight/obesity phenotypes among Iranian women: a cross sectional study. BMC Endocr Disord 2023; 23:84. [PMID: 37076804 PMCID: PMC10114364 DOI: 10.1186/s12902-023-01333-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Paradoxes have been found in obesity, including individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), and diet may be one of the reasons for the creation of these metabolic phenotypes. Hence, the purpose of the present study was to investigate the association of the Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet with metabolically unhealthy overweight/obesity (MUHOW/O) phenotypes. METHODS In this cross-sectional study, 229 overweight and obese women (body mass index (BMI) ≥ 25 kg/m2) aged 18-48 years were examined. Anthropometric measures and biochemical parameters were collected from all participants. The body composition of each participant was assessed using a bioelectrical impedance analyzer (BIA). The MIND diet score was determined based on 15 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. Karelis criteria was used to determine metabolically healthy/unhealthy phenotype (MH/MUH). RESULTS Among the participants, 72.5% of individuals were identified as MUH and 27.5% as MH, with a mean ± standard deviation (SD) age of 36.16 (8.33) years. The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was no significant association observed between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.01, 95% CI: 0.86-4.17, P-value = 0.10), T3 (OR: 1.89, 95% CI: 0.86-4.17, P-value = 0.11) of MIND score, and only the odds of MUH relative to MH with a marginal significant decreasing trend was observed from the second to the third tertile (1.89 vs. 2.01) (P - trend = 0.06). Also, after additional adjustment for marital status, the nonsignificant association between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.13, 95% CI: 0.89-5.10, P-value = 0.08), T3 (OR: 1.87, 95% CI: 0.83-4.23, P-value = 0.12) of MIND score remained, and the odds of MUH relative to MH with a significant decreasing trend was observed with increasing tertiles (P-trend = 0.04). CONCLUSIONS In conclusion, no significant associations were found between adherence to MIND diet with MUH, and only a significant downward trend in the odds of MUH was observed with increasing tertiles. We suggest further studies in this field.
Collapse
Affiliation(s)
- Alireza Khadem
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Fouad Y, Zheng MH. Metabolically Healthy Obese MAFLD: Are They Truly Healthy? Clin Gastroenterol Hepatol 2023; 21:857-858. [PMID: 35643417 DOI: 10.1016/j.cgh.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Yasser Fouad
- Department of Endemic Medicine and Gastroenterology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ming-Hua Zheng
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
15
|
Abiri B, Valizadeh M, Amini S, Kelishadi R, Hosseinpanah F. Risk factors, cutoff points, and definition of metabolically healthy/unhealthy obesity in children and adolescents: A scoping review of the literature. Obes Rev 2023; 24:e13548. [PMID: 36624970 DOI: 10.1111/obr.13548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/29/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
Diagnosis of metabolically healthy obesity (MHO) and its definition do not have universal criteria in the pediatric age group. Hence, this scoping review aims to identify the components, the cutoff points, and the definition of MHO in children and adolescents. A comprehensive, systematic search was conducted in PubMed, Scopus, EMBASE, and Google Scholar databases. A consensus-based definition of MHO was developed through a Delphi process involving an international panel of 23 experts. This review included a total of 63 non-randomized studies, published between 2007 and 2022. According to our consensus (≥80% agreement), the proposed definition for MHO included the following components: high-density lipoprotein cholesterol >40 mg/dl (or >1.03 mmol/l), triglycerides ≤150 mg/dl (or ≤1.7 mmol/l), fasting plasma glucose <100 mg/dl (or <5.6 mmol/l), a measure of insulin, and systolic and diastolic blood pressure ≤90th percentile. Therefore, MHO was defined as the absence of the above metabolic risk factors; and those children and adolescents with one or more criteria were considered as metabolically unhealthy. A universal definition of MHO will allow comparisons between studies in the field of childhood obesity and can be useful in clinical practice.
Collapse
Affiliation(s)
- Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Amini
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Ram D, Wilensky A, Zur D, Almoznino G. The Triangle of Nonalcoholic Fatty Liver Disease, Metabolic Dysfunction, and Periodontitis: Analysis of the Dental, Oral, Medical and Epidemiological (DOME) Records-Based Nationwide Research. Metabolites 2022; 12:metabo12121212. [PMID: 36557250 PMCID: PMC9780834 DOI: 10.3390/metabo12121212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/11/2022] Open
Abstract
This study aimed to analyze the associations of nonalcoholic fatty liver disease (NAFLD) with dental parameters, while controlling for socio-demographics, health-related habits, and each of the metabolic syndrome (MetS) components, consequences, and related conditions among a nationally representative sample of young and middle-aged adults. To that end, we analyzed data from the dental, oral, medical epidemiological (DOME) cross-sectional records-based study that combined comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of military personnel. Included were 132,529 subjects aged 18-50 who attended military dental clinics for one year. The prevalence of NAFLD in the study population was 0.7% (938/132,529). The following parameters maintained a statistically positive association with NAFLD in the multivariate analysis (from highest to lowest OR): male sex (OR = 3.91 (2.29-6.66)), hyperlipidemia (OR = 3.69 (2.75-4.95)), diabetes Type 2 (OR = 3.14 (2.21-4.46)), hypertension (OR = 1.67 (1.30-2.14)), periodontitis (OR = 1.42 (1.06-1.89)), body mass index (BMI) (OR = 1.15 (1.13-1.18)), and age (OR = 1.08 (1.06-1.09)). The multivariate analysis established a profile of the "patient vulnerable to NAFLD", including older age, male sex, and other MetS components, including diabetes type 2, hypertension, hyperlipidemia, BMI, and periodontitis. This profile aligns with the current new definition of metabolic dysfunction-associated fatty liver disease (MAFLD). We also analyzed the associations of the sum of the standard dental unit (SDU) scores of planned (SDU-P) and delivered (SDU-D) dental procedures per patient with NAFLD using receiver operating characteristic (ROC) analysis. The SDU-P (planned) score exhibited excellent discrimination for NAFLD (area under the curve (AUC) = 0.718 (0.703-0.734)). Overall, the results confirmed the hypothesis of this research, i.e., that NAFLD is associated with dental morbidity, particularly with periodontitis.
Collapse
Affiliation(s)
- Doron Ram
- In Partial Fulfillment DMD Thesis, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Asaf Wilensky
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Periodontology, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Dorit Zur
- Medical Information Department, General Surgeon Headquarter, Medical Corps, Israel Defense Forces, Tel Hashomer 02149, Israel
| | - Galit Almoznino
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Big Biomedical Data Research Laboratory; Dean’s Office, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Endodontics, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hadassah Medical Center, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +97-226-776-194; Fax: +97-226-447-919
| |
Collapse
|
17
|
Wen Y, Liu T, Li S, Gong R, Li C. Trends in the prevalence of metabolically healthy and unhealthy obesity in the US adult population: analysis of eight NHANES cross-sectional survey cycles, 1999-2014. BMJ Open 2022; 12:e062651. [PMID: 36450425 PMCID: PMC9716838 DOI: 10.1136/bmjopen-2022-062651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To exam the time trend of the prevalence of metabolically healthy obesity (MHO) in the US adult population. DESIGN Eight cross-sectional survey cycles. SETTING National Health and Nutrition Examination Survey (NHANES), 1999-2014. PARTICIPANTS 16 459 NHANES participants aged 20 years and older. PRIMARY OUTCOME MEASURE MHO was defined as central obesity (waist circumference ≥102 cm for men and ≥88 cm for women) without any of the following conditions: elevated levels of blood pressure (≥130/85 mm Hg), glucose (≥100 mg/dL) and triglycerides (≥150 mm/dL); reduced levels of high-density lipoprotein cholesterol (<40 mg/dL for men and <50 mg/dL for women) or any medication use for high cholesterol, hypertension or diabetes. RESULTS The prevalence of central obesity significantly increased from 45.2% in 1999-2000 to 56.7% in 2013-2014 (p=0.003). Over the same period, MHO prevalence among those with central obesity only slightly and non-significantly increased from 11.0% to 15.7% (p=0.38). However, MHO prevalence among women increased significantly (p=0.04) from 7.1% to 13.7%. Female gender, a younger age, being Hispanic and non-Hispanic black and high education (some college or above) were significantly (p<0.05) associated with higher prevalence of MHO. CONCLUSIONS While the prevalence of central obesity in the US population has increased since 1999, the prevalence of MHO among those who are centrally obese remained fairly stable.
Collapse
Affiliation(s)
- Yue Wen
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Tingting Liu
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Shengxu Li
- Children's Minnesota Research Institute, Tulane University School of Public Health and Tropical Medicine, Minneapolis, Minnesota, USA
| | - Renrong Gong
- Department of Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| |
Collapse
|
18
|
Circulating microRNA levels differ in the early stages of insulin resistance in prepubertal children with obesity. Life Sci 2022; 312:121246. [PMID: 36455651 PMCID: PMC10375861 DOI: 10.1016/j.lfs.2022.121246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
AIMS The increasing prevalence of childhood obesity escalates the risk for related complications. Circulating microRNAs (miRNAs) have been suggested as good predictive markers of insulin resistance in those with obesity. The aim was to identify a circulating miRNA profile that reflects insulin resistance in prepubertal children with obesity. MATERIAL AND METHODS Plasma miRNAs were measured in prepubertal children (n = 63, 5-9 years) using TaqMan Advanced miRNA Human Serum/Plasma plates and then were validated by RT-qPCR. Subjects were divided into normal weight (n = 20, NW) and overweight or obese (n = 43, OW/OB) groups according to their BMI z-scores. The OW/OB group was further subdivided into insulin sensitive or metabolically healthy obese (n = 26, MHO) and insulin resistant or metabolically unhealthy obese (n = 17, MUO) according to HOMA-IR. KEY FINDINGS While no differences were observed in the fasting plasma glucose levels, serum insulin levels were significantly elevated in the OW/OB compared to the NW group. Of 188 screened miRNAs, eleven were differentially expressed between the NW and OW/OB groups. Validation confirmed increased circulating levels of miR-146a-5p and miR-18a-5p in the OW/OB group, which correlated with BMI z-score. Interestingly, miR-146a-5p was also correlated with HOMA-IR index. While only miR-18a-5p was upregulated in the OW/OB children, independently of their degree of insulin sensitivity, miR-146-5p, miR-423-3p and miR-152-3p were associated with insulin resistance. SIGNIFICANCE The present study provides evidence of molecular alterations that occur early in life in prepubertal obesity. These alterations may potentially be crucial for targeted prevention or prompt precision therapeutic development and subsequent interventions.
Collapse
|
19
|
Guzmán-García JM, Romero-Saldaña M, Molina-Recio G, Álvarez-Fernández C, Raya-Cano E, Molina-Luque R. Diagnostic accuracy of the waist-to-height ratio and other anthropometric indices for metabolically healthy obesity in the working population. Front Nutr 2022; 9:962054. [DOI: 10.3389/fnut.2022.962054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Approximately one-third of overweight individuals, and half of those with obesity, do not have cardiometabolic disorders. For this reason, a phenotype called metabolically healthy obese (MHO) has emerged to describe this population group. The early detection of this situation could save costs associated with the development of comorbidities or pharmacological interventions. Therefore, the aim is to know the prevalence of MHO in the working population and propose variables for its detection. Cross-sectional descriptive study of 635 workers of the Cordoba City Council was carried out based on the results of the 2016 health surveillance. The outcome variables were the MHO, established based on the criteria of the IDF, NCEP—ATP III, and Aguilar—Salinas. In addition, the degree of agreement between the different MHO criteria was studied using Cohen's kappa (k), and the predictive capacity of the anthropometric variables was assessed with Receiver Operator Curves. The prevalence of MHO ranged from 6.6 to 9%. The highest agreement was reached between the IDF and NCEP-ATP III definitions (k = 0.811; 95% CI 0.724–0.898; p < 0.001). The waist-to-height ratio (WHtR) showed the highest discriminant capacity for MHO, with its best cut-off point at 0.55 for all criteria used. Sensitivity ranged from 84 to 93%. The prevalence of MHO in the working population differed according to the criteria used for diagnosis. The anthropometric variable with the highest discriminant capacity for MHO was WHtR, presenting the same cut-off point in the three criteria analyzed. Therefore, WHtR is the variable that best detects the presence of MHO.
Collapse
|
20
|
Khadem A, Shiraseb F, Mirzababaei A, Ghaffarian-Ensaf R, Mirzaei K. Association of Lifelines Diet Score (LLDS) and metabolically unhealthy overweight/obesity phenotypes in women: a cross-sectional study. BMC Womens Health 2022; 22:374. [PMID: 36096807 PMCID: PMC9469615 DOI: 10.1186/s12905-022-01957-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background Previous studies have shown the association of a number of dietary quality scores with metabolically phenotypes of obesity. Recently, the Lifelines Diet Score (LLDS), which is a fully food-based score based on the 2015 Dutch dietary guidelines and underlying international literature, has been proposed as a tool for assessing the quality of the diet. Therefore, this study was performed to investigate the association between LLDS and metabolically healthy/unhealthy overweight and obesity (MHO/MUHO) phenotypes. Methods This study was performed on 217 women, aged 18–48 years old. For each participant anthropometric values, biochemical test and body composition were evaluated by standard protocols and methods. The LLDS was determined based on 12 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. The metabolically healthy (MH) was evaluated using the Karelis criteria. Results Among the total participants in this study, 31.3% of the subjects were MHO while 68.7% were MUHO. After adjustment for potential confounding variables (age, energy intake, and physical activity), participants in highest LLDS tertile had a lower odds of MUHO compared with those in the lowest tertile (OR: 1.18; 95% CI: 0.23, 5.83; P-trend = 0.03). Also, after further adjustment with BMI, provided only small changes in "OR" and did not attenuate the significance (OR: 1.28; 95% CI: 0.23, 6.91; P-trend = 0.02). Conclusions The present evidence indicates that individuals with higher adherence to the LLDS had lower odds of metabolically unhealthy (MUH).
Collapse
|
21
|
A Multivariate Analysis of “Metabolic Phenotype” Patterns in Children and Adolescents with Obesity for the Early Stratification of Patients at Risk of Metabolic Syndrome. J Clin Med 2022; 11:jcm11071856. [PMID: 35407464 PMCID: PMC8999358 DOI: 10.3390/jcm11071856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Metabolic syndrome (MS) is closely linked to obesity; however, not all individuals with obesity will develop obesity-related complications and a metabolically healthy obesity (MHO) group is also described. Objective: To perform a multivariate analysis (MVA) of the anthropometric and biochemical data in pediatric patients with obesity to reveal a “phenotype” predictive for MS. Methods: We analyzed 528 children with obesity (OB) and 119 normal-weight pediatric patients (NW). Adiposity indices were recorded, and MS was detected. MVA was performed. Results: Analysis of the structure of correlation of the variables showed that the variables of waist circumference (WC), body mass index (BMI), and estimated fat mass (eFM) were positively correlated with each other as a whole. In addition, the variables of the triglycerides (TG), triglyceride–glucose (TyG) index, and visceral adiposity index were positively correlated with each other as a whole, although none were correlated with the variables of BMI z-score, waist-to-height ratio, WC, eFM, or weight. The variables that related to insulin resistance (IR) and dyslipidemia were crucial for the early stratification of patients at risk of MS. Conclusions: Independently of body weight, IR, dyslipidemia, hypertriglyceridemia, and fat distribution seem to be the strongest MS risk factors. The early detection of and intervention in these modifiable risk factors are useful to protect children’s health.
Collapse
|
22
|
Sensitivity and specificity of body mass index and main risk factors for cardiovascular disease in middle-income urban participants in Guanajuato, Mexico. NUTR HOSP 2022; 39:1027-1036. [DOI: 10.20960/nh.04074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
23
|
Verdú E, Homs J, Boadas-Vaello P. Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413333. [PMID: 34948944 PMCID: PMC8705491 DOI: 10.3390/ijerph182413333] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022]
Abstract
A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).
Collapse
Affiliation(s)
- Enrique Verdú
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
| | - Judit Homs
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Department of Physical Therapy, EUSES-University of Girona, 17190 Salt, Spain
| | - Pere Boadas-Vaello
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
| |
Collapse
|
24
|
Association of Metabolically Healthy and Unhealthy Obesity Phenotype with Markers Related to Obesity, Diabetes among Young, Healthy Adult Men. Analysis of MAGNETIC Study. Life (Basel) 2021; 11:life11121350. [PMID: 34947881 PMCID: PMC8708295 DOI: 10.3390/life11121350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
Adipose tissue secretes many regulatory factors called adipokines. Adipokines affect the metabolism of lipids and carbohydrates. They also influence the regulation of the immune system and inflammation. The current study aimed to evaluate the association between markers related to obesity, diabesity and adipokines and metabolically healthy and unhealthy obesity in young men. The study included 98 healthy participants. We divided participants into three subgroups based on body mass index and metabolic health definition: 49 metabolically healthy normal-weight patients, 27 metabolically healthy obese patients and 22 metabolically unhealthy obese patients. The 14 metabolic markers selected were measured in serum or plasma. The analysis showed associations between markers related to obesity, diabesity and adipokines in metabolically healthy and unhealthy obese participants. The decreased level of adipsin (p < 0.05) was only associated with metabolically healthy obesity, not with metabolically unhealthy obesity. The decreased level of ghrelin (p < 0.001) and increased level of plasminogen activator inhibitor-1 (p < 0.01) were only associated with metabolically unhealthy obesity, not with metabolically healthy obesity. The decreased level of adiponectin and increased levels of leptin, c-peptide, insulin and angiopoietin-like 3 protein were associated with metabolically healthy and unhealthy obesity. In conclusion, our data show that metabolically healthy obesity was more similar to metabolically unhealthy obesity in terms of the analyzed markers related to obesity and diabesity.
Collapse
|
25
|
Kim SA, Lim K, Lee JK, Kang D, Shin S. Metabolically healthy obesity and the risk of all-cause and cardiovascular disease mortality in a Korean population: a prospective cohort study. BMJ Open 2021; 11:e049063. [PMID: 34489281 PMCID: PMC8423515 DOI: 10.1136/bmjopen-2021-049063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES This study aimed to examine the association between metabolically healthy obesity and all-cause and cardiovascular disease (CVD) mortality in a Korean population. DESIGN A prospective study. SETTING This study used data from the Korean Genome and Epidemiology Study. PARTICIPANTS A total of 140 137 participants were followed up over a median period of 9.2 years. Participants were categorised into four groups according to obesity (obese: body mass index ≥25 kg/m2 or non-obese) and metabolic health (metabolically unhealthy: two or more metabolic abnormalities or metabolically healthy). PRIMARY AND SECONDARY OUTCOME MEASURES All-cause and CVD mortality of the participants until 31 December 2018 were ascertained by the National Health Insurance Service of beneficiary status of Korea. RESULTS Metabolically unhealthy non-obese participants were at elevated risk of all-cause mortality (HR, 1.12; 95% CI, 1.04 to 1.21; p=0.0019) and CVD mortality (HR, 1.39; 95% CI, 1.17 to 1.65; p=0.0002), particularly mortality from ischaemic heart disease (IHD) (HR, 1.54; 95% CI, 1.10 to 2.14; p=0.0116) compared with metabolically healthy non-obese participants. Surprisingly, metabolically healthy obese participants were at reduced risk of all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; p=0.0197). Metabolically unhealthy obese participants were at elevated risk of CVD mortality (HR, 1.51; 95% CI, 1.26 to 1.81; p<0.0001) and IHD mortality (HR, 1.88; 95% CI, 1.35 to 2.63; p=0.0002) compared with metabolically healthy non-obese participants. CONCLUSIONS In a Korean population, metabolically healthy obese participants had reduced risk of all-cause mortality compared with their non-obese counterparts, whereas metabolically unhealthy participants had elevated risk of CVD mortality, in particular mortality from IHD regardless of obesity.
Collapse
Affiliation(s)
- Seong-Ah Kim
- Department of Urban Society, Seoul Institute, Seoul, Republic of Korea
| | - Kyungjoon Lim
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria, Australia
| | - Jong-Koo Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Daehee Kang
- Department of Preventive Medicine, College of Medicine Seoul National University, Seoul, Republic of Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung Ang University, Anseong, Republic of Korea
| |
Collapse
|
26
|
Lopez-Pascual A, Trayhurn P, Martínez JA, González-Muniesa P. Oxygen in Metabolic Dysfunction and Its Therapeutic Relevance. Antioxid Redox Signal 2021; 35:642-687. [PMID: 34036800 DOI: 10.1089/ars.2019.7901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Significance: In recent years, a number of studies have shown altered oxygen partial pressure at a tissue level in metabolic disorders, and some researchers have considered oxygen to be a (macro) nutrient. Oxygen availability may be compromised in obesity and several other metabolism-related pathological conditions, including sleep apnea-hypopnea syndrome, the metabolic syndrome (which is a set of conditions), type 2 diabetes, cardiovascular disease, and cancer. Recent Advances: Strategies designed to reduce adiposity and its accompanying disorders have been mainly centered on nutritional interventions and physical activity programs. However, novel therapies are needed since these approaches have not been sufficient to counteract the worldwide increasing rates of metabolic disorders. In this regard, intermittent hypoxia training and hyperoxia could be potential treatments through oxygen-related adaptations. Moreover, living at a high altitude may have a protective effect against the development of abnormal metabolic conditions. In addition, oxygen delivery systems may be of therapeutic value for supplying the tissue-specific oxygen requirements. Critical Issues: Precise in vivo methods to measure oxygenation are vital to disentangle some of the controversies related to this research area. Further, it is evident that there is a growing need for novel in vitro models to study the potential pathways involved in metabolic dysfunction to find appropriate therapeutic targets. Future Directions: Based on the existing evidence, it is suggested that oxygen availability has a key role in obesity and its related comorbidities. Oxygen should be considered in relation to potential therapeutic strategies in the treatment and prevention of metabolic disorders. Antioxid. Redox Signal. 35, 642-687.
Collapse
Affiliation(s)
- Amaya Lopez-Pascual
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Paul Trayhurn
- Obesity Biology Unit, University of Liverpool, Liverpool, United Kingdom.,Clore Laboratory, The University of Buckingham, Buckingham, United Kingdom
| | - J Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain.,Precision Nutrition and Cardiometabolic Health, IMDEA Food, Madrid Institute for Advanced Studies, Madrid, Spain
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain
| |
Collapse
|
27
|
Zeng Q, Yang Z, Wang F, Li D, Liu Y, Wang D, Zhao X, Li Y, Wang Y, Feng X, Chen J, Li Y, Zheng Y, Kenney T, Gu H, Feng S, Li S, He Y, Xu X, Dai W. Association between metabolic status and gut microbiome in obese populations. Microb Genom 2021; 7. [PMID: 34356001 PMCID: PMC8549370 DOI: 10.1099/mgen.0.000639] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Despite that obesity is associated with many metabolic diseases, a significant proportion (10–30 %) of obese individuals is recognized as ‘metabolically healthy obeses’ (MHOs). The aim of the current study is to characterize the gut microbiome for MHOs as compared to ‘metabolically unhealthy obeses’ (MUOs). We compared the gut microbiome of 172 MHO and 138 MUO individuals from Chongqing (China) (inclined to eat red meat and food with a spicy taste), and performed validation with selected biomarkers in 40 MHOs and 33 MUOs from Quanzhou (China) (inclined to eat seafood and food with a light/bland taste). The genera Alistipes, Faecalibacterium and Odoribacter had increased abundance in both Chongqing and Quanzhou MHOs. We also observed different microbial functions in MUOs compared to MHOs, including an increased abundance of genes associated with glycan biosynthesis and metabolism. In addition, the microbial gene markers identified from the Chongqing cohort bear a moderate accuracy [AUC (area under the operating characteristic curve)=0.69] for classifying MHOs distinct from MUOs in the Quanzhou cohort. These findings indicate that gut microbiome is significantly distinct between MHOs and MUOs, implicating the potential of the gut microbiome in stratification and refined management of obesity.
Collapse
Affiliation(s)
- Qiang Zeng
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, PR China
| | - Zhenyu Yang
- School of Statistics and Data Science, Nankai University, Tianjin 300000, PR China.,Key Laboratory for Medical Data Analysis and Statistical Research of Tianjin, Tianjin 300000, PR China
| | - Fei Wang
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, PR China
| | - Dongfang Li
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, PR China
| | - Yanhong Liu
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, PR China
| | - Daxi Wang
- Melbourne Veterinary School, Department of Veterinary Biosciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Xiaolan Zhao
- Southwest Hospital, Third Military Medical University, Chongqing 400000, PR China
| | - Yinhu Li
- Department of Computer Science, College of Science and Engineering, City University of Hong Kong, Hong Kong 999077, PR China
| | - Yu Wang
- Health Management Center, 91st Hospital of the People's Liberation Army, Quanzhou 362000, PR China
| | - Xin Feng
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, PR China
| | - Jiaxing Chen
- Department of Computer Science, College of Science and Engineering, City University of Hong Kong, Hong Kong 999077, PR China
| | - Yongli Li
- Department of Health Management, Henan Provincial People's Hospital, Zhengzhou 450003, PR China
| | - Yuejie Zheng
- Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen 518000, PR China
| | - Toby Kenney
- Department of Mathematics and Statistics, Dalhousie University, Halifax 15000, Canada
| | - Hong Gu
- Department of Mathematics and Statistics, Dalhousie University, Halifax 15000, Canada
| | - Su Feng
- School of Statistics and Data Science, Nankai University, Tianjin 300000, PR China
| | - Shuangcheng Li
- Department of Computer Science, College of Science and Engineering, City University of Hong Kong, Hong Kong 999077, PR China
| | - Yuan He
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, PR China.,National Research Institute for Health, Beijing 100000, PR China
| | - Ximing Xu
- School of Statistics and Data Science, Nankai University, Tianjin 300000, PR China.,Key Laboratory for Medical Data Analysis and Statistical Research of Tianjin, Tianjin 300000, PR China
| | - Wenkui Dai
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518000, PR China
| |
Collapse
|
28
|
Zhang P, Wang W, Mao M, Gao R, Shi W, Li D, Calderone R, Sui B, Tian X, Meng X. Similarities and Differences: A Comparative Review of the Molecular Mechanisms and Effectors of NAFLD and AFLD. Front Physiol 2021; 12:710285. [PMID: 34393826 PMCID: PMC8362097 DOI: 10.3389/fphys.2021.710285] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/29/2021] [Indexed: 12/12/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) are the most prevalent metabolic liver diseases globally. Due to the complex pathogenic mechanisms of NAFLD and AFLD, no specific drugs were approved at present. Lipid accumulation, oxidative stress, insulin resistance, inflammation, and dietary habits are all closely related to the pathogenesis of NAFLD and AFLD. However, the mechanism that promotes disease progression has not been fully elucidated. Meanwhile, the gut microbiota and their metabolites also play an important role in the pathogenesis and development of NAFLD and AFLD. This article comparatively reviewed the shared and specific signaling pathways, clinical trials, and potential intervention effectors of NAFLD and AFLD, revealing their similarities and differences. By comparing the shared and specific molecular regulatory mechanisms, this paper provides mutual reference strategies for preventing and treating NAFLD, AFLD, and related metabolic diseases. Furthermore, it provides enlightenment for discovering novel therapies of safe and effective drugs targeting the metabolic liver disease.
Collapse
Affiliation(s)
- Pengyi Zhang
- School of Sports and Health, Shandong Sport University, Jinan, China
| | - Weiya Wang
- School of Sports and Health, Shandong Sport University, Jinan, China.,Shandong Academy of Pharmaceutical Science, Jinan, China
| | - Min Mao
- Department of Allied Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ruolin Gao
- School of Sports and Health, Shandong Sport University, Jinan, China
| | - Wenting Shi
- School of Sports and Health, Shandong Sport University, Jinan, China
| | - Dongmei Li
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States
| | - Richard Calderone
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States
| | - Bo Sui
- School of Sports and Health, Shandong Sport University, Jinan, China
| | - Xuewen Tian
- School of Sports and Health, Shandong Sport University, Jinan, China
| | - Xiangjing Meng
- Shandong Academy of Pharmaceutical Science, Jinan, China
| |
Collapse
|
29
|
Plaza-Florido A, Altmäe S, Esteban FJ, Cadenas-Sanchez C, Aguilera CM, Einarsdottir E, Katayama S, Krjutškov K, Kere J, Zaldivar F, Radom-Aizik S, Ortega FB. Distinct whole-blood transcriptome profile of children with metabolic healthy overweight/obesity compared to metabolic unhealthy overweight/obesity. Pediatr Res 2021; 89:1687-1694. [PMID: 33230195 DOI: 10.1038/s41390-020-01276-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/18/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Youth populations with overweight/obesity (OW/OB) exhibit heterogeneity in cardiometabolic health phenotypes. The underlying mechanisms for those differences are still unclear. This study aimed to analyze the whole-blood transcriptome profile (RNA-seq) of children with metabolic healthy overweight/obesity (MHO) and metabolic unhealthy overweight/obesity (MUO) phenotypes. METHODS Twenty-seven children with OW/OB (10.1 ± 1.3 years, 59% boys) from the ActiveBrains project were included. MHO was defined as having none of the following criteria for metabolic syndrome: elevated fasting glucose, high serum triglycerides, low high-density lipoprotein-cholesterol, and high systolic or diastolic blood pressure, while MUO was defined as presenting one or more of these criteria. Inflammatory markers were additionally determined. Total blood RNA was analyzed by 5'-end RNA-sequencing. RESULTS Whole-blood transcriptome analysis revealed a distinct pattern of gene expression in children with MHO compared to MUO children. Thirty-two genes differentially expressed were linked to metabolism, mitochondrial, and immune functions. CONCLUSIONS The identified gene expression patterns related to metabolism, mitochondrial, and immune functions contribute to a better understanding of why a subset of the population remains metabolically healthy despite having overweight/obesity. IMPACT A distinct pattern of whole-blood transcriptome profile (RNA-seq) was identified in children with metabolic healthy overweight/obesity (MHO) compared to metabolic unhealthy overweight/obesity (MUO) phenotype. The most relevant genes in understanding the molecular basis underlying the MHO/MUO phenotypes in children could be: RREB1, FAM83E, SLC44A1, NRG1, TMC5, CYP3A5, TRIM11, and ADAMTSL2. The identified whole-blood transcriptome profile related to metabolism, mitochondrial, and immune functions contribute to a better understanding of why a subset of the population remains metabolically healthy despite having overweight/obesity.
Collapse
Affiliation(s)
- Abel Plaza-Florido
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain.
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain.,Competence Centre on Health Technologies, Tartu, Estonia.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Francisco J Esteban
- Systems Biology Unit, Department of Experimental Biology, Faculty of Experimental Sciences, University of Jaen, Jaen, Spain
| | - Cristina Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain.,Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Concepción M Aguilera
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Centre for Biomedical Research, University of Granada, Granada, Spain.,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - Elisabet Einarsdottir
- Science for Life Laboratory, Department of Gene Technology, KTH Royal Institute of Technology, SE-171 21, Solna, Sweden
| | - Shintaro Katayama
- Stem Cells and Metabolism Research Program (STEMM), University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Kaarel Krjutškov
- Competence Centre on Health Technologies, Tartu, Estonia.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Institute of Clinical Medicine, Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia
| | - Juha Kere
- Stem Cells and Metabolism Research Program (STEMM), University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Frank Zaldivar
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
30
|
Nerurkar PV, Gandhi K, Chen JJ. Correlations between Coffee Consumption and Metabolic Phenotypes, Plasma Folate, and Vitamin B12: NHANES 2003 to 2006. Nutrients 2021; 13:nu13041348. [PMID: 33919513 PMCID: PMC8073624 DOI: 10.3390/nu13041348] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 12/18/2022] Open
Abstract
Metabolic syndrome (MetS) is prevalent not only among the overweight and obese but also normal weight individuals, and the phenotype is referred to as a metabolically unhealthy phenotype (MUHP). Besides normal weight individuals, overweight/obese individuals are also protected from MetS, and the phenotype is known as a metabolically healthy phenotype (MHP). Epidemiological studies indicate that coffee and micronutrients such as plasma folate or vitamin B12 (vit. B12) are inversely associated with MetS. However, correlations among coffee consumption metabolic phenotypes, plasma folate, and vit. B12 remain unknown. Our objective was to investigate the correlation between coffee consumption, metabolic phenotypes, plasma folate, and vit. B12 as well as to understand associations between plasma folate, vit. B12, and metabolic phenotypes. Associations among coffee consumption metabolic phenotypes, plasma folate, and vit. B12 were assessed in a cross-sectional study of 2201 participants, 18 years or older, from 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys (NHANES). MUHP was classified as having > three metabolic abnormalities. Coffee consumption was not associated with metabolic phenotypes, but negatively correlated with several metabolic variables, including BMI (p < 0.001). Plasma folate was positively associated with MUHP (p < 0.004), while vit. B12 was inversely associated with MUHP (p < 0.035). Our results suggest the potential protective impact of coffee on individual components of MetS and indicate a positive correlation between coffee consumption and MUHP among overweight individuals. Identifying possible dietary factors may provide practical and low-cost dietary intervention targets, specifically for early intervention. Larger and randomized intervention studies and prospective longitudinal studies are required to further evaluate these associations.
Collapse
Affiliation(s)
- Pratibha V. Nerurkar
- Laboratory of Metabolic Disorders and Alternative Medicine, Department of Molecular Biosciences and Bioengineering (MBBE), College of Tropical Agriculture and Human Resources (CTAHR), University of Hawaii at Manoa, Honolulu, HI 96822, USA
- Correspondence: ; Tel.: +1-(808)-956-9195
| | - Krupa Gandhi
- Division of Biostatistics, Thomas Jefferson University Hospitals, Philadelphia, PA 19107, USA;
| | - John J. Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA;
| |
Collapse
|
31
|
Generation of a Novel Transgenic Zebrafish for Studying Adipocyte Development and Metabolic Control. Int J Mol Sci 2021; 22:ijms22083994. [PMID: 33924375 PMCID: PMC8069137 DOI: 10.3390/ijms22083994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/10/2023] Open
Abstract
Zebrafish have become a popular animal model for studying various biological processes and human diseases. The metabolic pathways and players conserved among zebrafish and mammals facilitate the use of zebrafish to understand the pathological mechanisms underlying various metabolic disorders in humans. Adipocytes play an important role in metabolic homeostasis, and zebrafish adipocytes have been characterized. However, a versatile and reliable zebrafish model for long-term monitoring of adipose tissues has not been reported. In this study, we generated stable transgenic zebrafish expressing enhanced green fluorescent protein (EGFP) in adipocytes. The transgenic zebrafish harbored adipose tissues that could be detected using GFP fluorescence and the morphology of single adipocyte could be investigated in vivo. In addition, we demonstrated the applicability of this model to the long-term in vivo imaging of adipose tissue development and regulation based on nutrition. The transgenic zebrafish established in this study may serve as an excellent tool to advance the characterization of white adipose tissue in zebrafish, thereby aiding the development of therapeutic interventions to treat metabolic diseases in humans.
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
Deciphering Biochemical and Molecular Signatures Associated with Obesity in Context of Metabolic Health. Genes (Basel) 2021; 12:genes12020290. [PMID: 33669862 PMCID: PMC7923210 DOI: 10.3390/genes12020290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022] Open
Abstract
This study aims to identify the clinical and genetic markers related to the two uncommon nutritional statuses—metabolically unhealthy normal-weight (MUNW) and metabolically healthy overweight/obese (MHOW) individuals in the physically active individuals. Physically active male volunteers (n = 120) were recruited, and plasma samples were analyzed for the clinical parameters. Triglycerides, HDL-Cholesterol, LDL-cholesterol, total cholesterol, C-reactive protein, and insulin resistance were considered as markers of metabolic syndrome. The subjects were classified as ‘healthy’ (0 metabolic abnormalities) or ‘unhealthy’ (≥1 metabolic abnormalities) in their respective BMI group with a cut-off at 24.9 kg/m2. Analysis of biochemical variables was done using enzyme linked immunosorbent assay (ELISA) kits with further confirmation using western blot analysis. The microarray was conducted, followed by quantitative real-time PCR to identify and analyze differentially expressed genes (DEGs). The MHOW group constituted 12.6%, while the MUNW group constituted 32.4% of the total study population. Pro-inflammatory markers like interleukin-6, tumor necrosis factor (TNF)-α, and ferritin were increased in metabolically unhealthy groups in comparison to metabolically healthy groups. Gene expression profiling of MUNW and MHOW individuals resulted in differential expression of 7470 and 5864 genes, respectively. The gene ontology (GO) biological pathway analysis showed significant enrichment of the ‘JAK/STAT signaling pathway’ in MUNW and ‘The information-processing pathway at the IFN-β enhancer′ pathway in MHOW. The G6PC3 gene has genetically emerged as a new distinct gene showing its involvement in insulin resistance. Biochemical, as well as genetic analysis, revealed that MUNW and MHOW are the transition state between healthy and obese individuals with simply having fewer metabolic abnormalities. Moreover, it is possible that the state of obesity is a biological adaptation to cope up with the unhealthy parameters.
Collapse
|
34
|
Association between metabolically healthy obesity/overweight and cardiovascular disease risk: A representative cohort study in Taiwan. PLoS One 2021; 16:e0246378. [PMID: 33524067 PMCID: PMC7850496 DOI: 10.1371/journal.pone.0246378] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/15/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals. Methods Taiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5–23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis. Results Among 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99). Conclusions Individuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control.
Collapse
|
35
|
Mayoral LPC, Andrade GM, Mayoral EPC, Huerta TH, Canseco SP, Rodal Canales FJ, Cabrera-Fuentes HA, Cruz MM, Pérez Santiago AD, Alpuche JJ, Zenteno E, Ruíz HM, Cruz RM, Jeronimo JH, Perez-Campos E. Obesity subtypes, related biomarkers & heterogeneity. Indian J Med Res 2021; 151:11-21. [PMID: 32134010 PMCID: PMC7055173 DOI: 10.4103/ijmr.ijmr_1768_17] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Obesity is a serious medical condition worldwide, which needs new approaches and recognized international consensus in treating diseases leading to morbidity. The aim of this review was to examine heterogeneous links among the various phenotypes of obesity in adults. Proteins and associated genes in each group were analysed to differentiate between biomarkers. A variety of terms for classification and characterization within this pathology are currently in use; however, there is no clear consensus in terminology. The most significant groups reviewed include metabolically healthy obese, metabolically abnormal obese, metabolically abnormal, normal weight and sarcopenic obese. These phenotypes do not define particular genotypes or epigenetic gene regulation, or proteins related to inflammation. There are many other genes linked to obesity, though the value of screening all of those for diagnosis has low predictive results, as there are no significant biomarkers. It is important to establish a consensus in the terminology used and the characteristics attributed to obesity subtypes. The identification of specific molecular biomarkers is also required for better diagnosis in subtypes of obesity.
Collapse
Affiliation(s)
- Laura Perez-Campos Mayoral
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Gabriel Mayoral Andrade
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Eduardo Perez-Campos Mayoral
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | | | - Socorro Pina Canseco
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Francisco J Rodal Canales
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Héctor Alejandro Cabrera-Fuentes
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore; Institute of Biochemistry, Medical School, Justus-Liebig University, Giessen, Germany
| | | | | | - Juan José Alpuche
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Edgar Zenteno
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Hector Martínez Ruíz
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Ruth Martínez Cruz
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Julia Hernandez Jeronimo
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Oaxaca, Mexico
| | - Eduardo Perez-Campos
- National Technological Institute of Mexico, ITOaxaca; Clinical Pathology Laboratory 'Dr. Eduardo Pérez Ortega' Oaxaca, Mexico
| |
Collapse
|
36
|
Yu J, Sun H, Zhu J, Wei X, Shi H, Shen B, Ren L, He Y, Zhang R, Zhang M, Peng H. Asymptomatic Hyperuricemia and Metabolically Unhealthy Obesity: A Cross-Sectional Analysis in the Tianning Cohort. Diabetes Metab Syndr Obes 2021; 14:1367-1374. [PMID: 33790604 PMCID: PMC8006809 DOI: 10.2147/dmso.s301363] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The relationship between obesity and hyperuricemia has been demonstrated by many studies. However, whether or to what extent metabolic condition influents the association between obesity and hyperuricemia was not clear. Here, we aimed to examine the association between obese-metabolic phenotype and hyperuricemia in a large sample of Chinese adults. METHODS According to BMI and metabolic syndrome, obese-metabolic phenotype was defined as metabolically unhealthy obesity (MUO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically healthy non-obesity (MHNO)in the Tianning cohort (N=5072). We conducted a cross-sectional analysis between obese-metabolic phenotype and hyperuricemia, followed by a Mendelian Randomization analysis using GWAS summary data to confirm the causality between uric acid and BMI. RESULTS The average level of serum UA showed 41.87-higher μmol/L in participants with MHO (β=41.87, P<0.001) and 63.18-higher μmol/L in participants with MUO (β=63.18, P<0.001), compared to those with MHNO. Compared to participants with MHNO, those with MUO had the highest likelihood to have hyperuricemia (OR=4.56, P<0.001), followed by those with MHO (OR=3.32, P<0.001). Mendelian randomization analysis indicated that uric acid was more likely to be a consequence of BMI (β=0.059, P=6.54×10-154). CONCLUSION MUO, in comparison with MHO, was significantly associated with hyperuricemia in Chinese adults.
Collapse
Affiliation(s)
- Jia Yu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hongyan Sun
- Center for Disease Prevention and Control of Tianning District, Changzhou, People’s Republic of China
| | - Jinhua Zhu
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Xintong Wei
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hongfei Shi
- Center for Disease Prevention and Control of Tianning District, Changzhou, People’s Republic of China
| | - Bin Shen
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Liyun Ren
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Rongyan Zhang
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Mingzhi Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, People’s Republic of China
- Correspondence: Hao Peng Department of Epidemiology, School of Public Health, Medical College of Soochow University, 199 Renai Road, Industrial Park, Suzhou, 215123, People’s Republic of ChinaTel +86 512 6588 0078Fax +86 512 6588 0052 Email
| |
Collapse
|
37
|
Sarkar TR, McNeal CJ, Meininger CJ, Niu Y, Mallick BK, Carroll RJ, Wu G. Dietary Intakes of Amino Acids and Other Nutrients by Adult Humans. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1332:211-227. [PMID: 34251646 DOI: 10.1007/978-3-030-74180-8_12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Measuring usual dietary intake in freely living humans is difficult to accomplish. As a part of our recent study, a food frequency questionnaire was completed by healthy adult men and women at days 0 and 90 of the study. Data from the food questionnaire were analyzed with a nutrient analysis program ( www.Harvardsffq.date ). Healthy men and women consumed protein as 19-20% and 17-19% of their total energy intakes, respectively, with animal protein representing about 75 and 70% of their total protein intakes, respectively. The intake of each nutritionally essential amino acid (EAA) by the persons exceeded that recommended for healthy adults with a minimal physical activity. In all individuals, the dietary intake of leucine was the highest, followed by lysine, valine, and isoleucine in descending order, and the ingestion of amino acids that are synthesizable de novo in animal cells (AASAs) was about 20% greater than that of total EAAs. The intake of each AASA met those recommended for healthy adults with a minimal physical activity. Intakes of some AASAs (alanine, arginine, aspartate, glutamate, and glycine) from a typical diet providing 90-110 g food protein/day does not meet the requirements of adults with an intensive physical activity. Within the male or female group, there were not significant differences in the dietary intakes of all amino acids between days 0 and 90 of the study, and this was also true for nearly all other essential nutrients. Our findings will help to improve amino acid nutrition and health in both the general population and exercising individuals.
Collapse
Affiliation(s)
- Tapasree R Sarkar
- Department of Biology, Texas A&M University, College Station, TX, 77843, USA
| | - Catherine J McNeal
- Department of Internal Medicine, Baylor Scott & White Health, Temple, TX, 76508, USA
| | - Cynthia J Meininger
- Department of Medical Physiology, Texas A&M University, College Station, TX, 77843, USA
| | - Yabo Niu
- Department of Statistics, Texas A&M University, College Station, TX, 77843, USA
| | - Bani K Mallick
- Department of Statistics, Texas A&M University, College Station, TX, 77843, USA
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, College Station, TX, 77843, USA.,Faculty of Nutrition, Texas A&M University, College Station, TX, 77843, USA
| | - Guoyao Wu
- Faculty of Nutrition, Texas A&M University, College Station, TX, 77843, USA. .,Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA.
| |
Collapse
|
38
|
Korduner J, Nilsson PM, Melander O, Gerl MJ, Engström G, Bachus E, Magnusson M, Ottosson F. Proteomic and Metabolomic Characterization of Metabolically Healthy Obesity: A Descriptive Study from a Swedish Cohort. J Obes 2021; 2021:6616983. [PMID: 34659828 PMCID: PMC8514926 DOI: 10.1155/2021/6616983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/23/2021] [Indexed: 12/18/2022] Open
Abstract
METHOD Associations between different biomarkers (proteomics, lipidomics, and metabolomics) coupled to either MHO or metabolically unhealthy obese (MUO) individuals were analyzed through principal component analysis (PCA). Subjects were identified from a subsample of 416 obese individuals, selected from the Malmö Diet and Cancer study-Cardiovascular arm (MDCS-CV, n = 3,443). They were further divided into MHO (n = 143) and MUO (n = 273) defined by a history of hospitalization, or not, at baseline inclusion, and nonobese subjects (NOC, n = 3,027). Two distinctive principle components (PL2, PP5) were discovered with a significant difference and thus further investigated through their main loadings. RESULTS MHO individuals had a more metabolically favorable lipid and glucose profile than MUO subjects, that is, lower levels of traditional blood glucose and triglycerides, as well as a trend of lower metabolically unfavorable lipid biomarkers. PL2 (lipidomics, p=0.02) showed stronger associations of triacylglycerides with MUO, whereas phospholipids correlated with MHO. PP5 (proteomics, p=0.01) included interleukin-1 receptor antagonist (IL-1ra) and leptin with positive relations to MUO and galanin that correlated positively to MHO. The group differences in metabolite profiles were to a large extent explained by factors included in the metabolic syndrome. CONCLUSION Compared to MUO individuals, corresponding MHO individuals present with a more favorable lipid metabolic profile, accompanied by a downregulation of potentially harmful proteomic biomarkers. This unique and extensive biomarker profiling presents novel data on potentially differentiating traits between these two obese phenotypes.
Collapse
Affiliation(s)
- J. Korduner
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - P. M. Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - O. Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - G. Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - E. Bachus
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - M. Magnusson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa
| | - F. Ottosson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| |
Collapse
|
39
|
Liu L, Liu S, Song Q, Luo D, Su Y, Qi X, Wang Q, Ning J, Lv Y, Guan Q. Association of Metabolic Obesity Phenotypes and Total Testosterone in Chinese Male Population. Diabetes Metab Syndr Obes 2021; 14:399-408. [PMID: 33542639 PMCID: PMC7853434 DOI: 10.2147/dmso.s293259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/22/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Obesity and metabolic syndrome have been reported to exert an impact on the male reproductive system with decreasing levels of serum total testosterone (TT); however, the effect of different metabolic obesity phenotypes on testosterone has been poorly studied. We aimed to evaluate the association of metabolic obesity phenotypes and total testosterone levels in a Chinese male population. METHODS We performed a retrospective study based on an epidemiological investigation, a total of 4,081 male individuals aged from 40-75 years old were recruited. The population was classified as metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO) according to normal weight (BMI<25.0) and overweight/obesity (BMI≥25.0) with or without metabolic syndrome. RESULTS We collected 563 hypotestosteronemia among 4,081 male individuals. The odds ratios (ORs) (95% CIs) of hypotestosteronemia in obesity and metabolic syndrome were 3.072 (2.414-3.911) and 3.294 (2.631-4.125), respectively, after adjusting for age, luteinizing hormone, smoking status, and alcohol consumption. Compared to the MHNW group, male subjects in MHO, MUNW, and MUO groups had decreased serum TT levels. Additionally, the MUO group had a lowest concentration of serum TT and a highest proportion of hypotestosteronemia. There was no significant difference of TT levels between the MHO and MUNW groups. CONCLUSION Obesity and metabolic syndrome are independent risk factors of hypotestosteronemia in Chinese male populations. Our study also suggested that individuals with MHO, MUNW, and MUO have a higher risk of developing hypotestosteronemia.
Collapse
Affiliation(s)
- Luna Liu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Shuang Liu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qianmei Song
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Dandan Luo
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Yu Su
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Xiangyu Qi
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qian Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong250021, People’s Republic of China
| | - Jing Ning
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Youyuan Lv
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong250021, People’s Republic of China
- Correspondence: Qingbo Guan Tel +86-531-68776375Fax +86-531-87068707 Email
| |
Collapse
|
40
|
Abstract
Adipose, or fat, tissue (AT) was once considered an inert tissue that primarily existed to store lipids, and was not historically recognized as an important organ in the regulation and maintenance of health. With the rise of obesity and more rigorous research, AT is now recognized as a highly complex metabolic organ involved in a host of important physiological functions, including glucose homeostasis and a multitude of endocrine capabilities. AT dysfunction has been implicated in several disease states, most notably obesity, metabolic syndrome and type 2 diabetes. The study of AT has provided useful insight in developing strategies to combat these highly prevalent metabolic diseases. This review highlights the major functions of adipose tissue and the consequences that can occur when disruption of these functions leads to systemic metabolic dysfunction.
Collapse
Affiliation(s)
- Innocence Harvey
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Anik Boudreau
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Jacqueline M Stephens
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.,Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
| |
Collapse
|
41
|
Shestakova EA, Sklyanik IA, Panevina AS, Nikankina LV, Shestakova MV, Dedov II. [Obesity without diabetes: the role of hormonal regulation]. TERAPEVT ARKH 2020; 92:15-22. [PMID: 33346474 DOI: 10.26442/00403660.2020.10.000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022]
Abstract
AIM Obese patients without diabetes present an interesting phenotype to explore protective mechanisms against type 2 diabetes (T2D) development. In our study we looked for specific hormonal features of obese patients without T2D. MATERIALS AND METHODS We included 6 groups of patients with different metabolic profiles (n=212): controls with BMI25 kg/m2, HbA1c6%, age 30 years; patients with 25BMI30 kg/m2and HbA1c6%; patients with 25BMI30 kg/m2and HbA1c6%; patients with BMI30 kg/m2and HbA1c6% (+ Obesity - T2D) obese patients without T2D or prediabetes; patients with BMI30 kg/m2and newly-diagnosed T2D/prediabetes, HbA1c6%; patients with known history of T2D on glucose-lowering drugs with BMI30 kg/m2. Insulin, GLP-1, GIP were measured during glucose-tolerance test at 0, 30 and 120 minutes; insulin resistance (IR) was assessed by HOMA-IR. RESULTS Waist circumference was bigger in patients with obesity despite their metabolic profile comparing to patients without obesity (p0.001). Waist-to-hip ratio was similar in patients with different metabolic status. According to IR + Obesity - T2D group had intermediate position: IR was higher in that group comparing to people without obesity, but was less that in patients with obesity and HbA1c6% (p0.001). + Obesity - T2D group had the most potent baseline insulin secretion, assessed by НОМА-%band the highest postprandial secretion, measured by insulinogenic index among all patient groups with obesity (p0.001). There was no significant difference in GLP-1 secretion; GIP secretion was higher in patients with BMI30 kg/m2comparing to people with BMI30 kg/m2(p0.01).
Collapse
|
42
|
Fernández-Verdejo R, Moya-Osorio JL, Fuentes-López E, Galgani JE. Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017. PLoS One 2020; 15:e0236451. [PMID: 32697789 PMCID: PMC7375524 DOI: 10.1371/journal.pone.0236451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Lifestyle habits associate with metabolic health in overall populations. Whether such association is similar among subjects with a different nutritional status has been less studied. We aimed to (i) determine the prevalence of metabolic phenotypes in Chile, and (ii) determine the association between lifestyle habits and metabolic health according to the nutritional status. METHODS The National Health Survey of Chile 2016-2017 was analyzed. A metabolically unhealthy phenotype was defined as manifesting ≥3 of the following risk factors: elevated blood pressure, elevated triglycerides, elevated glucose, elevated waist circumference, or reduced high-density lipoprotein cholesterol. Individuals manifesting <2 risk factors were considered as healthy. The nutritional status was defined as normal weight (18.5 to <25 kg/m2), overweight (25 to <30 kg/m2) or obesity (≥30 kg/m2). Questionnaires were used to estimate smoking habits, alcohol intake, sedentary behavior, moderate-vigorous physical activity, fruits/vegetables consumption, and fish/seafood consumption. The association (odds ratio [95%CI]) between lifestyle habits and metabolic health was determined within each nutritional status, adjusting for age, sex, BMI (in kg/m2), and education. RESULTS The prevalence of a metabolically unhealthy phenotype was 36% in the overall sample. Such a prevalence was 7%, 33% and 58% among subjects with normal weight, overweight and obesity, respectively. In subjects with normal weight, the highest quartile of fruits/vegetables consumption was associated with reduced odds of having a metabolically unhealthy phenotype (0.09 [0.01-0.48]). In subjects with obesity, the highest quartile of moderate-vigorous physical activity was associated with reduced odds of having a metabolically unhealthy phenotype (0.29 [0.09-0.91]). CONCLUSION One third of the Chilean population manifests an unhealthy phenotype. We identified associations between lifestyle habits and metabolic health that are specific to the nutritional status. Thus, emphasizing fruits/vegetables consumption in subjects with normal weight, and physical activity in subjects with obesity, may maximize the benefits of public health interventions.
Collapse
Affiliation(s)
- Rodrigo Fernández-Verdejo
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | - José Luis Moya-Osorio
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose E. Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
43
|
Fang Y, Kaszuba T, Imoukhuede PI. Systems Biology Will Direct Vascular-Targeted Therapy for Obesity. Front Physiol 2020; 11:831. [PMID: 32760294 PMCID: PMC7373796 DOI: 10.3389/fphys.2020.00831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Healthy adipose tissue expansion and metabolism during weight gain require coordinated angiogenesis and lymphangiogenesis. These vascular growth processes rely on the vascular endothelial growth factor (VEGF) family of ligands and receptors (VEGFRs). Several studies have shown that controlling vascular growth by regulating VEGF:VEGFR signaling can be beneficial for treating obesity; however, dysregulated angiogenesis and lymphangiogenesis are associated with several chronic tissue inflammation symptoms, including hypoxia, immune cell accumulation, and fibrosis, leading to obesity-related metabolic disorders. An ideal obesity treatment should minimize adipose tissue expansion and the advent of adverse metabolic consequences, which could be achieved by normalizing VEGF:VEGFR signaling. Toward this goal, a systematic investigation of the interdependency of vascular and metabolic systems in obesity and tools to predict personalized treatment ranges are necessary to improve patient outcomes through vascular-targeted therapies. Systems biology can identify the critical VEGF:VEGFR signaling mechanisms that can be targeted to regress adipose tissue expansion and can predict the metabolic consequences of different vascular-targeted approaches. Establishing a predictive, biologically faithful platform requires appropriate computational models and quantitative tissue-specific data. Here, we discuss the involvement of VEGF:VEGFR signaling in angiogenesis, lymphangiogenesis, adipogenesis, and macrophage specification – key mechanisms that regulate adipose tissue expansion and metabolism. We then provide useful computational approaches for simulating these mechanisms, and detail quantitative techniques for acquiring tissue-specific parameters. Systems biology, through computational models and quantitative data, will enable an accurate representation of obese adipose tissue that can be used to direct the development of vascular-targeted therapies for obesity and associated metabolic disorders.
Collapse
Affiliation(s)
- Yingye Fang
- Imoukhuede Systems Biology Laboratory, Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Tomasz Kaszuba
- Imoukhuede Systems Biology Laboratory, Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - P I Imoukhuede
- Imoukhuede Systems Biology Laboratory, Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, MO, United States
| |
Collapse
|
44
|
Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, Zelber-Sagi S, Wai-Sun Wong V, Dufour JF, Schattenberg JM, Kawaguchi T, Arrese M, Valenti L, Shiha G, Tiribelli C, Yki-Järvinen H, Fan JG, Grønbæk H, Yilmaz Y, Cortez-Pinto H, Oliveira CP, Bedossa P, Adams LA, Zheng MH, Fouad Y, Chan WK, Mendez-Sanchez N, Ahn SH, Castera L, Bugianesi E, Ratziu V, George J. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol 2020; 73:202-209. [PMID: 32278004 DOI: 10.1016/j.jhep.2020.03.039] [Citation(s) in RCA: 2055] [Impact Index Per Article: 513.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 02/06/2023]
Abstract
The exclusion of other chronic liver diseases including "excess" alcohol intake has until now been necessary to establish a diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD). However, given our current understanding of the pathogenesis of MAFLD and its rising prevalence, "positive criteria" to diagnose the disease are required. In this work, a panel of international experts from 22 countries propose a new definition for the diagnosis of MAFLD that is both comprehensive and simple, and is independent of other liver diseases. The criteria are based on evidence of hepatic steatosis, in addition to one of the following three criteria, namely overweight/obesity, presence of type 2 diabetes mellitus, or evidence of metabolic dysregulation. We propose that disease assessment and stratification of severity should extend beyond a simple dichotomous classification to steatohepatitis vs. non-steatohepatitis. The group also suggests a set of criteria to define MAFLD-associated cirrhosis and proposes a conceptual framework to consider other causes of fatty liver disease. Finally, we bring clarity to the distinction between diagnostic criteria and inclusion criteria for research studies and clinical trials. Reaching consensus on the criteria for MAFLD will help unify the terminology (e.g. for ICD-coding), enhance the legitimacy of clinical practice and clinical trials, improve clinical care and move the clinical and scientific field of liver research forward.
Collapse
Affiliation(s)
- Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia.
| | - Philip N Newsome
- National Institute for Health Research Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, UK; Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, UK; Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Quentin M Anstee
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Manuel Romero-Gomez
- UCM Digestive Diseases, Virgen del Rocio University Hospital, Instituto de Biomedicina de Sevilla, CIBEREHD, University of Seville, Sevilla, Spain
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa, Israel; Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Jean-François Dufour
- University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Switzerland; Department of Biomedical Research, University of Bern, Switzerland
| | - Jörn M Schattenberg
- Department of Medicine, University Medical Centre, Johannes Gutenberg University Mainz, Germany
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile and Centro de Envejecimiento y Regeneracion (CARE), Departamento de Biologia Celular y Molecular, Facultad de Ciencias Biologicas Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, and Translational Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Gamal Shiha
- Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Egypt
| | | | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, and Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Jian-Gao Fan
- Center for Fatty Liver, Department of Gastroenterology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Henning Grønbæk
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey; Institute of Gastroenterology, Marmara University, Istanbul, Turkey
| | - Helena Cortez-Pinto
- Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Claudia P Oliveira
- Department of Gastroenterology, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - Pierre Bedossa
- Department of Pathology, Physiology and Imaging, Beaujon Hospital Paris Diderot University, Paris, France
| | - Leon A Adams
- Medical School, Sir Charles Gairdner Hospital Unit, University of Western Australia, Nedlands, WA, Australia
| | - Ming-Hua Zheng
- NAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China
| | - Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University Hospitals, Minya, Egypt
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nahum Mendez-Sanchez
- Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Laurent Castera
- Université Paris VII, Inserm Umr 1149, Centre de Recherche Sur L'inflammation, Paris, France
| | - Elisabetta Bugianesi
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Vlad Ratziu
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière-, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia.
| |
Collapse
|
45
|
Svendsen K, Olsen T, Nordstrand Rusvik TC, Ulven SM, Holven KB, Retterstøl K, Telle-Hansen VH. Fatty acid profile and estimated desaturase activities in whole blood are associated with metabolic health. Lipids Health Dis 2020; 19:102. [PMID: 32438926 PMCID: PMC7243306 DOI: 10.1186/s12944-020-01282-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 05/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aim was to investigate if fatty acid profile and estimated desaturase activities; stearoyl CoA-desaturase (SCD), delta-5-desaturase and delta-6-desaturase (D5D; D6D), differ between individuals with metabolically healthy (MH) and unhealthy (MU) phenotypes. We also explored these associations according to BMI categories. METHODS Men and women at moderately elevated risk of cardiovascular disease were included in this cross-sectional study (n = 321). If subjects met ≥4 out of 5 criteria (elevated triglycerides, total and LDL-cholesterol, HbA1c and low HDL-cholesterol), they were classified as MU (n = 52). If levels were within reference ranges for ≥3 of the same criteria, subjects were classified as MH (n = 150). Utilizing the entire population, a score ranging from 0 to 5 denoting the number of MU criteria met was computed. Estimated desaturase activities were calculated as product-to-precursor ratio of fatty acids in whole blood (SCD16 [16:1n7/16:0], SCD18 [18:1n9/18:0], D5D [18:3n6/18:2n6], D6D [20:4n6/20:3n6]). RESULTS Individuals with MH had lower estimated SCD16 and SCD18 activities, whereas estimated D6D activity was higher compared to MU. Similar, SCD16 and SCD18 increased, whereas D6D decreased with increasing criteria of MU. Trends were similar across BMI categories. CONCLUSIONS This study supports the notion of estimated desaturase activities as possible novel biomarkers of metabolic health irrespectively of BMI.
Collapse
Affiliation(s)
- Karianne Svendsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tove C. Nordstrand Rusvik
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stine M. Ulven
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kirsten B. Holven
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Vibeke H. Telle-Hansen
- Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St Olavs Plass, 0130 Oslo, Norway
| |
Collapse
|
46
|
Bolognese MA, Franco CB, Ferrari A, Bennemann RM, Lopes SMA, Bertolini SMMG, Júnior NN, Branco BHM. Group Nutrition Counseling or Individualized Prescription for Women With Obesity? A Clinical Trial. Front Public Health 2020; 8:127. [PMID: 32426316 PMCID: PMC7203219 DOI: 10.3389/fpubh.2020.00127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/30/2020] [Indexed: 01/21/2023] Open
Abstract
Background: This study investigates the effects of group counseling vs. individual dietary prescription on physical, nutritional, and mental health in overweight or obese women. Methods: Seventy-four women aged 40-59 years with body mass index ≥ 25 kg/m2 were randomized into 2 intervention arms: group nutrition counseling (GNC) or individualized nutrition prescription (INP). Twenty-seven women completed the 12-week intervention protocol. The GNC received counseling once a week and the INP received an individualized prescription once a month. All participants attended physical exercise sessions 3 times a week following the same protocol. Body mass, body mass index, fat mass, body fat percentage, lean mass, lipid profile, hemoglobin A1c, insulin and liver transaminases were measured pre- and post-intervention in both arms. A 3 day food record was applied to calculate the intake of calories, carbohydrates, proteins, and lipids. Body image dissatisfaction, level of anxiety, self-esteem measure and pathological eating attitudes were measured. Results: Both dietary interventions decreased body mass, body mass index, fat mass, body fat percentage, total caloric intake, carbohydrates, proteins, lipids, body dissatisfaction, anxiety, and saturated and polyunsaturated fats (p < 0.05). Lean mass, metabolic variables, self-esteem and pathological eating attitudes remained unchanged (p > 0.05). Conclusion: Both nutritional interventions combined with concurrent exercise were effective to improve anthropometrics, body composition, food intake, and some mental health parameters. We suggest that the choice of nutritional intervention (GNC or INP) could be based on the participants preference, considering the adherence and satisfaction, to promote health and quality of life.
Collapse
Affiliation(s)
- Marciele Alves Bolognese
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
- Research Group in Physical Education, Physiotherapy, Sports, Nutrition and Performance of the University Center of Maringa (GEFFEND/UniCesumar), Maringa, Brazil
| | | | - Ariana Ferrari
- Post-Graduation Program in Science, Technology and Food Safety, University Center of Maringa, Maringa, Brazil
| | - Rose Mari Bennemann
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
| | | | | | - Nelson Nardo Júnior
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Braulio Henrique Magnani Branco
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
- Research Group in Physical Education, Physiotherapy, Sports, Nutrition and Performance of the University Center of Maringa (GEFFEND/UniCesumar), Maringa, Brazil
| |
Collapse
|
47
|
Sinn DH, Kang D, Cho SJ, Chang Y, Ryu S, Song YB, Paik SW, Hong YS, Zhao D, Guallar E, Cho J, Gwak GY. Weight Change and Development of Subclinical Carotid Atherosclerosis Among Metabolically Healthy Adults: A Cohort Study. J Clin Endocrinol Metab 2020; 105:5572846. [PMID: 31545359 DOI: 10.1210/clinem/dgz040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/20/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The benefit of weight loss for reducing cardiovascular disease (CVD) risk in metabolically healthy obese people is unknown. OBJECTIVES We evaluated the association between weight change and incident subclinical carotid atherosclerosis (SCA) in metabolically healthy but overweight or obese subjects. METHODS Cohort study of 3117 metabolically healthy overweight or obese adults who did not have any metabolic syndrome components or insulin resistance at baseline. SCA was assessed using carotid artery ultrasonography. The study outcome was the development of incident SCA among participants free of the disease at baseline. RESULTS During 12 248 person-years of follow-up (median 3.42 years), 747 participants developed SCA. The proportions of participants with no reduction or increased weight, reduction in weight from 0.1% to 4.9%, and reduction in weight ≥ 5% during follow-up were 47.0%, 44.4%, and 8.6%, respectively. The fully-adjusted hazard ratios (HRs) for incident SCA in participants with a reduction in weight of 0.1% to 4.9% and ≥ 5% compared with those with no reduction or increased weight were 0.84 (95% CI, 0.72-0.98) and 0.66 (95% CI, 0.50-0.87), respectively. CONCLUSIONS In a large cohort study of metabolically healthy but overweight or obese adult men and women, weight reduction was associated with a lower incidence of SCA. Our findings suggest that metabolically healthy overweight or obese subjects may benefit from weight reduction in terms of CVD risk.
Collapse
Affiliation(s)
- Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Gangnam-gu, South Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Gangnam-gu, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Gangnam-gu, South Korea
| | - Soo Jin Cho
- Center for Health Promotion, Samsung Medical Center, Seoul, Gangnam-gu, South Korea
| | - Yoosoo Chang
- Center for Total Health Studies, Kangbuk Samsung Hospital, Seoul, Jongro-gu, South Korea
| | - Seungho Ryu
- Center for Total Health Studies, Kangbuk Samsung Hospital, Seoul, Jongro-gu, South Korea
| | - Young Bin Song
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Gangnam-gu, South Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Gangnam-gu, South Korea
| | - Yun Soo Hong
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Di Zhao
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Eliseo Guallar
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Gangnam-gu, South Korea
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Gangnam-gu, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Gangnam-gu, South Korea
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Gangnam-gu, South Korea
| |
Collapse
|
48
|
Association between body size-metabolic phenotype and nonalcoholic steatohepatitis and significant fibrosis. J Gastroenterol 2020; 55:330-341. [PMID: 31535207 DOI: 10.1007/s00535-019-01628-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 09/03/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Body size-metabolic phenotype may help predict whether or not individuals with nonalcoholic fatty liver disease (NAFLD) develop advanced liver disease. We studied the association of body size-metabolic phenotype with nonalcoholic steatohepatitis (NASH) and significant fibrosis. METHODS Our cross-sectional study included 559 subjects (mean age of 53 years; women 51%) with biopsy-proven NAFLD. Clinical, genetic, and histological characteristic features of NAFLD were evaluated. The metabolically unhealthy phenotype was defined by the presence of two or more metabolic components, while body size was categorized based on body mass index: obese (≥ 25 kg/m2) or non-obese (< 25 kg/m2). Body size-metabolic phenotypes were divided into four study groups: (1) non-obese metabolic syndrome (MS)-, (2) non-obese MS+ , (3) obese MS-, and (4) obese MS+. RESULTS Obese MS- and non-obese MS+ groups demonstrated comparable levels of insulin resistance, adipose tissue insulin resistance indexes, and visceral adipose tissue (VAT) areas. The VAT area was significantly higher in the obese MS+ group versus obese MS- group. However, the VAT to subcutaneous adipose tissue (SAT) ratio was highest in the non-obese MS+ group. There was no difference in histology between the non-obese MS+, obese MS-, and obese MS+ groups. Multivariate analyses adjusted for age, sex, smoking status, PNPLA3, TM6SF2, and VAT/SAT areas demonstrated an independent and dose-dependent relationship between the body size-metabolic phenotype and NASH or significant fibrosis. CONCLUSION The non-obese MS+ group displayed similar degree of hepatic histological severity compared to their obese MS- counterparts. Metabolic milieu beyond obesity may play a pathogenic role in non-obese MS+ individuals who develop NASH with significant hepatic fibrosis. CLINICAL TRIAL NUMBER NCT02206841.
Collapse
|
49
|
Metabolically Healthy Obesity-Heterogeneity in Definitions and Unconventional Factors. Metabolites 2020; 10:metabo10020048. [PMID: 32012784 PMCID: PMC7074352 DOI: 10.3390/metabo10020048] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 02/06/2023] Open
Abstract
The concept of heterogeneity among obese individuals in their risk for developing metabolic dysfunction and associated complications has been recognized for decades. At the origin of the heterogeneity idea is the acknowledgement that individuals with central obesity are more prone to developing type 2 diabetes and cardiovascular disease than those with peripheral obesity. There have been attempts to categorize subjects according to their metabolic health and degree of obesity giving rise to different obese and non-obese phenotypes that include metabolically unhealthy normal-weight (MUHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Individuals belonging to the MHO phenotype are obese according to their body mass index although exhibiting fewer or none metabolic anomalies such as type 2 diabetes, dyslipidemia, hypertension, and/or unfavorable inflammatory and fribinolytic profiles. However, some authors claim that MHO is only transient in nature. Additionally, the phenotype categorization is controversial as it lacks standardized definitions possibly blurring the distinction between obesity phenotypes and confounding the associations with health outcomes. To add to the discussion, the factors underlying the origin or protection from metabolic deterioration and cardiometabolic risk for these subclasses are being intensely investigated and several hypotheses have been put forward. In the present review, we compare the different definitions of obesity phenotypes and present several possible factors underlying them (adipose tissue distribution and cellularity, contaminant accumulation on the adipose tissue, dysbiosis and metabolic endotoxemia imposing on to the endocannabinoid tone and inflammasome, and nutrient intake and dietary patterns) having inflammatory activation at the center.
Collapse
|
50
|
Cordeiro A, Campos B, Pereira SE, Saboya CJ, Ramalho A. Inadequacy of Vitamin D Nutritional Status in Individuals with Metabolically Unhealthy Obesity Phenotype: The Relevance of Insulin Resistance. Diabetes Metab Syndr Obes 2020; 13:4131-4139. [PMID: 33177853 PMCID: PMC7652567 DOI: 10.2147/dmso.s256132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim was to evaluate 25(OH)D serum concentrations in metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) and its relation with biochemical and clinical parameters in both groups according to homeostatic model assessment-insulin resistance (HOMA-IR) definition of the obesity phenotypes. PATIENTS AND METHODS Descriptive cross-sectional study was conducted with individuals of both genders. Anthropometric data [waist circumference, body mass index (BMI)] and metabolic parameters: blood glucose, glycated hemoglobin, insulin, lipid profile, calcium, phosphorus, parathyroid hormone (PTH) and high-sensitivity c-reactive protein (hs-CRP) and (25(OH)D) were obtained. The cutoff points for vitamin D deficiency and insufficiency were ≤20 and 21-29 ng/mL, respectively. Individuals were classified as MUHO according to HOMA-IR≥2.5. RESULTS This study comprised 232 individuals with obesity (BMI≥35 kg/m2; 42.6±4.7 kg/m2). The MUHO phenotype was observed in 76.7% of the population. The mean values of glucose (P<0.001), insulin (P<0.001), HOMA-IR (P<0.001), and triglycerides (P=0.049) were significantly higher in the MUHO than in the MHO phenotype group. The mean value of 25(OH)D showed a significant difference between the MHO and MUHO phenotype groups (P=0.011). Additionally, and in line, lower mean 25(OH)D values were found in the MUHO vs the MHO phenotype group in the deficiency (14.5±3.6 ng/mL/17.1±2.7 ng/mL, P=0.004) and insufficiency (24.5±2.9 ng/mL/25.7±2.6 ng/mL, P=0.077) 25(OH)D groups. An increase of 1 ng/mL of vitamin D increased in 1.051 (95% CI= 1.011-1.093, P=0.012) the odds of the healthy phenotype. CONCLUSION The highest prevalence of inadequacy of serum concentrations of 25(OH)D and greater severity of this deficiency in individuals with MUHO phenotype were observed. Low serum concentrations of this vitamin were associated, mainly, with insulin resistance. Monitoring the nutritional status of vitamin D in individuals with obesity that present with MUHO phenotype may contribute to minimize the occurrence and aggravation of diseases associated with obesity.
Collapse
Affiliation(s)
- A Cordeiro
- Department of Social Applied Nutrition, Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Biomedicine, Unit of Biochemistry, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
- Correspondence: A Cordeiro Al. Prof. Hernâni Monteiro, Porto4200 - 319, PortugalTel +351-966669689Fax +351 220 426 937 Email
| | - B Campos
- Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro, Brazil
| | - S E Pereira
- Department of Social Applied Nutrition, Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - C J Saboya
- Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro, Brazil
| | - A Ramalho
- Department of Social Applied Nutrition, Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| |
Collapse
|