Metabolically Obese Normal Weight; Visceral adipose tissue; Obesity; Metabolic syndrome
Abstract :
[en] Around 30 to 50% of obese subjects are “metabolically normal” (MHO) whereas numerous nonobese subjects are “metabolically abnormal”. The distribution and function of adipose deposits seem to play a crucial role in explaining this apparent paradox. The aim of this first article is to describe the clinical and biological characteristics that lead to the diagnosis of MHO, attempt to discover the etiopathogenesis of this syndrome and analyze the underlying pathophysiological mechanisms and, finally, to assess the prevalence of the MHO phenotype, which may vary according to the definition used and the population studied. [fr] Environ 30 à 50 % des sujets obèses sont « métaboliquement normaux » (MHO metabolically healthy, but obese) alors qu’inversement, nombre de sujets non obèses sont « métaboliquement anormaux ». La topographie et la fonction des dépôts graisseux semblent jouer un rôle déterminant pour expliquer cet apparent paradoxe. Ce premier article vise à présenter les éléments conduisant au diagnostic du phénotype MHO, à tenter d’en cerner l’étiopathogénie et de mieux comprendre sa physiopathologie et, enfin, à analyser la prévalence de ce syndrome, quelque peu différente en fonction de la définition retenue et de la population étudiée.
Paquot, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Language :
French
Title :
Sujets « métaboliquement sains », bien qu’obèses. Première partie: diagnostic, physiopathologie et prévalence
Alternative titles :
[en] Metabolically healthy, but obese subjects. First part: definition, pathophysiology and prevalence
Publication date :
March 2009
Journal title :
Obésité: Revue Francophone pour la Recherche Clinique, la Prévention et la Prise en Charge de l'Obésité
Scheen AJ (2007) Diabetes, obesity and metabolic syndrome. In: Meckling KA (Ed) Nutrient-drug interactions. CRC Press Taylor et Francis, Boca Raton, FL, US, pp. 1-30
Scheen AJ (2001) Obesity and diabetes. In: Kopelman PG (Ed) The management of obesity and related disorders. Martin Dunitz Ltd, London, UK, 11-44
E. Beck N. Paquot A.J. Scheen 2008 Sujets étaboliquement obèses Première partie: diagnostic, physiopathologie et prévalence Obésité 3 184 193
E. Beck N. Paquot A.J. Scheen 2008 Sujets étaboliquement obèses Deuxième partie: pronostic et prise en charge Obésité 3 280 285
N. Ruderman D. Chisholm X. Pi-Sunyer S. Schneider 1998 The metabolically obese, normal-weight individual revisited Diabetes 47 699 713
M. Brochu A. Tchernof I.J. Dionne 2001 What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab 86 1020 1025
E.A. Sims 2001 Are there persons who are obese, but metabolically healthy? Metabolism 50 1499 1504
A.D. Karelis D.H. Saint-Pierre F. Conus 2004 Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 89 2569 2575
A.D. Karelis 2008 Metabolically healthy but obese individuals Lancet 372 1281 1283
R.P. Wildman P. Muntner K. Reynolds 2008 The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering Prevalence and correlates of two phenotypes among the US population (NHANES 1999-2004.ArchInternMed168 1617 1624
N. Stefan K. Kantartzis J. Machann 2008 Identification and characterization of metabolically benign obesity in humans Arch Intern Med 168 1609 1616
R. Kelishadi S.R. Cook M. Esmaeil 2008 Metabolically obese normal weight and phenotypically obese metabolically normal youths: the CASPIAN study J Am Diet Assoc 108 82 90
N. Bouhours-Nouet S. Dufresne F. Boux de Casson 2008 High-birth weight and early postnatal weight gain protect obese children and adolescents from truncal adiposity and insulin resistance. Metabolically healthy but obese subjects? Diabetes Care 31 1031 1036
G. Reaven 2005 All obese are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals Diab Vasc Dis Res 2 105 112
H.B. Holt S.H. Wild N. Wareham 2007 Differential effects of fatness, fitness and physical activity energy expenditure on whole-body, liver and fat insulin sensitivity Diabetologia 50 1698 1706
D. Magis I. Geronooz A.J. Scheen 2002 Tabagisme, insulinoré sistance et diabète de type 2 Rev Med Liège 57 575 581
A. Chiolero D. Faeh F. Paccaud J. Cornuz 2008 Consequences of smoking for body weight, body fat distribution and insulin resistance Am J Clin Nutr 87 801 809
D. Magis B.J. Jandrain A.J. Scheen 2003 Alcool, sensibilité à l'insuline et diabète sucré Rev Med Liège 58 501 507
A.D. Karelis J. Fontaine R. Rabasa-Lhoret 2006 Psychological profile of the metabolically healthy but obese postmenopausal woman Diabetes Metab 32 90 91
C.L. Jennings E.V. Lambert M. Collins 2008 Determinants of insulin-resistant phenotypes in normal-weight and obese Black African women Obesity 16 1602 1609
G. Marchesini N. Melchionda G. Apolone 2004 The metabolic syndrome in treatment-seeking obese persons Metabolism 53 435 440
L. Hayes M.S. Pearce N.C. Unwin 2006 Lifecourse predictors of normal metabolic parameters in overweight and obese adults Int J Obes (Lond) 30 970 976
O. Colombo S. Villani G. Pinelli 2008 To treat or not to treat: comparison of different criteria used to determine whether weight loss is to be recommended Nutr J 7 5
I. Janssen P.T. Katzmarzyk R. Ross 2004 Waist circumference and not body mass index explains obesity-related health risk Am J Clin Nutr 79 379 384
J.B. Meigs P.W.F. Wilson C.S. Fox 2006 Body mass index, metabolic syndrome and risk of type 2 diabetes or cardiovascular disease J Clin Endocrinol Metab 91 2906 2912
B. Buemann A. Astrup O. Pedersen 2006 Possible role of adiponectin and insulin sensitivity in mediating the favorable effects of lower body fat mass on blood lipid J Clin Endocrinol Metab 91 1698 1704
M.B. Snijder J.M. Dekker M. Visser 2003 Larger thigh and hip circumferences are associated with better glucose tolerance: the HOORN Study Obes Res 11 104 111
E.S. Freedland 2004 Role of a critical adipose tissue threshold (CVATT) in metabolic syndrome: implication of controlling dietary carbohydrates: a review Nutr Metab (Lond) 1 12
E. Succurro M.A. Marini S. Frontoni 2008 Insulin secretion in metabolically obese, but normal weight, and in metabolically healthy but obese individuals Obesity 16 1881 1886
A.J. Scheen 2007 évaluation de l'insulinosécrétion et de l'insulinosensibilité chez l'homme Thérapie 62 311 318
C.A. Aguilar-Salinas E. Garcia Garcia L. Robles 2008 High adiponectin concentrations are associated with the metabolically healthy obese phenotype J Clin Endocrinol Metab 93 4075 4079
A.D. Karelis M. Faraj J.P. Bastard 2005 The metabolically healthy but obese individual presents a favorable inflammation profile J Clin Endocrinol Metab 90 4145 4150
M.J. Shin Y.J. Hyun O.Y. Kim 2006 Weight loss effect on inflammation and LDL oxidation in metabolically healthy but obese (MHO) individuals: low inflammation and LDL oxidation in MHO women Int J Obes Relat Metab Disord 30 1529 1534
A.D. Karelis V. Messier M. Brochu R. Rabasa-Lhoret 2008 Metabolically healthy but obese women: effect of an energyrestricted diet Diabetologia 51 1752 1754
E.W. Demerath D. Reed N. Roggers 2008 Visceral adiposity and its anatomical distribution as predictors of the metabolic syndrome and cardiometabolic risk factor levels Am J Clin Nutr 88 1263 1271
B.L. Wajchenberg 2000 Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome Endocr Rev 21 697 738
G. Iacobellis M.C. Ribaudo A. Zappaterreno 2005 Prevalence of uncomplicated obesity in an Italian obese population Obes Res 13 1116 1122
C.S. Fox J.M. Massaro U. Hoffmann 2007 Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic factors in the Framingham Heart study Circulation 116 39 48
J.P. Després 2006 Is visceral obesity the cause of the metabolic syndrome? Ann Med 38 52 63
Esser N, Scheen AJ (2009) Sujets obèses sans anomalies métaboliques. Rev Med Liège 64 (sous presse)
S. De Ferranti D. Mozaffarian 2008 The perfect storm: obesity, adipocyte dysfunction and metabolic consequences Clin Chem 54 945 955
A. Kotronen H. Yki-Järvinen 2008 Fatty liver: a novel component of the metabolic syndrome Arterioscler Thromb Vasc Biol 28 27 38
P.D. Berk 2008 Regulatable fatty acid transport mechanisms are central to the pathophysiology of obesity, fatty liver and metabolic syndrome Hepatology 48 1362 1376
M.B. Snijder P.Z. Zimmer M. Visser 2004 Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab study Int J Obes Relat Metab Disord 28 402 409
B. Buemann T.I. Sorensen O. Pedersen 2005 Lower-body fat mass as an independent marker of insulin sensitivity - the role of adiponectin Int J Obes 29 624 631
Boorsma W, Snijder MB, Nijpels G, et al (2008) Body composition, insulin sensitivity and cardiovascular disease profile in healthy Europeans. Obesity Oct 16 [Epub ahead of print]
M. Guerre-Millo 2008 Adiponectin: an update Diabetes Metab 34 12 18
F. Abbasi J.W. Chu C. Malendola 2004 Discrimination between obesity and insulin resistance in the relationship with adiponectin Diabetes 53 585 590
R. Pasquali 2006 Obesity and androgens: facts and perspectives Fertil Steril 85 1319 1340
A. Scheen 1997 Perspective in the treatment of insulin resistance Hum Reprod 12 63 71
M.H. Gannagé-Yared S. Khalife M. Semaan 2006 Serum adiponectin and leptin levels in relation to the metabolic syndrome, androgenic profile and somatrotropic axis in healthy non-diabetic elderly men Eur J Endocrinol 155 167 176
S.A. Kaplan A.G. Meehan A. Shah 2006 The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol 176 1524 1528
R.L. Atkinson N.V. Dhurandhar D.B. Allison 2005 Human adenovirus-36 is associated with increased body weight and paradoxical reduction of serum lipids Int J Obes 29 281 286
S.D. Vangipuram M. Yu J. Tian 2007 Adipogenic human adenovirus-36 reduces leptin expression and secretion and increases glucose uptake by fat cells Int J Obes 31 87 96
P.M. Rogers N. Mashtalir M.A. Rathod 2007 Metabolically favourable remodeling of human adipose tissue by human adenovirus type 36 Diabetes 57 2321 2331
Y.W. Park S. Zhu L. Palaniappan 2003 The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994 Arch Intern Med 163 427 436
E.S. Ford 2005 Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US Diabetes Care 28 2745 2749
E. Bonora J. Kiechl F. Oberhollenzer 1998 Prevalence of insulin resistance in metabolic disorders: the Brunneck study Diabetes 47 1643 1650
T. McLaughlin F. Abasi K. Cheal 2003 Use of metabolic markers to identify overweight individuals who are insulin resistant Ann Intern Med 139 802 809
T. McLaughlin G. Allison F. Abbasi 2004 Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight and obese individuals Metabolism 53 495 499
E. Ferrannini A. Natali P. Bell 1997 Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR) J Clin Invest 100 1166 1173
