Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese
Abstract
According to recent studies, adipose tissue secretes a large number of bioactive proteins, which affect the whole body metabolism. The amount of adipose tissue is the main factor that explains metabolic disorders; however, obesity is not necessarily the result of increased body weight. Interestingly, there is a subgroup of patients with normal weight and high-risk metabolic profile. Consequently, they are significantly more likely to have metabolic disorders or cardiovascular disease (CVD). Conversely, some individuals, called metabolically healthy obese (MHO), demonstrate a favourable metabolic profile despite having high BMI index and excessive adipose tissue. The aim of this paper is to review recent studies about obesity phenotypes. Better understanding of differences between metabolically obese normal-weight (MONW) and MHO may improve the therapy and treatment of metabolic health in all obese patients. Equally importantly, it may lead to an increase in early detection of individuals with metabolic disorders, regardless of their body mass value or BMI.
Keywords: adipose tissueobesity phenotypesmetabolically healthy obesevisceral adipose tissuemetabolically obese normal-weight
References
- Roberson LL, Aneni EC, Maziak W, et al. Beyond BMI: The "Metabolically healthy obese" phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic review. BMC Public Health. 2014; 14: 14.
- Rodríguez-Hernández H, Simental-Mendía LE, Rodríguez-Ramírez G, et al. Obesity and inflammation: epidemiology, risk factors, and markers of inflammation. Int J Endocrinol. 2013; 2013: 678159.
- Alfadda AA. Circulating Adipokines in Healthy versus Unhealthy Overweight and Obese Subjects. Int J Endocrinol. 2014; 2014: 170434.
- Giordano A, Smorlesi A, Frontini A, et al. White, brown and pink adipocytes: the extraordinary plasticity of the adipose organ. Eur J Endocrinol. 2014; 170(5): R159–R171.
- De Lorenzo A, Soldati L, Sarlo F, et al. New obesity classification criteria as a tool for bariatric surgery indication. World J Gastroenterol. 2016; 22(2): 681–703.
- Bluher M. Are metabolically obese individuals are really healthy? Endocrine Abstracts. 2014; 171: R209–R219.
- Phillips CM, Dillon C, Harrington JM, et al. Defining metabolically healthy obesity: role of dietary and lifestyle factors. PLoS One. 2013; 8(10): e76188.
- Samocha-Bonet D, Dixit VD, Kahn CR, et al. Metabolically healthy and unhealthy obese--the 2013 Stock Conference report. Obes Rev. 2014; 15(9): 697–708.
- Blundell JE, Dulloo AG, Salvador J, et al. EASO SAB Working Group on BMI. Beyond BMI--phenotyping the obesities. Obes Facts. 2014; 7(5): 322–328.
- Jung UnJu, Choi MS. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease. Int J Mol Sci. 2014; 15(4): 6184–6223.
- Shah RV, Murthy VL, Abbasi SA, et al. Visceral adiposity and the risk of metabolic syndrome across body mass index: the MESA Study. JACC Cardiovasc Imaging. 2014; 7(12): 1221–1235.
- Bener A, Yousafzai MT, Darwish S, et al. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes. 2013; 2013: 269038.
- Patel P, Abate N. Role of subcutaneous adipose tissue in the pathogenesis of insulin resistance. J Obes. 2013; 2013: 489187.
- Huffman DM, Barzilai N. Role of visceral adipose tissue in aging. Biochim Biophys Acta. 2009; 1790(10): 1117–1123.
- Lee SH, Han K, Yang HK, et al. A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. Nutr Diabetes. 2015; 5: e149.
- Denis GV, Obin MS. 'Metabolically healthy obesity': origins and implications. Mol Aspects Med. 2013; 34(1): 59–70.
- Shaharyar S, Roberson LL, Jamal O, et al. Obesity and metabolic phenotypes (metabolically healthy and unhealthy variants) are significantly associated with prevalence of elevated C-reactive protein and hepatic steatosis in a large healthy Brazilian population. J Obes. 2015; 2015: 178526.
- Du T, Zhang J, Yuan G, et al. Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes. Nutr Metab Cardiovasc Dis. 2015; 25(1): 100–107.
- Bays H. Central obesity as a clinical marker of adiposopathy; increased visceral adiposity as a surrogate marker for global fat dysfunction. Curr Opin Endocrinol Diabetes Obes. 2014; 21(5): 345–351.
- Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013; 93(1): 359–404.
- Wajchenberg BL, Nery M, Cunha MR, et al. Adipose tissue at the crossroads in the development of the metabolic syndrome, inflammation and atherosclerosis. Arq Bras Endocrinol Metabol. 2009; 53(2): 145–150.
- Britton KA, Massaro JM, Murabito JM, et al. Ectopic fat depots and cardiovascular disease. Circulation. 2011; 124(24): e837–e841.
- Matsuzawa Y. Establishment of a concept of visceral fat syndrome and discovery of adiponectin. Proc Jpn Acad Ser B Phys Biol Sci. 2010; 86(2): 131–141.
- Ebbert JO, Jensen MD. Fat depots, free fatty acids, and dyslipidemia. Nutrients. 2013; 5(2): 498–508.
- De Lorenzo A, Del Gobbo V, Premrov MG, et al. Normal-weight obese syndrome: early inflammation? Am J Clin Nutr. 2007; 85(1): 40–45.
- Milewicz A. Fenotypy otyłości a skład masy ciała i profil metaboliczny. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii. 2005; 1: 15–19.
- Di Renzo L, Galvano F, Orlandi C, et al. Oxidative stress in normal-weight obese syndrome. Obesity (Silver Spring). 2010; 18(11): 2125–2130.
- Fitzgibbons TP, Czech MP. Epicardial and perivascular adipose tissues and their influence on cardiovascular disease: basic mechanisms and clinical associations. J Am Heart Assoc. 2014; 3(2): e000582.
- Mittendorfer B. Origins of metabolic complications in obesity: adipose tissue and free fatty acid trafficking. Curr Opin Clin Nutr Metab Care. 2011; 14(6): 535–541.
- Shea JL, King MTC, Yi Y, et al. Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects. Nutr Metab Cardiovasc Dis. 2012; 22(9): 741–747.
- Nowak M, Grzywa M. Metaboliczna otyłość z prawidłową masą ciała i otyłość z prawidłowymi wskaźnikami metabolicznymi a ryzyko metaboliczno-naczyniowe. Przegląd Medyczny Uniwersytetu Rzeszowskiego i Narodowego Instytutu Leków w Warszawie. 2015; 13(3): 270–278.
- Mathew H, Farr OM, Mantzoros CS. Metabolic health and weight: Understanding metabolically unhealthy normal weight or metabolically healthy obese patients. Metabolism. 2016; 65(1): 73–80.
- Pajunen P, Kotronen A, Korpi-Hyövälti E, et al. Metabolically healthy and unhealthy obesity phenotypes in the general population: the FIN-D2D Survey. BMC Public Health. 2011; 11: 754.
- Lee TH, Jeon WS, Han KiJ, et al. Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status. Endocrinol Metab (Seoul). 2015; 30(2): 185–194.
- Seo MiH, Rhee EJ. Metabolic and cardiovascular implications of a metabolically healthy obesity phenotype. Endocrinol Metab (Seoul). 2014; 29(4): 427–434.
- Eckel N, Mühlenbruch K, Meidtner K, et al. Characterization of metabolically unhealthy normal-weight individuals: Risk factors and their associations with type 2 diabetes. Metabolism. 2015; 64(8): 862–871.
- Gondim OS, de Camargo VT, Gutierrez FA, et al. Benefits of Regular Exercise on Inflammatory and Cardiovascular Risk Markers in Normal Weight, Overweight and Obese Adults. PLoS One. 2015; 10(10): e0140596.
- Camhi SM, Crouter SE, Hayman LL, et al. Lifestyle Behaviors in Metabolically Healthy and Unhealthy Overweight and Obese Women: A Preliminary Study. PLoS One. 2015; 10(9): e0138548.
- Berezina A, Belyaeva O, Berkovich O, et al. Prevalence, Risk Factors, and Genetic Traits in Metabolically Healthy and Unhealthy Obese Individuals. Biomed Res Int. 2015; 2015: 548734.
- Messier V, Karelis AD, Robillard ME, et al. Metabolically healthy but obese individuals: relationship with hepatic enzymes. Metabolism. 2010; 59(1): 20–24.