Predicting the development of the metabolically healthy obese phenotype

Area of Science:

• Cardiovascular health and metabolic syndrome research.
• Obesity phenotyping and risk stratification.

Background:

• Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) have different cardiovascular risks.
• Predicting MHO development and MUHO progression is crucial for cardiovascular risk management.

Purpose of the Study:

• To examine predictors of developing MHO and MUHO phenotypes.
• To assess the long-term stability of the MHO phenotype.

Main Methods:

• Longitudinal population-based study of cardiometabolic risk factors.
• Included 2368 Mexican American and non-Hispanic white participants without diabetes at baseline.
• Defined MHO as obesity with ≤1 metabolic abnormality; MUHO as obesity with ≥2 abnormalities.

Main Results:

• Obesity, triglycerides, and HDL-C predicted incident MHO in non-obese individuals.
• Obesity and triglycerides predicted incident MUHO in non-obese individuals.
• Obesity increased the odds of developing multiple metabolic abnormalities in those with ≤1 abnormality.

Conclusions:

• Triglycerides and HDL-C may predict progression to MHO.
• MHO may not be a stable phenotype, as it is associated with increased risk of developing multiple metabolic abnormalities.