Metabolically obese but normal weight, metabolically healthy obesity phenotypes and metabolic – cardiovascular risk
DOI:
https://doi.org/10.15584/przmed.2015.3.7Keywords:
Obesity, metabolic disturbances, cardiovascular diseaseAbstract
The obesity is a risk factor for cardiovascular, cancer and general mortality. It is also an independent risk factor for atherosclerosis. The incidence of obesity-related diseases depends not only on the degree of obesity but mainly on the fat tissue deposition. It is the visceral fat tissue that plays the major role in the development of insulin resistance, impaired glucose tolerance, diabetes, hypertension and cardiovascular diseases. The research showed that the population of obese people is not homogenous in terms of metabolic profile and that a BMI is not the universal obesity indicator. In the 80s Ruderman distinguished metabolic obesity with normal weight. It is defined as an increased amount of visceral and subcutaneous abdominal fat and is associated with an increased risk of metabolic disorders. Insulin resistance and hyperinsulinemia are considered to be the fundamental disorders in this group. The coexistence of impaired carbohydrate and lipid metabolism and hypertension leads to a high risk of cardiovascular disease. The fat tissue deposition enabled also to identify the obese patients that are not at risk of insulin resistance, glucose or lipid metabolism disorders and hypertension (“metabolically healthy”). There are some studies that show the reduction of cardiovascular risk among obese patients with normal metabolic parameters. However, the current knowledge does not allow us to regard obesity with normal metabolic parameters as completely safe.
Downloads
References
Després JP. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006;8:4-12.
Yusuf S, Hawken S, Ounpuu S i wsp. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case control study. Lancet 2005;366:1640-1649.
World Health Statistics 2012. http:/www.who.int/gho/publications/world health statistics/2012 (10.03.2014).
World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation (WHO Technical Report Series 894) 2000;9.
Yusuf S, Hawken S, Ounpuu S i wsp. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case control study. Lancet 2005;366:1640-1649.
Hamdy O. The role of adipose tissue as an endocrine gland. Curr Diab 2005; 5:317-319.
Dickey RA, Bartuska DG, Bray GW i wsp. AACE/ACE Position Statement on the Prevention, Diagnosis, and Treatment of Obesity (1998 Revision). Endocr Pract 1998; 5:300.
Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004;89:2548-2556.
Neels JG, Olefsky JM. Inflamed fat : what starts the fire ? J Clin Invest 2006;116: 33-36.
Van Gaal LF, Mertens IL, De Block CE. Mechanisms linking obesity with cardiovascular disease. Nature 2006;444:875-880.
Klein S, Allison DB, Heymsfield SB i wsp. Waist circumference and cardiometabolic risk: a consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention, NAASO, The Obesity Society, The American Society for Nutrition and the American Diabetes Association. Obesity 2007;15:1061-1067.
Liu J, Fox CS, Hickson DA i wsp. Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factor: The Jacksfon Heart Study. J Clin Endocrinol Metab 2010;95:5419-5426.
Ruderman NB, Schneider SH, Berchtold P. The Metabolically obese normal-weight individuals. Am J Clin Nutr. 1981;34:1617-1621.
Ruderman NB, Berchtold P, Schneider S. Obesity-associated disorders in normal-weight individuals: some speculations. Int J Obes 1982;6:151-157.
Ruderman NB, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual-revisited. Diabetes 1998;47:699-713.
Sims EA. Are there persons who are obese, but metabolically healthy. Metabolism 2001;50:1499-1504.
Katsuki A, Sumida Y, Urakawa H i wsp. Increased visceral fat and serum levels of triglyceride are associated with insulin resistance in Japanese metabolically obese, normal weight subjects with normal glucose tolerance. Diabetes Care 2003;26:2341-2344.
Conus F, Allison DB, Raabasa-Lhoret R i wsp. Metabolic and behavioral characteristics of metabolically obese but normal-weight women. J Clin Endocrinol Metab 2004;89:5013-5020.
Molero-Conejo E, Morales LM, Fernandez V i wsp. Lean adolescents with increased risk for metabolic syndrome Arch. Latinoam. Nutr. 2003;53:39-46.
Nowak M: Profil metaboliczny, skład masy ciała i wskaźniki stanu zapalnego u mężczyzn ze stabilną chorobą wieńcową i normowagą. Praca doktorska. Biblioteka UM Lublin 2014 .
Dvorak RV, De Nino WF, Ades PA. Poehlman ET. Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women. Diabetes 1999;48:2210-2214.
Bluher M. The distinction of metabolically healthy from unhealthy obese individuals. Curr Opin Lipidol 2010;21:38-43.
Katsuki A, Sumida Y, Urakawa H i wsp. Plasma levels of adiponectin are associated with insulin resistance and serum levels triglyceride in Japanese metabolically obese, normal weight men with normal glucose tolerance. Diabetes Care 2003;26:2964-296.
Bednarek-Tupikowska G, Stachowska B, Miazgowski T. Evaluation of the prevalence of metabolic obesity and normal weight among the Polish population. Endokrynol Pol 2012;63:447-455.
Goodpaster BH, Krishnaswami S, Resnick H i wsp. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 2003;26:372-379.
De Lorenzo A, Gobbo V, Premrov MG, Bigioni M, Galvano F, Di Renzo L. Normal –weight syndrome: early inflammation? Am J Clin Nutr 2007; 85:40-5.
Meigs JB, Wilson PW, Fox CS i wsp. Body mass index metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 2006;91:2906-2912.
Romero-Corral A, Somers VK, Sierra-Johnson J i wsp. Normal Weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur. Heart J 2010;31:737-746.
Arnlöv J, Ingelsson E, Sundström J, Lind L. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation 2010;121:230-236.
Philips CM , Perry IJ. Does inflammation determine metabolic health status in obese and nonobese adults. JCEM 2013;98(10):1610-1619.
Wildman RP, Munter P, Reynolds K i wsp. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: Prevalence and correlates of 2 phenotypes among the us population (NHANES 1999-2004). Arch Intern Med. 2008;168:1617-1624.
Vliet-Ostaptchouk JV, Nuotino ML, Slagter SN i wsp. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocr Disord 2014;14:9.
Karelis AD: To be obese – does it matter if you are metabolically healthy? Nat Rev Endocrinol 2011;7:699-700.
Stefan N, Haring HU, Hu FB, Schulze MB. Metabolically healthy obesity: epidemiology, mechanism, and clinical implications. Lancet Diabetes Endocrinol 2013;1:152-162.
Marini MA, Succuro E, Frontoni S i wsp. Metabolically healthy but obese women have an intermediate cardiovascular risk profile between healthy non-obese women and insulin – resistant women. Diabetes Care 2007;30:1609-1616.
Katzmarzyk PT, Janssen I, Ross R, Church TS, Blair SN. The importance of waist circumference in the definition of metabolic syndrome: prospective analyses of mortality in men. Diabetes Care 2006;29:404–409.
St-Pierre AC, Cantin B, Mauriège P i wsp. Insulin resistance syndrome, body mass index and the risk of ischemic heart disease. CMAJ 2005;172:1301–1305.
Ogorodnikova AD, Kim M, McGinn AP, Muntner P, Khan U, Wildman RP. Incident cardiovascular disease events in metabolically benign obese individuals. Obesity 2012; 20:651–629.
Hamer M. Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J Clin Endocrinol Metab 2012; 97:2482-2488.
Kuk JL, Arden Cl. Are metabolically normal but obese individuals at lower risk for all –cause mortality? Diabetes Care 2009; 32:2297-2299.
Hinnouho GM, Czernichow S, Dugravot A i wsp. Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. Eur Heart J 2015;36(9):551-559.
Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy over weight and obesity benign conditions? A systematic review and meta-analysis. Ann Intern Med. 2013;159(3):758-769.
Morkedal B, Vatten LJ, Romundstad PR, Laugsand LE, Janszky I. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals : HUNT (Nord-Trondelag Health Study). JACC 2014;63:1071-1078.
Chang Y, Kim BK, Yun KE i wsp. Metabolically-Healthy Obesity and coronary artery calcification. JAAC 2014;63:2679-2686.
Karelis AD, Messier V, Brochu M, Rabasa-Lhoret R. Metabolically healthy but obese women: effect of an energy-restricted diet. Diabetologia 2008;51:1752-1754.
Arsenault BJ, Cote M, Cartier A i wsp. Effect of exercise training on cardiometabolic risk markers among sedentary, but metabolically healthy overweight or obese post-menopausal women with elevated blood pressure. Atherosclerosis 2009;207:530-533.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Medical Journal of the Rzeszow University and the National Medicines Institute, Warsaw
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
