Excess weight increases the risk for metabolic syndrome, a constellation of cardiovascular risk factors that includes abdominal adiposity, dyslipidemia, elevated blood pressure. Total body fat, visceral fat, and waist circumference were similar in obese participants regardless of insulin sensitivity. Metabolically healthy and unhealthy obesity phenotypes in. Background previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. However, a proportion of obese individuals might not be at an increased risk for metabolic complications of obesity and, therefore, their phenotype can be referred to as metabolically healthy obesity. Are metabolically healthy abdominal obese benign conditions abdominal obesity phenotypes, cardiovascular disease. Metabolically healthy obesity and cardiovascular events. Methods we used linked electronic health records 1995 to 2015 in the. The association between mho phenotype and incident ckd is unclear. Normalweight individuals with adverse metabolic status have also been described. Pdf the relationship between obesity and other metabolic diseases have been. The main outcome of the study was to determine potential factors that could promote a metabolically benign obesity, which was defined by insulin sensitivity. Metabolically healthy but obese individuals the lancet. Obesity is associated with reduced life expectancy, owing to increased risk of metabolic abnormalities, cardiovascular disease, and several types of cancer.
Stability and changes in metabolically healthy overweight. With aging, a slowdown in exercise, or other changes, metabolically healthy obesity can morph into its harmful counterpart. When metabolically healthy obesity was stratified into class i bmi 30. Overweight and obesity are associated with several disease conditions. Is the metabolically healthy obesity phenotype an irrelevant artifact for public health. Compared with lean adults, those with a bmi equal or greater than 40 have an increased chance of being diagnosed with type 2 diabetes, hypertension, hypercholesterolemia, asthma, arthritis, and a poor general health status 7. Metabolically healthy overweight and obesity annals of. This historical cohort study included 19,685 japanese individuals who received healthcheckup programs from 2003 to 2016.
Are metabolically healthy overweight and obesity benign conditions. Healthy overweight and obese persons had higher risk, which refuted the notion that metabolically healthy obese phenotype is a benign condition. Download citation are metabolically healthy overweight and obesity benign conditions. Just because a person has metabolically healthy obesity at one point doesnt it will stay that way. Yet, although mho patients are free of obesity associated complications, they might not be entirely precluded from developing cardiometabolic disorders. Yet, although mho patients are free of obesityassociated complications, they might not be entirely precluded from developing cardiometabolic disorders. Are metabolically healthy overweight and obesity benign. There is actually no consensus about the possibility that in some instances, obesity may be a benign metabolically healthy mh condition as opposed to a normalweight but metabolically unhealthy muh state. Metabolically healthy obese and incident cardiovascular. Overweight and obese individuals can be metabolically healthy i.
Metabolically healthy obesity is a condition characterised by obesity in the absence of metabolic abnormalities e. Lower liver fat content and visceral adipose tissue, greater insulin sensitivity and secretion, greater cardiorespiratory fitness, and a predominantly lower body i. Recent studies describe a unique subset of obese individuals with normal metabolic profiles despite having excess weight called metabolically healthy but obese mho. Metabolically healthy obesity and risk of kidney function decline. Natural course of metabolically healthy overweightobese. The finnish type 2 diabetes find2d survey, a part of the larger implementation study, was carried out in. Metabolically healthy obesity and risk of mortality. Is metabolically healthy overweight or obesity a myth. Basic confounders were sex, peak height velocity years, parental education level noneoneboth of them, and body mass index kgm2. However accumulating evidence suggests that not all obese subjects are at increased cardiometabolic risk and that the metabolically healthy obese mho phenotype may exist in the absence of metabolic. Metabolically healthy obesity and risk of allcause and. Hinnouho gm, czernichow s, dugravot a, batty gd, kivimaki m, singhmanoux a. Without metabolic syndrome, obese people had a similar risk of events to people of normal weight rr 1. Obesity is associated with increased risk of developing metabolic syndrome mets, type 2 diabetes mellitus t2dm and cardiovascular disease cvd leading to higher allcause mortality.
Metabolically healthy obesity, metabolic syndrome, and. O at the examination in year 0 and in year 2, respectively. Metabolically healthy obesity and risk of cardiovascular. Metabolically healthy obesity and risk of kidney function. Metabolically healthy obesity and risk of incident ckd. Thus, this study investigated the association between mho phenotype and incident ckd. Included studies evaluated allcause mortality or cardiovascular events or both and clinical characteristics of 6 patient groups defined by bmi category normal weightoverweightobesity and metabolic status healthyunhealthy, as defined by the presence or absence of components of the metabolic syndrome by adult treatment panel iii or. Metabolically healthy indicates metabolically unhealthy normal weight muhnw patients have an unexpectedly high risk of cardiometabolic mortality. Metabolically healthy versus metabolically unhealthy obesity. There is actually no consensus about the possibility that in some instances, obesity may be a benign metabolically healthy mh condition as. In studies with at least 10 years of followup, overweight people were at a higher risk rr 1.
Background debate over the cardiometabolic risk associated with metabolically healthy obesity mho continues. Metabolically healthy obesity is characterized by a. There is heterogeneity among obese individuals, as some appear to have healthier metabolic profiles and decreased health risks. Metabolically healthy obesity was defined as patients with a body mass index.
We hypothesized that the risk of incident gastric cancer in mho is lower than that in mao. Metabolically healthy obesity mho is a concept derived from clinical. Metabolically healthy obesity with cardiovascular disease. However, there is conflicting evidence regarding the metabolic course of this subpopulation. Methods we used linked electronic health records 1995 to 2015 in the health. Then, we categorized participants into four groups. Metabolically healthy and unhealthy obesity phenotypes in the. A subset of obese individuals seems to be protected against obesityrelated metabolic complications. Conclusions metabolically healthy obesity is not a stable or reliable indicator of.
Differences in brain volume between metabolically healthy and. Furthermore, they provide data indicating that the muhnw class may represent a lipodystrophylike phenotype in the general population and address implications of this phenotype for the prevention and treatment of cardiometabolic diseases. Mar 27, 2018 the concept of metabolically healthy obesity mho and metabolically unhealthy obesity muo has thus been proposed. Association of metabolically healthy obesity with cardiovascular disease and allcause mortality odds ratios and 95% confidence intervals in 5,841 mesa participants. Advertisers institutions editorial policies archive of pdf issues rss. The firstline treatment option for obesity is lifestyle intervention.
Alarmingly, a lower proportion of adults have tried to lose weight during the past decade than during the mid1980s to 1990s. Nw, b metabolically healthy and overweight or obese mh. Among patients with morbid obesity mo who are referred to bariatric surgery, a subset of. Nw, or d metabolically abnormal and overweight or obese ma. Metabolically healthy indicates 45 ul and asparate aminotransferase levels 40 ul were observed in 28 10. Studies have indicated that the metabolically healthy obesity phenotype would not be considered a harmless condition with regard to the risk of developing type 2 diabetes 516. Introduction metabolically healthy obese phenotype mho refers to obese individuals with an adequate metabolic profile and absence of metabolic syndrome. The risk of colon or breast cancer in metabolically healthy obese mho were lower than that in metabolically abnormal obese mao. A peculiar category of persons with obesity lacking common metabolic disturbances has been depicted and termed as metabolically healthy obesity mho. Patients with clinically metabolically healthy obesity are.
The aim of this work was to examine the prevalence of different metabolical phenotypes of obesity, and to analyze, by using different risk scores, how the metabolic syndrome mets definition discriminates between unhealthy and healthy metabolic phenotypes in different obesity classes. Compared with metabolically healthy normalweight participants, metabolically healthy obese participants in 1 study had a mortality rate just short of significance and in the other study had an rr of 1. The prevalence of metabolically healthy and unhealthy obesity. Obesityrelated disease risks may vary depending on whether the subject has.
Background and objectives metabolically healthy obesity mho is a unique obesity phenotype that apparently protects people from the metabolic complications of obesity. Prevalence and characteristics of individuals without. Relations of metabolically healthy and unhealthy obesity. Objectives this study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. Differences in brain volume between metabolically healthy. In the united states, 38% of adults have obesity bmi. Jul 14, 2010 this clinical condition, termed benign obesity or metabolically healthy obesity mho, is restricted to a unique subset of the obese population which, despite excessive body mass index bmi or. Heterogeneity in the metabolic risk status of individuals with normal weight nw, overweight, or obesity raised the hypothesis that metabolically healthy mhobese individuals have no additional metabolic risk.
Open questions about metabolically normal obesity hug. Are metabolically healthy abdominal obese benign conditions abdominal obesity phenotypes, cardiovascular disease, allcause mortality hosseinpanah, farhad, doustmohammadian, sorayya, doustmohammadian, aazam on. Prevalence estimates of mho have varied from 6 to 75 percent, and it has been argued that between 10 and 25 percent of obese individuals are metabolically healthy. Compared with metabolically healthy normalweight participants, metabolically healthy obese. Obesity has become a worldwide epidemic that poses substantial health problems for both individuals and society. Characterization of metabolically healthy obese people and. Many prospective studies have reported the benign condition relating the mho phenotype and its potential role in reducing risk of cardiovascular disease, total cancer, and allcause and causespecific mortality. More recent data suggesting that the mho phenotype is not a cardiometabolically benign condition 43 seem to justify the. This novel concept of metabolically healthy obesity might become increasingly.
Diabetes risk among overweight and obese metabolically. Life course factors associated with metabolically healthy obesity. In kramer and colleagues metaanalysis, metabolically healthy obese persons had an intermediate risk for total mortality and cardiovascular events, higher than that for metabolically healthy lean and overweight persons but lower than that for. Causes, characteristics, and consequences of metabolically. Obesity increases the risk of several other chronic diseases and, because of its epidemic proportions, has become a major public health problem worldwide. Metabolically healthy obesity, transition to metabolic. During 20092010, 525 subjects without any metabolic. Metabolically healthy obese individuals were found to have almost a 25% higher risk of cardiovascular disease and death from any cause compared to metabolically. This conclusion was based on one subgroup analysis, and may be too strong given the less conclusive results from the other analyses.
Jun 19, 2014 recent studies describe a unique subset of obese individuals with normal metabolic profiles despite having excess weight called metabolically healthy but obese mho. Objectives the authors hypothesized that mho at baseline is transient and that transition to metabolic syndrome mets and duration of mets explains. This study aimed to prospectively investigate the natural course of metabolically healthy overweightobese mhowob adults, and to assess the impact of weight change on developing metabolic abnormalities. The prevalence of overweight and obesity continues to rise worldwide. Muo metabolically unhealthy obesity categories are mutually exclusive. Pdf characterization of metabolically healthy obese people and. Metabolically healthy obesity was associated with adverse cardiovascular outcomes. To date, most research on mho has been crosssectional or focused on disease. For years, people have debated whether high bodymass index bmi is itself an independent risk factor for adverse cardiovascular outcomes or whether such adverse outcomes are mediated by metabolic abnormalities that often accompany high bmi.
These individuals are defined as metabolically healthy obese mho, whilst those with unhealthy metabolic profiles are defined as metabolically unhealthy obese muo. Metabolically healthy indicates apr 01, 2014 metabolically healthy persons, as classically defined, may still have metabolic disorders. Mao, metabolically abnormal obesity hashimoto et al. Recent interest has focused on a unique subgroup of overweight and obese individuals who have normal metabolic features despite increased adiposity. Dec 03, 20 metabolically healthy obese individuals relative risk rr, 1. Strict criteria were used to ensure that only patients without signs of metabolic unhealthiness were included in our study. Kramer and colleagues and hill and wyatt suggest that healthy obesity is a myth.
Many studies have investigated this relationship by examining mho at baseline with longitudinal followup, with inconsistent results. This clinical condition, termed benign obesity or metabolically healthy obesity mho, is restricted to a unique subset of the obese population which, despite excessive body mass index bmi or. Metabolically healthy obesity refers to an obesity phenotype with no or little evidence of metabolic dysfunction. The research calls into question the notion of the metabolically healthy obese person, which some prior work has suggested could apply to up to 30% of obese individuals. Obesity is a wellrecognized risk factor for type 2 diabetes, cardiovascular disease, and several types of cancer. Few studies have described the characteristics of metabolically healthy individuals with excess fat in the chinese population. Association of metabolically healthy obesity with cardiovascular disease and allcause mortality odds ratios and 95% confidence intervals in 5841 mesa participants. Impact of metabolically healthy obesity on the risk of. Metabolically healthy obese individuals relative risk rr, 1.
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