Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence? / Jovens iranianas obesas metabolicamente saudáveis têm maior risco de incidência de DCV?

Abstract Background The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear. Objectives We examined the association between MHO and CVD risk in young Iranian women. Methods We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants. Results The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO. Conclusions Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.

Resumo Contexto A associação entre o fenótipo obeso metabolicamente saudável (OMS) na ausência de síndrome metabólica e doença cardiovascular subsequente permanece incerta. Objetivos Examinamos a associação entre o fenótipo OMS e risco de DCV em jovens iranianas. Métodos Analisamos 183 mulheres com idade de 20-35 anos de uma população de 308 candidatas. Classificamos as participantes em quatro fenótipos. Mensuramos composição corporal, pressão arterial e fatores bioquímicos em todas as participantes. Resultados Os fenótipos com peso normal metabolicamente saudável (PNMS) e obeso com peso normal não apresentaram diferenças estatísticas em nenhuma das variáveis bioquímicas. Os níveis de glicemia sanguínea em jejum (GSJ), triglicerídeos (TG), relação LDL/HDL, HDL, proteína C reativa ultrassensível (PCR-us) e índice aterogênico do plasma (IAP) foram mais elevados em obesas metabolicamente não saudáveis (OMNS) do que em indivíduos OMSs, enquanto o HDL foi maior em OMSs do que em indivíduos OMNSs. A relação LDL/HDL e o nível de PCR-us foram mais elevados em participantes OMSs do que em participantes com PNMS, enquanto o HDL foi maior naquelas com PNMS do que nas OMSs. Conclusões Os resultados do presente estudo demonstram que mulheres jovens com o fenótipo OMS têm um perfil metabólico favorável, conforme demonstrado pelos níveis menores de GSJ, TG, relação LDL/HDL, HDL, PCR-us e IAP e pelos níveis maiores de HDL em comparação às mulheres com o fenótipo OMNS. Entretanto, indivíduos OMSs ainda apresentavam maior risco de DCV incidente (níveis menores de HDL e maiores de PCR-us) do que indivíduos com PNMS.

Incidence of Prostate Cancer according to Metabolic Health Status: a Nationwide Cohort Study

BACKGROUND: We assessed the association between metabolic health status and incidence of prostate cancer using the National Health Check-ups (NHC) database of Korea. METHODS: A total of 11,771,252 men who participated in the NHC between 2009 and 2012 and 56,552 men who were newly diagnosed with prostate cancer were analyzed. Normal-weight and obesity were defined as body mass index (BMI) < 25 kg/m2 and ≥ 25 kg/m2, respectively. Metabolic obesity was defined as the presence ≥ 3 components of the metabolic syndrome. Participants were stratified into 4 groups: metabolically healthy, normal-weight; metabolically obese, normal-weight (MONW); metabolically healthy, obese (MHO); and metabolically obese, obese. Multivariate Cox regression analysis was performed to examine the relationship between metabolic health status and incidence of prostate cancer. RESULTS: During a mean 5.4 ± 1.1 years of follow-up, 56,552 patients were registered with a diagnosis of prostate cancer. When analyzed according to metabolic health status classification, the multivariable-adjusted hazard ratio (HR) was 1.143 for the MONW group, 1.097 for the MHO group, showing the HR for the MONW group was higher than that for the MHO group. As the number of metabolic syndrome components increased, HR increased significantly. When stratified based on BMI, metabolically obese patients showed significantly higher HR than metabolically healthy patients in all BMI groups. CONCLUSION: This population-based nationwide study revealed an association between metabolic health status and the incidence of prostate cancer, and the risk increased according to the number of components of the metabolic syndrome.

Análisis de la longitud de los telómeros en obesos metabólicamente sanos / Analysis of telomere length in the metabolically healthy obese

La obesidad es el principal componente del síndrome metabólico (SM) y determina la progresión de la enfermedad a las complicaciones metabólicas. Los individuos obesos metabólicamente sanos (OMS) parecen estar protegidos contra esas complicaciones. La longitud de los telómeros (LT) es un nuevo marcador del envejecimiento celular, que tiene una relación compleja con el SM. El objetivo principal de este estudio fue investigar por primera vez la LT en OMS y estudiar la asociación entre LT y el número de componentes del SM. Se estudió a 398 mujeres con una edad media de 46,76 ± 15,47 años (rango: 18-86 años), que se agruparon en: individuos con normopeso sin ningún componente del SM (NP0), obesos sin SM (OMS) y de acuerdo con el número de componentes de SM en los grupos sin ningún componentes de SM (0), con uno o 2 componentes (1 + 2) y con SM por la presencia de 3 o más componentes (SM). La LT de los OMS no se diferenció de la de los NP0, pero fue significativamente mayor que la de los individuos con SM (p = 0,032). Se observó una disminución de la LT con el aumento progresivo del número de componentes del SM (p = 0,004), en donde el grupo 0 presentó una LT significativamente mayor que los grupos 1 + 2 (p = 0,027) y SM (p = 0,003). Demostramos por primera vez que las mujeres OMS presentan una LT similar a las mujeres NP0 y más larga que aquellas mujeres con SM. Además, confirmamos que la LT se acorta con el aumento en el número de alteraciones del SM.

Obesity is the principal component in Metabolic Syndrome (MetS) and determines the progression of metabolic complications. Metabolically healthy obese individuals (MHO) seem to be protected against those complications. Telomere length (TL), as a novel marker of cellular aging, has a complex relationship with MetS. The principal aim of this study was to investigate TL in MHO, and to study the association between TL and the number of MetS components. A study was conducted on 398 women (mean age: 46.76 ± 15.47 years; range: 18 - 86 years), grouped according to the number of MetS components (0, 1 + 2, MetS), a group of normal-weight individuals with 0 MetS components (NW0), and a group of obese without MetS (MHO). No differences were found in the TL of the MHO group compared to the NW0, but it was significantly higher than that of individuals with MetS (P = .032). A decrease in TL was observed with a progressive increase in the number of MetS components (P = .004), whereas the group of individuals without MetS components had significantly longer TL than the groups with 1 and 2 components (P = .027), and MetS (P = .003). Shorter TL is not associated with MHO, but is related to MetS and with an increased number of metabolic abnormalities.

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes

ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.

Characteristics of Young Korean Metabolically Healthy Obese Patient: Based on Retrospective Analysis of Republic of Korea Navy Soldiers' Medical Examination

OBJECTIVE: The aim of this study was to evaluate the characteristics of the young Korean obese but metabolically healthy subjects and to identify the factors associated with metabolic health status among them. METHODS: We reviewed the medical record of South-Korea Navy soldiers at 1st marine division with routine medical examination. Within this population, we selected obese subjects whose body mass index (BMI) were more than 25 kg/m². The clinical characteristics between obese subjects with metabolically healthy and unhealthy factors were retrospectively compared. RESULTS: Of the 1,522 subjects with medical record, 319 (20.9%) subjects were identified as obese. Among them, 60 subjects (18.8%) were classified as metabolically unhealthy, whereas 259 (81.2%) subjects were metabolically healthy. Multivariate analysis revealed that higher BMI (odds ratio, OR 1.26, 95% confidence interval, CI, 1.07-1.49), higher alanine transaminase (ALT) (OR 1.03, 95% CI 1.01-1.06), and drinking alcohol (OR 3.65, 95% CI 1.02-13.02) were associated with metabolically unhealthy status in obese subjects. Meanwhile, regular physical activity was associated with metabolically healthy status in obese subjects. (OR 0.33, 95% CI 0.17-0.62) CONCLUSION: This study found that higher BMI, higher ALT, and drinking alcohol were related to metabolically unhealthy status in young Korean obese subjects; meanwhile, regular physical activity was related to metabolically healthy status.

Obesity and adipose tissue remodeling / 中国药理学通报

Obesity is a major risk factor for the generation and development of diabetes, atherosclerosis, hyperlipidemia and cancer. Obesity is accompanied with remodeling of adipose tis-sue, such as changed cell component and function, angiogene-sis, extracellular matrix remodeling and infiltration of inflamma-tory cells. It is important for the prevention of obesity to study adipose tissue remodeling. This review summarizes recent ad-vances in adipose tissue remodeling.

Association between serum Klotho and oxidative stress in metabolically healthy obese individuals / 安徽医科大学学报

Objective To investigate the association between serum Klotho and oxidative stress in metabolically healthy obese individuals. Methods 180 physicalexamination subjects were investigated. They were devided into 3 groups:60 cases of normal weight and metabolic normality,60 cases of metabolically healthy but obese( MHO) ,60 cases of obesity with metabolic syndrome. Fasting blood glucose(FBG),2 h blood glucose(2 hBG),triglyceride ( TG) ,high densitylipoprotein cholesterol( HDL-C) , systolic blood pressure, diastolic blood pressure,body height, body weight,waist circumference,body mass index( BMI) were recorded. Malondialdehyde( MDA) ,superoxide dis-mutase( SOD) ,total antioxidation capacity( TAOC) ,Klotho were detected by ELISA. The difference of clinical pa-rameters,metabolic parameters,oxidative stress and Klotho among these three groups was compared by the methods of covariance analysis. Regression analysis and pearson correlation were used to evaluate the relationship of Klotho with oxidative stress. Results Compared with the control group, TAOC, SOD, Klotho were decreased significantly while MDA elevated significantly in both MHO group and obesity with metabolic syndrome group(P<0. 05). Com-pared with MHO group, TAOC, Klotho were significantly lower in obesity with metabolic syndrome ( P<0. 05 ) . Klotho protein was significantly positively associated with SOD, TAOC, negatively associated with waist circumfer-ence,BMI,FBG,2 hBG(r= -0. 182,-0. 225,-0. 221,-0. 202,-0. 188,P<0. 05). SOD,TAOC were deter-minants for Klotho. Conclusion The balancebetween oxidative and antioxidative system is disturbed in subjects with MHO. Klotho protein may maintain the normal metabolism of thebody by regulating the oxidative stress.

Comparison of Metabolic Characteristics of Metabolically Healthy but Obese (MHO) Middle-Aged Men According to Different Criteria / 가정의학회지

BACKGROUND: To compare the prevalence and metabolic characteristics of metabolically healthy but obese (MHO) individuals according to different criteria. METHODS: We examined 186 MHO middle-aged men (age, 37.2 years; body mass index [BMI], 27.2 kg/m2). The following methods were used to determine MHO: the National Cholesterol Education Program (NCEP) Adult Treatment Panel III criteria, 0-2 cardiometabolic abnormalities; the Wildman criteria, 0-1 cardiometabolic abnormalities; the Karelis criteria, 0-1 cardiometabolic abnormalities; the homeostasis model assessment [HOMA] criteria (lowest quartile of HOMA). After dividing the overall subjects into two age groups, we compared the prevalence and clinical characteristics between MHO and at-risk groups according to four different criteria. RESULTS: The prevalence of MHO using the NCEP, Wildman, Kaleris, and HOMA criteria were 70.4%, 59.7%, 28.5%, and 24.2%, respectively. The agreement between the groups according to the NCEP and Wildman criteria was substantial (kappa = 0.8, P < 0.001). Among individuals 35 years or younger, and regardless of method, the MHO subjects had significantly lower weight, waist circumference, BMI, body fat percentage, insulin, HOMA, alanine aminotransferase, triglyceride (TG), and TG/high density lipoprotein cholesterol (HDL-C) ratio than the at-risk subjects (P < 0.05); However, among individuals older than 35 years old, and regardless of method, the MHO subjects had different insulin, HOMA, HDL-C, and TG/HDL-C levels than the at-risk subjects (P < 0.05). CONCLUSION: The differences in metabolic profile between MHO and at-risk groups varied according to age. MHO prevalence varies considerably according to the criteria employed. Expert consensus is needed in order to define a standardized protocol for determining MHO.