Physiological and Lifestyle Traits of Metabolic Dysfunction in the Absence of Obesity

Klitgaard, H.; Kilbak, Jesper Hoffmann; Nozawa, Erica Arhnung; Seidel, Ann V; Magkos, Faidon

doi:10.1007/s11892-020-01302-2

Cited by 21 publications

(32 citation statements)

References 74 publications

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“…However, these studies did not speci cally report on the paradoxical co-existence of anthropometric undernutrition (thinness or stunting) and metabolic obesity. Progressively more metabolic abnormalities (0, 1, 2, or 3) are associated with dose-dependent increases in the risk of cardiovascular disease in normal-weight adults [13]. Clustering of two and all three core biochemical abnormalities (2-MetS and 3-MetS), commonly used for de ning metabolic syndrome [25], occurred in 13% and 2% of thin and normal-weight participants, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…A 2-month life style modi cation trial in 12-16-year olds, comprising aerobic activity classes, diet education and behaviour modi cation, reduced body fat mass and improved lipid pro le and in ammation [40]. Postulated mechanisms from observational evidence in adults and children also include greater relative fat accumulation, especially in the visceral adipose tissue, liver and upper body, inferior aerobic tness, lower skeletal muscle mass and strength, increased screen time and diet quality -lower fruits and vegetables -and higher fructose and glucose intakes [13,41,42]. Mechanisms underlying a similar phenomenon in thin (underweight) subjects have not been investigated.…”

Section: Discussionmentioning

confidence: 99%

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Intraindividual coexistence of anthropometric undernutrition and “metabolic obesity” in Indian Children: A paradox that needs action

Sachdev

Porwal

Sarna

et al. 2020

Preprint

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BackgroundIntraindividual coexistence of anthropometrically defined undernutrition and “metabolic obesity”, characterised by presence of at least one abnormal cardiometabolic risk factor, is rarely investigated in young children and adolescents, particularly in Low-and-Middle-Income-Countries undergoing rapid nutrition transition. MethodsPrevalence of biomarkers of metabolic obesity was related to anthropometric and socio-demographic characteristics in 5-19 years old participants from the population-based Comprehensive National Nutrition Survey in India (2016-2018). The biomarkers, serum lipid-profile (total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides), fasting glucose, and glycosylated hemoglobin (HbA1C), and all jointly were analysed in 22567, 23192, 25962 and 19143 participants, respectively.ResultsOverall (entire dataset), the prevalence of abnormalities was low (4.3-4.5%) for LDL and TC, intermediate for dysglycemia (10.9-16.1%), and high for HDL and triglycerides (21.7-25.8%). Proportions with ≥1 abnormal metabolic obesity biomarker(s) were 56.2% overall, 54.2% in thin (BMI-for-age <-2SD) and 59.3% in stunted (height-for-age <-2SD) participants. Comparable prevalence was evident in mild undernutrition (-1 to -2 SD). Clustering of two borderline abnormalities occurred in one-third, warranting active life-style interventions. Metabolic obesity prevalence increased with BMI-for-age. Among those with metabolic obesity, only 9% were overweight/obese (>1SD BMI-for-age). Among poor participants, triglyceride, glucose and HDL abnormalities were higher. ConclusionsA paradoxical, counter-intuitive prevalence of metabolic obesity biomarker(s) exists in over half of anthropometrically undernourished and normal-weight Indian children and adolescents. There is a crucial need for commensurate investments to address overnutrition along with undernutrition. Nutritional status should be characterized through additional reliable biomarkers, instead of anthropometry alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraindividual coexistence of anthropometric undernutrition and “metabolic obesity” in Indian Children: A paradox that needs action

Sachdev

Porwal

Sarna

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Up to 50% of population falls into these two categories with obesity indices poorly defined: metabolically healthy obese and metabolically unhealthy normal weight [ 30 , 31 , 32 ].…”

Section: On Fatnessmentioning

confidence: 99%

“…Up to 30% of normal weight adults have an accumulation of adipose tissue in the truncal area, with waist circumference not necessarily larger than adults with similar BMI [ 32 ]. Thus, these individuals exhibit one or more metabolic abnormalities that typically accompany obesity (e.g., hypertriglyceridemia, impaired fasting glucose, hyperinsulinemia) and have an increased risk of diabetes and heart disease [ 32 ]. There is a lack of consensus in referring this phenotype—with metabolically unhealthy normal weight (MUNW) being one of the terms.…”

Section: On Fatnessmentioning

confidence: 99%

“…The hallmark of MUNW phenotype is fat accumulation as abdominal subcutaneous and visceral depots, and in the liver, but not in skeletal muscle. Often is MUNW phenotype also characterized with lower cardiorespiratory fitness and muscle mass [ 32 ]. A recent study on 1114 individuals suggested that higher intakes of potassium, calcium, magnesium, and vitamin A (i.e., nutraceuticals) reduce the risk of development of unhealthy phenotype in normal weight adults [ 33 ].…”

Section: On Fatnessmentioning

confidence: 99%

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Intervertebral Disc and Adipokine Leptin—Loves Me, Loves Me Not

Ćurić

2020

IJMS

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Leptin—the most famous adipose tissue-secreted hormone—in the human body is mostly observed in a negative connotation, as the hormone level increases with the accumulation of body fat. Nowadays, fatness is becoming another normal body shape. Fatness is burdened with numerous illnesses—including low back pain and degenerative disease of lumbar intervertebral disc (IVD). IVD degeneration and IVD inflammation are two indiscerptible phenomena. Irrespective of the underlying pathophysiological background (trauma, obesity, nutrient deficiency), the inflammation is crucial in triggering IVD degeneration. Leptin is usually depicted as a proinflammatory adipokine. Many studies aimed at explaining the role of leptin in IVD degeneration, though mostly in in vitro and on animal models, confirmed leptin’s “bad reputation”. However, several studies found that leptin might have protective role in IVD metabolism. This review examines the current literature on the metabolic role of different depots of adipose tissue, with focus on leptin, in pathogenesis of IVD degeneration.

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Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight

Agius,

Pace,

Fava

2023

Diabetes Metabolism Res

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Over the past 4 decades, research has shown that having a normal body weight does not automatically imply preserved metabolic health and a considerable number of lean individuals harbour metabolic abnormalities typically associated with obesity. Conversely, excess adiposity does not always equate with an abnormal metabolic profile. In fact, evidence exists for the presence of a metabolically unhealthy normal weight (MUHNW) and a metabolically healthy obese (MHO) phenotype. It has become increasingly recognised that different fat depots exert different effects on the metabolic profile of each individual by virtue of their location, structure and function, giving rise to these different body composition phenotypes. Furthermore, other factors have been implicated in the aetiopathogenesis of the body composition phenotypes, including genetics, ethnicity, age and lifestyle/behavioural factors. Even though to date both MHO and MUHNW have been widely investigated and documented in the literature, studies report different outcomes on long‐term cardiometabolic morbidity and mortality. Future large‐scale, observational and population‐based studies are required for better profiling of these phenotypes as well as to further elucidate the pathophysiological role of the adipocyte in the onset of metabolic disorders to allow for better risk stratification and a personalised treatment paradigm.

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Physiological and Lifestyle Traits of Metabolic Dysfunction in the Absence of Obesity

Cited by 21 publications

References 74 publications

Intraindividual coexistence of anthropometric undernutrition and “metabolic obesity” in Indian Children: A paradox that needs action

Intraindividual coexistence of anthropometric undernutrition and “metabolic obesity” in Indian Children: A paradox that needs action

Intervertebral Disc and Adipokine Leptin—Loves Me, Loves Me Not

Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight

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