Metabolic health in normal-weight and obese individuals

Schulze, Matthias B.

doi:10.1007/s00125-018-4787-8

Cited by 135 publications

(111 citation statements)

References 46 publications

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“…In this respect data from the Prevención con Dieta Mediterránea (PREDIMED) study show that even in the absence of a large amount of weight loss, adherence to a Mediterranean diet can promote the transition to MH in subjects with MUHO and protect against deterioration of MH in subjects with MHO [45]. Similar results were also found in other studies involving healthy diets [18].…”

Section: Predictors Of the Change Of Metabolic Healthsupporting

confidence: 74%

“…Importantly, assuming that subjects cannot be considered 'metabolically healthy' when setting the cut-off for 'health' <3 parameters of the metabolic syndrome, they considered individuals being metabolically healthy when <2 parameters of the metabolic syndrome, except waist circumference, and high HOMA-IR and hs-CRP levels were present. Thus, while currently there is no broad agreement among the researchers and clinicians on how to define metabolic health (MH) [16][17][18][19][20][21], the definition proposed by Wildman et al [15] appears to be most useful (Table 1). Nevertheless, many studies having investigated the relationship of metabolic healthy obesity (MHO) with cardiometabolic risk or cardiometabolic mortality used the definition of the metabolic syndrome.…”

Section: Metabolically Healthy Obesitymentioning

confidence: 99%

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Metabolically Healthy and Unhealthy Normal Weight and Obesity

Stefan¹

2020

Endocrinol Metab

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Increased fat mass is an established risk factor for the cardiometabolic diseases type 2 diabetes and cardiovascular disease (CVD) and is associated with increased risk of all-cause and CVD mortality. However, also very low fat mass associates with such an increased risk. Whether impaired metabolic health, characterized by hypertension, dyslipidemia, hyperglycemia, insulin resistance, and subclinical inflammation, may explain part of the elevated risk of cardiometabolic diseases that is found in many subjects with very low fat mass, as it does in many obese subjects, is unknown. An important pathomechanism of impaired metabolic health is disproportionate fat distribution. In this article the risk of cardiometabolic diseases and mortality in subjects with metabolically healthy and unhealthy normal weight and obesity is summarized. Furthermore, the change of metabolic health during a longer period of follow-up and its impact on cardiometabolic diseases is being discussed. Finally, the implementation of the concept of metabolic health in daily clinical practice is being highlighted.

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Section: Predictors Of the Change Of Metabolic Healthsupporting

confidence: 74%

Section: Metabolically Healthy Obesitymentioning

confidence: 99%

Metabolically Healthy and Unhealthy Normal Weight and Obesity

Stefan¹

2020

Endocrinol Metab

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“…However, such investigations are hampered by the long time that it takes to develop T2DM. On the other hand, based on previous data , there is no reason to doubt that apparently healthy overweight/obese individuals have an increased T2DM risk.…”

Section: Discussionmentioning

confidence: 98%

“…However, up to one‐third of overweight or obese subjects display an apparently healthy metabolic phenotype with no in vivo insulin resistance . Despite this, ‘metabolically healthy’ overweight/obese individuals are still at risk of developing T2DM and other disorders associated with insulin resistance . This suggests that they have an abnormal phenotype, which is not revealed by classic clinical examinations.…”

Section: Introductionmentioning

confidence: 99%

Insulin action is severely impaired in adipocytes of apparently healthy overweight and obese subjects

et al. 2019

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Ryd en M, Petrus P, Andersson DP, Medina-G omez G, Escasany E, Corrales Cord on P, Dahlman I, Kulyt e A, Arner P (Karolinska ). Insulin action is severely impaired in adipocytes of apparently healthy overweight and obese subjects. J Intern Med 2019; 285: 578-588.Objective. Many overweight/obese subjects appear metabolically healthy with normal in vivo insulin sensitivity. Still, they have increased long-term risk of developing type 2 diabetes. We hypothesized that adipose tissue dysfunction involving decreased insulin action in adipocytes is present in apparently healthy overweight/obese subjects.Design/Methods. Subjects with normal metabolic health according to Adult Treatment Panel-III or Framingham risk score criteria were subdivided into 67 lean, 32 overweight and 37 obese according to body mass index. They were compared with 200 obese individuals with metabolic syndrome. Insulin sensitivity and maximum action on inhibition of lipolysis and stimulation of lipogenesis was determined in subcutaneous adipocytes. Gene expression was determined by micro-array and qPCR.DNA methylation was assessed by array, pyrosequencing and reporter assays.Results. Compared with lean, adipocytes in overweight/obese displayed marked reductions in insulin sensitivity in both antilipolysis and lipogenesis as well as an attenuated maximum lipogenic response. Among these, only antilipolysis sensitivity correlated with whole-body insulin sensitivity. These differences were already evident in the overweight state, were only slightly worse in the unhealthy obese state and were not related to fat cell size. Adipose tissue analyses linked this to reduced expression of the insulin signalling protein AKT2, which associated with increased methylation at regulatory sites in the AKT2 promoter.Conclusions. Apparently healthy subjects have severely disturbed adipocyte insulin signalling already in the overweight state which involves epigenetic dysregulation of AKT2. This may constitute an early defect in insulin action that appears even upon modest increases in fat mass.Insulin action and excess body fat / M. Ryd en et al.

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“…The metabolically unhealthy normal-weight (MUHNW) served as a subgroup of MetS. MUHNW individuals were those who presented with MetS with a normal body mass index (BMI) (18.5-24.9 kg/m 2 ) [6]. Nowadays, information on the global prevalence of MUHNW is scarce and inconsistent for different criteria of metabolic abnormalities [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The Association Between Parity and Metabolically Unhealthy Normal-Weight in Chinese Postmenopausal Women

Shi¹,

Zhou²,

Zheng³

et al. 2020

Preprint

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BackgroundStudies analyzing the association between parity and metabolically unhealthy normal-weight (MUHNW) individuals in postmenopausal women remain limited, this study aimed to explore the association between parity and MUHNW among Chinese postmenopausal women.MethodsIn total, 776 normal-weight undiagnosed type 2 diabetes postmenopausal women who visited the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University for a routine health check-up between 1 January 2017 and 31 December 2019 were included in the study. All individuals had fully completed information records encompassing standardized electronic medical records, physical examinations, and biochemical measurements. The association between parity and MUHNW was analyzed using multivariate logistic regression.ResultsCompared to women with a parity of one, the odds ratios (OR) [95% confidence interval (CI)] of the parity 2, 3, and ≥4 groups were observed to be 1.40 (0.89, 2.20), 2.00 (1.16, 3.44) and 1.87 (0.96, 3.62), respectively, with P for trend < 0.05 after adjusting for potential confounding factors. Women with a higher parity (≥3) had an increased OR of abdominal obesity, while the OR (95% CI) of the parity 3 group was 2.54 (1.46, 4.40) and that of the parity 4 group was 4.25 (2.11, 8.56), the P for trend < 0.001 after adjusting for age, body mass index (BMI), education level, first-degree relatives of patients with diabetes, smoking status, alcohol drinking status, physical activity, pregnancy losses, age at menarche, and duration of reproductive years. No significant differences were detected for other metabolic disorders including high levels of triglycerides (TG), blood pressure, fasting plasma glucose (FPG), and decreased high-density lipoprotein cholesterol (HDL-C) in different parity groups.ConclusionHigher parity was associated with a higher risk of MUHNW in Chinese postmenopausal women. Accordingly, it may be plausible that parity serves as a risk factor for metabolic disorders irrespective of BMI, and abdominal obesity may play an important role in metabolic disorders.

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Metabolic health in normal-weight and obese individuals

Cited by 135 publications

References 46 publications

Metabolically Healthy and Unhealthy Normal Weight and Obesity

Metabolically Healthy and Unhealthy Normal Weight and Obesity

Insulin action is severely impaired in adipocytes of apparently healthy overweight and obese subjects

The Association Between Parity and Metabolically Unhealthy Normal-Weight in Chinese Postmenopausal Women

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