A metabolically healthy obese phenotype in hispanic participants in the IRAS family study

Abstract

Objective Some obese individuals appear to be protected from developing type 2 diabetes mellitus and cardiovascular disease (CVD). This has led to characterizing body size phenotypes based on cardiometabolic risk factors specifically as obese or overweight, and as metabolically healthy (MH) or metabolically abnormal (MA) based upon blood pressure, lipids, glucose homeostasis and inflammatory parameters. The aim of this study was to measure the prevalence of and describe fat distribution across these phenotypes in a minority population. Design and Methods Hispanic participants (N=1054) in the IRAS Family Study were categorized into different body size phenotypes. Computed tomography (CT) abdominal scans were evaluated for measures of non-alcoholic fatty liver disease (NAFLD) and abdominal fat distribution. Statistical models adjusting for familial relationships were estimated. Results Seventy percent (70%) of the Hispanic cohort was overweight (32%) or obese (38%). Forty-one percent (n=138) of overweight participants and 19% (n=74) of obese participants met criteria for MH. Adjusted analyses showed the MH phenotype was associated with lower visceral adipose tissue (VAT) and higher liver density (indicating lower fat content) in obese participants (p=0.0005 and p=0.0002, respectively), and lower VAT but not liver density in overweight participants (p=0.008 and p=0.162, respectively) compared to their MA counterparts. Odds of NAFLD were reduced in MH obese (OR=0.34, p=0.0007) compared to MA obese. VAT did not differ between MH obese or overweight and normal weight groups. Conclusions These findings suggest that lower levels of visceral and liver fat, despite overall increased total body fat, may be a defining feature of MH obesity in Hispanic Americans.

Are Obese Individuals with no Feature of Metabolic Syndrome but Increased Waist Circumference Really Healthy? A Cross Sectional Study

“…This is in contradiction with lower liver enzymes levels associated with metabolic health defined as no insulin resistance in post menopausal obese Caucasian women (Messier et al, 2010) and associated with MHO phenotype in Korean people with overweight or obesity (Hong et al, 2013). However, in our population, the prevalence of increased γ glutamyltransferase in MUO was slightly higher than in definite MHO individuals, and was probably associated with hepatic steatosis (Samaropoulos et al, 2013;Stefan et al, 2008). In addition, an increasing number of features of the metabolic syndrome was associated with fatty liver index, an estimate of liver fat content (Bedogni et al, 2006;Messier et al, 2010), suggesting an association between non alcoholic fatty liver disease and unfavourable metabolic and cardiovascular (Oni et al, 2013) profile.…”

Stability and changes in metabolically healthy overweight or obesity and risk of future diabetes: Niigata wellness study

“…However, we did not have available data on waist circumference or fat distribution in this study, and it was suggested that the inflammatory status might play an important role in defining metabolic health. Also, studies of other populations that investigated characteristics of metabolic phenotypes reported that differences in fat distribution were observed across obese phenotypes . Nonetheless, our results indicated that the risk of diabetes could substantially vary if we considered changes in and stability of MH‐O and MA‐O phenotypes that were defined using common clinical markers in this study.…”

Increased Cardiometabolic Risk Factors and Inflammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy

“…Some authors have found higher adiponectin concentrations in MHO as compared with MAO, which has been related to reduced inflammation and improved metabolic function (25,26). The similarly reduced levels observed in the current study have been reported previously (7,27,28) and together with the comparable concentrations of leptin and resistin suggest that MHO and MAO show a very similarly altered adipokine profile.…”