Metabolic normality in overweight and obese subjects. Which parameters? Which risks?
Z Pataky1, V Makoundou, P Nilsson
1Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
International Journal of Obesity (2005)
|January 6, 2011
Summary
Metabolically normal obese individuals have a less favorable cardiometabolic profile. Increased body mass index (BMI) and fasting insulin are key factors contributing to this risk, even in those without metabolic syndrome.
Area of Science:
- Cardiology
- Metabolic Health
- Obesity Research
Background:
- Defining metabolic normality is crucial for understanding obesity-related health risks.
- Metabolically normal obese (MNO) individuals present a complex cardiometabolic profile.
- Previous studies have not fully elucidated the cardiometabolic characteristics of MNO subjects.
Purpose of the Study:
- To establish criteria for metabolic normality.
- To investigate the cardiometabolic profile of metabolically normal obese individuals.
- To identify factors contributing to adverse cardiometabolic profiles in obesity.
Main Methods:
- A cross-sectional study involving 382 normal body weight and 185 overweight/obese subjects across 21 European research centers.
- Insulin sensitivity assessed using the clamp technique.
- Metabolic normality defined by normal insulin sensitivity and fasting insulin levels, based on quartiles from normal body weight subjects.
Main Results:
- Only 11% of overweight/obese subjects were metabolically normal, compared to 37% of normal body weight subjects (P<0.0001).
- Overweight/obese subjects exhibited higher fasting insulin, LDL-cholesterol, and blood pressure compared to normal body weight subjects.
- Body mass index (BMI) independently influenced HDL-cholesterol, hs-CRP, and blood pressure, and shared influence with insulinemia on total cholesterol, LDL-cholesterol, and triglycerides.
Conclusions:
- Fasting insulin levels are essential for defining metabolic normality in obese individuals.
- Even metabolically normal obese subjects face an elevated risk for cardiometabolic diseases.
- Increased BMI, with or without elevated fasting insulin, is the primary driver of unfavorable cardiometabolic profiles in obesity.
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