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Metabolic health in normal-weight and obese individuals

Matthias B Schulze1,2,3

  • 1Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. mschulze@dife.de.

Diabetologia
|December 21, 2018
PubMed

Insights

Metabolically healthy obesity (MHO) may not increase cardiovascular risk, while some normal-weight individuals are metabolically unhealthy. This review explores these phenotypes, challenging MHO definitions and emphasizing fat distribution for risk assessment.

Area of Science:

  • Cardiology
  • Metabolic Health
  • Obesity Research

Background:

  • Obesity is linked to cardiovascular complications, but a subset of obese individuals exhibit metabolically healthy obesity (MHO).
  • Metabolically unhealthy individuals, regardless of BMI, face high cardiovascular disease (CVD) risk, including normal-weight individuals.

Purpose of the Study:

  • To review prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes.
  • To address the ongoing debate regarding MHO definitions and the dynamic nature of metabolic health.
  • To highlight alternative measures for body fatness and CVD risk stratification.

Main Methods:

  • Review of prospective studies examining MHO and MUHNW phenotypes.
  • Analysis of research on fat distribution as an alternative to BMI for assessing metabolic health.
  • Examination of studies on transitions between metabolic health states and their determinants.

Main Results:

  • The concept of MHO lacks a uniform definition and metabolic health can be transient.
  • Fat distribution measures may be more relevant than BMI for defining MHO and MUHNW.
  • Risk stratification needs to account for the continuum of CVD risk across various factors.

Conclusions:

  • Further research is needed to refine the understanding of MHO and MUHNW.
  • Alternative measures of body fatness and risk stratification are crucial for accurate CVD risk assessment.
  • Epidemiological studies can inform the debate on metabolic health across different body fatness levels.

Keywords:
Cardiovascular diseasesCohort studiesMetabolically benignObesityReview

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