The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

Abstract

Objective: Obesity-related disease risks may vary depending on whether the subject has metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). At least 5 definitions/criteria of obesity and metabolic disorders have been documented in the literature, yielding uncertainties in a reliable international comparison of obesity phenotype prevalence. This report aims to compare differences in MHO and MUO prevalence according to the 5 most frequently used definitions. Methods: A random sample of 4,757 adults aged 35 years and older (male 51.1%) was enrolled. Obesity was defined either according to body mass index or waist circumference, and the definitions of metabolic abnormalities were derived from 5 different criteria. Results: In MHO, the highest prevalence was obtained when using the homeostasis model assessment (HOMA) criteria (13.6%), followed by the Chinese Diabetes Society (11.4%), Adult Treatment Panel III (10.3%), Wildman (5.2%), and Karelis (4.2%) criteria; however, the MUO prevalence had an opposite trend to MHO prevalence. The magnitude of differences in the age-specific prevalence of MHO and MUO varied greatly and ranked in different orders. The proportion of insulin resistance for MHO and MUO individuals differed significantly regardless of which metabolic criterion was used. Conclusion: The prevalence of MHO and MUO in the Chinese population varies according to different definitions of obesity and metabolic disorders.

Metabolically healthy general and abdominal obesity are associated with increased risk of hypertension

“…The prevalence of MHO ranges from 1•1 to 28•5 % in different populations (30) . The prevalence of MHO we reported in our rural Chinese adults was obviously lower than that in previous studies because of the strictness of the metabolically healthy definition (16,31) . By contrast, the proportions of metabolically unhealthy individuals with or without obesity were relatively higher, which indicates the need for making interventional strategies to ensure that people are metabolically healthy in rural China.…”

Fatty acid profile and estimated desaturase activities in whole blood are associated with metabolic health

“…In total 10% defined as MH obese is among the highest prevalence independent of criteria used for metabolic health summarized by Liu et al [40] and Wildman et al [41]. Using BMI rather than waist circumference to define obesity often yields higher prevalence of MH obese [40]. Yet, other studies have found comparable prevalence of MH obese as the present study using ≥2 criteria for metabolic health [42].…”

“…It is however possible that our study population is healthier than other populations. In total 10% defined as MH obese is among the highest prevalence independent of criteria used for metabolic health summarized by Liu et al [40] and Wildman et al [41]. Using BMI rather than waist circumference to define obesity often yields higher prevalence of MH obese [40].…”

A Metabolically Healthy Profile Is a Transient Stage When Exercise and Diet Are Not Supervised: Long-Term Effects in the EXERDIET-HTA Study

“…A CRF ( · VO 2max in mL·kg −1 ·min −1 ) reference value lower than the 50th percentile was used as the cut-off point, according to the FRIEND Registry [29]. The definition of the MUO and the MHO phenotypes were obtained based on the joint combination of obesity markers (i.e., BMI) and cardiometabolic abnormalities, taking into account the following definitions: the National Cholesterol Education Program-Adults Treatment Panel III, Wildman, Wildman Modified and Ortega [4,5,30].…”