Metabolically healthy obese individuals -- mechanisms and clinical relevance

Obesity is associated with an increased risk of premature death and represents a fast growing worldwide health problem. Although it has been long recognized that obesity is associated with an impaired insulin sensitivity, significantly increases the risk of developing type 2 diabetes, dyslipidemia, fatty liver disease, hypertension, cardiovascular disease and certain types of cancers, a subgroup of obese individuals called metabolic healthy obese seems to be protected from metabolic and cardiovascular obesity comorbidities. This article focuses on potential mechanisms underlying the healthy obese phenotype (protection against development of hepatic steatosis, inflammation of visceral adipose tissue, ectopic fat deposition and adipose tissue dysfunction) and on clinical relevance of this interesting subgroup of obese individuals. Additionally, definition, epidemiology and stability of healthy obese phenotype are discussed.