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Wani K, Rahman S, Draz H. Editorial: Dysbiosis, obesity, and inflammation: interrelated phenomena causes or effects of metabolic syndrome? Front Endocrinol (Lausanne) 2023; 14:1265314. [PMID: 37916148 PMCID: PMC10616948 DOI: 10.3389/fendo.2023.1265314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Kaiser Wani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
- University Institute of Biotechnology, Chandigarh University, Mohali, India
| | - Shakilur Rahman
- Department of Medical Elementology and Toxicology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Hossam Draz
- Charles River Laboratories, Senneville, QC, Canada
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Mirmiran P, Moslehi N, Golzarand M, Azizi F. Ultra-processed foods consumption and the risk of metabolically unhealthy phenotype in normal-weight and overweight/obese adults: a prospective investigation. Int J Food Sci Nutr 2023:1-10. [PMID: 37334484 DOI: 10.1080/09637486.2023.2222935] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
This study investigated the association between ultra-processed foods (UPF) and the risk of metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obese (MUO). We included 512 normal-weight and 787 overweight/obese adults with a metabolically healthy phenotype from the Tehran and Lipid Glucose Study, who were followed from the third (baseline) to the sixth study examinations. Each 10% increase in energy intake from UPF was related to a 54% (95% CI = 21-96%) and 2% (95% CI = 1-3%) higher risk of MUNW and MUO, respectively. The risk of MUNW was significantly higher in quartile 4 compared to quartile 1. The restricted cubic splines suggested that the risk of MUNW increases monotonically when UPF accounts for at least 20% of energy intake. No non-linear association was observed between UPF and the risk of MUO. Energy intake from UPF was positively related to the risk of MUNW and MUO.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Oh S, Kim E, Shoda J. Editorial: Lifestyle modification strategies as first line of chronic disease management. Front Physiol 2023; 14:1204581. [PMID: 37234423 PMCID: PMC10206390 DOI: 10.3389/fphys.2023.1204581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Affiliation(s)
- Sechang Oh
- Faculty of Rehabilitation, R. Professional University of Rehabilitation, Tsuchiura, Japan
| | - Eonho Kim
- Department of Physical Education, Dongguk University, Seoul, South Korea
| | - Junichi Shoda
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Jung Y, Kim GN, Oh EB, Ohn K, Moon JI. Metabolic Health, Obesity, and Intraocular Pressure. J Clin Med 2023; 12. [PMID: 36902853 DOI: 10.3390/jcm12052066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 03/08/2023] Open
Abstract
Obesity has been associated with increased intraocular pressure (IOP), but the results are inconsistent. Recently, a subgroup of obese individuals with good metabolic profiles were suggested to have better clinical outcomes than normal-weight individuals with metabolic diseases. The relationships between IOP and different combinations of obesity and metabolic health status have not been investigated. Therefore, we investigated the IOP among groups with different combinations of obesity status and metabolic health status. We examined 20,385 adults aged 19 to 85 years at the Health Promotion Center of Seoul St. Mary's Hospital between May 2015 and April 2016. Individuals were categorized into four groups according to obesity (body mass index (BMI) ≥ 25 kg/m2) and metabolic health status (defined based on prior medical history or abdominal obesity, dyslipidemia, low high-density lipoprotein cholesterol, high blood pressure, or high fasting blood glucose levels upon medical examination). ANOVA and ANCOVA were performed to compare the IOP among the subgroups. The IOP of the metabolically unhealthy obese group (14.38 ± 0.06 mmHg) was the highest, followed by that of the metabolically unhealthy normal-weight group (MUNW, 14.22 ± 0.08 mmHg), then, the metabolically healthy groups (p < 0.001; 13.50 ± 0.05 mmHg and 13.06 ± 0.03 mmHg in the metabolically healthy obese (MHO) and metabolically healthy normal-weight groups, respectively). Subjects who were metabolically unhealthy showed higher IOP compared to their counterparts who were metabolically healthy at all BMI levels, and there was a linear increase in IOP as the number of metabolic disease components increased, but no difference between normal-weight vs. obese individuals. While obesity, metabolic health status, and each component of metabolic disease were associated with higher IOP, those who were MUNW showed higher IOP than those who were MHO, which indicates that metabolic status has a greater impact than obesity on IOP.
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Abstract
BACKGROUND It is well-recognized that hyperuricemia is a common abnormality among individuals with metabolic syndrome. AIMS The objective of this study was to determine whether hyperuricemia is associated with the metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) phenotypes. METHODS Men and women equal or greater than 18 years of age were enrolled in a cross-sectional study. Normal-weight subjects were allocated into the MONW or healthy normal-weight (HNW) groups; while obese individuals were divided into the MHO and metabolically unhealthy obese (MUO) subgroups. MONW phenotype was defined by body mass index (BMI) <25.0 kg/m2 accompanied by at least one cardiovascular risk factor (hyperglycemia, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol), and MHO phenotype was considered in obese subjects (BMI ≥30 kg/m2) without metabolic abnormalities. RESULTS A total of 567 individuals were enrolled; of them, normal-weight subjects were allocated into the MONW (n = 101) and control (n = 72) groups, whereas obese individuals into the MHO (n = 61) and MUO (n = 333) groups. The multiple logistic regression analysis adjusted by age, gender, and body mass index revealed that hyperuricemia is significantly associated with MONW (OR = 5.14; 95% CI: 1.37-19.29) and MHO (OR = 0.34; 95% CI: 0.14-0.82) phenotypes. CONCLUSION Results of our study showed that hyperuricemia is associated with both MONW and MHO phenotypes.
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Affiliation(s)
- Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
| | - Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
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Oguoma VM, Abu-Farha M, Coffee NT, Alsharrah S, Al-Refaei FH, Abubaker J, Daniel M, Al-Mulla F. Metabolically Healthy and Unhealthy Obese Phenotypes among Arabs and South Asians: Prevalence and Relationship with Cardiometabolic Indicators. Nutrients 2022; 14:nu14050915. [PMID: 35267891 PMCID: PMC8912281 DOI: 10.3390/nu14050915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 12/27/2022] Open
Abstract
Obesity is a public health crisis in Kuwait. However, not all obese individuals are metabolically unhealthy (MuHO) given the link between obesity and future cardiovascular events. We assessed the prevalence of the metabolically healthy obese (MHO) phenotype and its relationship with high sensitivity C-reactive protein (hs-CRP), serum alanine aminotransferase (ALT), and insulin resistance (HOMA-IR) in Arab and South Asian ethnic groups in Kuwait. The national cross-sectional survey of diabetes and obesity in Kuwait adults aged 18–60 years were analysed. The harmonised definition of metabolic syndrome was used to classify metabolic health. Multinomial logistic regression analysis was used to model the relationship between the MHO and MuHO phenotypes and hs-CRP, ALT and HOMA-IR levels. Overall, the prevalence of MHO for body mass index (BMI)- and waist circumference (WC)-defined obesity was 30.8% and 56.0%, respectively; it was greater in women (60.4% and 61.8%, respectively) than men (39.6% and 38.2%, respectively). Prevalence rates were also lower for South Asians than for Arabs. The MHO phenotype had hs-CRP values above 3 µg/mL for each age group category. Men compared to women, and South Asians compared to Arabs had a lower relative risk for the MHO group relative to the MuHO group. This study shows there is high prevalence of MHO in Kuwait.
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Affiliation(s)
- Victor M. Oguoma
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
- Correspondence:
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (J.A.)
| | - Neil T. Coffee
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
| | - Saad Alsharrah
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
| | | | - Jehad Abubaker
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (J.A.)
| | - Mark Daniel
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Melbourne 3010, Australia
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
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Wan Mohd Zin RM, Jalaludin MY, Yahya A, Nur Zati Iwani AK, Md Zain F, Hong JYH, Mokhtar AH, Wan Mohamud WN. Prevalence and clinical characteristics of metabolically healthy obese versus metabolically unhealthy obese school children. Front Endocrinol (Lausanne) 2022; 13:971202. [PMID: 36072927 PMCID: PMC9441792 DOI: 10.3389/fendo.2022.971202] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Children with obesity in the absence of traditional cardiometabolic risk factors (CRF) have been described as metabolically healthy obese (MHO). Children with MHO phenotype has a favorable metabolic profile with normal glucose metabolism, lipids, and blood pressure compared to children with metabolically unhealthy obese (MUO) phenotype. This study aimed to compare several parameters related to obesity between these two groups and to examine the predictors associated with the MHO phenotype. METHODS This study included a cross-sectional baseline data of 193 children with obesity (BMI z-score > +2 SD) aged 8-16 years enrolled in MyBFF@school program, a school-based intervention study conducted between January and December 2014. Metabolic status was defined based on the 2018 consensus-based criteria with MHO children had no CRF (HDL-cholesterol > 1.03 mmol/L, triglycerides ≤ 1.7 mmol/L, systolic and diastolic blood pressure ≤ 90th percentile, and fasting plasma glucose ≤ 5.6 mmol/L). Those that did not meet one or more of the above criteria were classified as children with MUO phenotype. RESULTS The prevalence of MHO was 30.1% (95% CI 23.7 - 37.1) among schoolchildren with obesity and more common in younger and prepubertal children. Compared to MUO, children with MHO phenotype had significantly lower BMI, lower waist circumference, lower uric acid, higher adiponectin, and higher apolipoprotein A-1 levels (p < 0.01). Multivariate logistic regression showed that adiponectin (OR: 1.33, 95% CI 1.05 - 1.68) and apolipoprotein A-1 (OR: 1.02, 95% CI 1.01 - 1.03) were independent predictors for MHO phenotype in this population. CONCLUSIONS MHO phenotype was more common in younger and prepubertal children with obesity. Higher serum levels of adiponectin and apolipoprotein A-1 increased the possibility of schoolchildren with obesity to be classified into MHO phenotype.
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Affiliation(s)
- Ruziana Mona Wan Mohd Zin
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin,
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Kamil Nur Zati Iwani
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Fuziah Md Zain
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Janet Yeow Hua Hong
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wan Nazaimoon Wan Mohamud
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
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Martin-Piedra L, Alcala-Diaz JF, Gutierrez-Mariscal FM, Arenas de Larriva AP, Romero-Cabrera JL, Torres-Peña JD, Caballero-Villarraso J, Luque RM, Perez-Martinez P, Lopez-Miranda J, Delgado-Lista J. Evolution of Metabolic Phenotypes of Obesity in Coronary Patients after 5 Years of Dietary Intervention: From the CORDIOPREV Study. Nutrients 2021; 13:4046. [PMID: 34836298 DOI: 10.3390/nu13114046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. Methods: The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Results: Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p < 0.05). Most of the MUO (92%) patients maintained unhealthy phenotypes (MUO-Non-Responders), but 8% became metabolically healthy (MUO-Responders) after a significant decrease in their BMI and FLI-score, with improvement in all metabolic criteria. No differences were found among dietary groups. Conclusions: A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.
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Kim HS, Lee J, Cho YK, Park JY, Lee WJ, Kim YJ, Jung CH. Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study. Front Endocrinol (Lausanne) 2021; 12:625083. [PMID: 33716978 PMCID: PMC7947792 DOI: 10.3389/fendo.2021.625083] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/14/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Metabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years. METHODS The Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first. RESULTS The MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20-1.39], 1.37 [1.22-1.53], and 1.63 [1.50-1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status. CONCLUSIONS Metabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.
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Affiliation(s)
- Hwi Seung Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Jiwoo Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Yun Kyung Cho
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Woo Je Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- *Correspondence: Chang Hee Jung, ; Ye-Jee Kim,
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
- *Correspondence: Chang Hee Jung, ; Ye-Jee Kim,
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Hosseini SA, Aghamohammadi V, Ashtary-Larky D, Alipour M, Ghanavati M, Lamuchi-Deli N. Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence? J Vasc Bras 2020; 19:e20190106. [PMID: 34290747 PMCID: PMC8276644 DOI: 10.1590/1677-5449.190106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 04/20/2020] [Indexed: 01/10/2023] Open
Abstract
Background The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear. Objectives We examined the association between MHO and CVD risk in young Iranian women. Methods We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants. Results The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO. Conclusions Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.
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Affiliation(s)
- Seyed Ahmad Hosseini
- Ahvaz Jundishapur University of Medical Sciences, Hyperlipidemia Research Center, Ahvaz, Iran.,Ahvaz Jundishapur University of Medical Sciences, Nutrition and Metabolic Diseases Research Center, Ahvaz, Iran
| | | | - Damoon Ashtary-Larky
- Ahvaz Jundishapur University of Medical Sciences, Nutrition and Metabolic Diseases Research Center, Ahvaz, Iran
| | - Meysam Alipour
- Ahvaz Jundishapur University of Medical Sciences, Nutrition and Metabolic Diseases Research Center, Ahvaz, Iran
| | - Matin Ghanavati
- Ahvaz Jundishapur University of Medical Sciences, Nutrition and Metabolic Diseases Research Center, Ahvaz, Iran
| | - Nasrin Lamuchi-Deli
- Ahvaz Jundishapur University of Medical Sciences, School of Medicine, Department of Clinical Biochemistry, Ahvaz, Iran
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Mirmiran P, Moslehi N, Hosseinpanah F, Sarbazi N, Azizi F. Dietary determinants of unhealthy metabolic phenotype in normal weight and overweight/obese adults: results of a prospective study. Int J Food Sci Nutr 2020; 71:891-901. [PMID: 32237941 DOI: 10.1080/09637486.2020.1746955] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We aimed to investigate associations of dietary intakes with unhealthy metabolic phenotype development, in normal weight and overweight/obese adults separately. A total of 1114 individuals, aged ≥19 years, with healthy phenotype in the third examination cycle of Tehran Lipid and Glucose Study were followed until the fifth examination. Dietary intakes were estimated using the food frequency questionnaires, collected during the study. The participants were grouped as normal weight and overweight/obese according to the baseline body mass index (BMI). Unhealthy metabolic status was determined as having more than one component of metabolic syndrome using the Joint Interim Statement. Regardless of BMI, higher intakes of magnesium, dairy products, poultry, apples/pears, citrus fruits, and tea/coffee decreased the risk of developing unhealthy phenotype, while higher intakes of fast foods, organ meats, and potatoes increased the risk. Food intake can influence the transition to unhealthy phenotype in metabolically healthy adults, irrespective of the BMI status.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Sarbazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Liu M, Zhang K, Wang L, Yang H, Yan K, Pan H, Zhu H, Gong F. Serum ZAG and Adiponectin Levels Were Closely Related to Obesity and the Metabolically Abnormal Phenotype in Chinese Population. Diabetes Metab Syndr Obes 2020; 13:3099-3112. [PMID: 32904655 PMCID: PMC7457588 DOI: 10.2147/dmso.s257643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/03/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION To explore serum zinc-α2-glycoprotein (ZAG) and adiponectin in metabolically healthy non-obese (MHNO), metabolically healthy obesity (MHO), metabolically abnormal obesity (MAO) and metabolically abnormal diabetic obese (MADO) subjects and the relationship with metabolically phenotypes of obesity. METHODS Two hundred twenty-five subjects including 32 with MHNO, 40 with MHO, 104 with MAO and 49 with MADO were enrolled. Baseline clinical data and biochemical variables were collected. Serum ZAG and adiponectin levels were measured by enzyme-linked immunosorbent assay (ELISA) kits. Metabolically healthy (<3 metabolic abnormalities) or abnormal (≥3 metabolic abnormalities) subjects were classified based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP/ATP III) criteria. Obesity (body mass index ≥28 kg/m2) was recommended by China Obesity Task Force. RESULTS Serum ZAG levels were higher in the MHO group, but were progressively lower in MAO and MADO groups (P all<0.05). In all subjects, total cholesterol, 2-hour postprandial blood glucose and homeostasis model assessment of adiponectin were independent variables to serum ZAG levels. Compared with subjects in the highest tertile of ZAG, the odds ratio (OR) of metabolically abnormal risks of subjects in the lowest and median tertiles of ZAG were higher both in a univariate and three adjustment models (P all<0.05). Serum ZAG could discriminate the metabolically abnormal phenotype with receiver operating characteristic (ROC) curve area of 0.622 (95% CI, 0.539-0.706, P<0.05). Combination of ZAG and adiponectin had improved diagnosis value accuracy, with ROC curve area of 0.703 (95% CI, 0.629-0.776, P<0.05), and 62.7% sensitivity and 73.6% specificity. CONCLUSION Serum ZAG levels were higher in MHO subjects, but lower in MAO and MADO subjects. The decreased serum ZAG levels were closely related to the metabolically abnormal phenotype of obese patients. Serum ZAG, especially the combination with adiponectin might be the potential diagnostic biomarkers for metabolically abnormal obese patients.
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Affiliation(s)
- Meijuan Liu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Kun Zhang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Linjie Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Kemin Yan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
| | - Fengying Gong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing100730, People’s Republic of China
- Correspondence: Fengying Gong; Huijuan Zhu Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1# Shuaifuyuan, Wangfujing, Beijing100730, People’s Republic of ChinaTel +86 10 69155100Fax +86 10 69155073 Email ;
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Nie X, Ma X, Xu Y, Shen Y, Wang Y, Bao Y. Characteristics of Serum Thyroid Hormones in Different Metabolic Phenotypes of Obesity. Front Endocrinol (Lausanne) 2020; 11:68. [PMID: 32184757 PMCID: PMC7058591 DOI: 10.3389/fendo.2020.00068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 02/03/2020] [Indexed: 12/14/2022] Open
Abstract
Aim: Metabolically healthy obese (MHO) individuals have attracted broad attention. We aimed to investigate the characteristics of serum thyroid hormones in different metabolic phenotypes of obesity. Methods: The study included 1,023 community-based euthyroid subjects (age range: 27-81 years), of whom 586 were women. Fat% was detected by a bioelectrical impedance analyzer. Two definitions of obesity were applied as follows: (1) fat% ≥ 25% for men and ≥ 30% for women; (2) body mass index (BMI) ≥ 25 kg/m2. According to the diagnostic criteria for metabolic syndrome by the Chinese Diabetes Society, metabolically unhealthy was defined as two or more components of metabolic syndrome, excluding waist circumference. Serum-free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels were measured by electrochemiluminescence immunoassay. Results: The proportions of obesity defined by fat% and BMI were 41.3 and 27.1%, respectively. The proportion of metabolically unhealthy was 41.6%. After adjusting for age and gender, regardless of the definitions based on fat% or BMI, FT3 was positively related to both the MHO and the metabolically unhealthy obese (MUO) phenotypes [MHO: odds ratio (OR)s = 1.676 based on fat% and 2.055 based on BMI; MUO: ORs = 1.818 based on fat% and 1.526 based on BMI; all P < 0.05]; FT4 was negatively related to the MUO phenotype (ORs = 0.870 based on fat% and 0.849 based on BMI, all P < 0.05); FT3/FT4 was also positively related to both the MHO and the MUO phenotypes (MHO: ORs = 1.678 based on fat% and 2.825 based on BMI; MUO: ORs = 2.866 based on fat% and 2.883 based on BMI; all P < 0.05); and TSH was positively related to the metabolically unhealthy non-obese phenotype (ORs = 1.329 based on fat% and 1.321 based on BMI, all P < 0.01). Conclusions: In euthyroid population, both the MHO and the MUO phenotypes were characterized by increased FT3 and FT3/FT4 levels.
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Affiliation(s)
- Xiaomin Nie
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojing Ma
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- *Correspondence: Xiaojing Ma
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yufei Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Yuqian Bao
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Esmaili H, Heshmat R, Ejtahed HS, Rastad H, Motlagh ME, Asayesh H, Jafarnejad M, Seif E, Qorbani M, Kelishadi R. Association of Serum 25-Hydroxyvitamin D Level With Metabolic Phenotypes of Obesity in Children and Adolescents: The CASPIAN-V Study. Front Endocrinol (Lausanne) 2020; 11:310. [PMID: 32612573 PMCID: PMC7308554 DOI: 10.3389/fendo.2020.00310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/23/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Different metabolic phenotypes of obesity are related to cardiometabolic risk factors in children and adolescents. Vitamin D, as one important factor, could be related to different subgroups of metabolic obesity and might affect metabolic disorders. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents. Methods: This nationwide cross-sectional study was conducted in the framework of the fifth survey of a national surveillance program, the CASPIAN study. Overall, 2,594 students aged 7-18 years were assessed for 25-hydroxyvitamin D status. Metabolic syndrome (MetS) was defined according to the ATP III criteria modified for the pediatric age group. Participants were classified into four metabolic phenotypes of obesity according to categories of the BMI and metabolic status: "metabolically healthy obese" (MHO), "metabolically non-healthy non-obese" (MNHNO), "metabolically non-healthy obese" (MNHO), and "metabolically healthy non-obese" (MHNO). Multinomial logistic regression analysis was performed for evaluating the association of 25-hydroxyvitamin D status with different metabolic phenotypes of obesity. Results: In this study, 85.2% of participants were classified as MHNO, 11.0 % as MHO, 2.5% as MNHNO, and 1.3% as MNHO. The frequency of hypovitaminosis D was more prevalent in MNHO (85.3%) than in other phenotypes (MHNO: 70%; MHO: 76.5%; MNHNO: 78.1%, respectively; p < 0.05). In the multivariate model, hypovitaminosis D significantly increased the odds of being MHO (OR: 1.46; 95% CI: 1.07-1.77) and MNHO (OR: 2.89; 1.05-8.31) compared to the healthy group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25-hydroxyvitamin D concentration, the odds of MNHNO and MNHO decreased significantly by 7% (OR: 0.93; 0.91-0.96) and 6% (OR: 0.94; 0.91-0.98) respectively. Conclusion: Our results support the hypothesis that 25-hydroxyvitamin D concentration is associated with metabolic obesity phenotypes. Longitudinal studies are necessary to assess the clinical impacts of this finding.
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Affiliation(s)
- Haleh Esmaili
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadith Rastad
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Marzieh Jafarnejad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Qorbani
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Roya Kelishadi
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Abstract
Obesity is now a worldwide epidemic. In recent years, different phenotypes of obesity, ranging from metabolically healthy normal weight to metabolically unhealthy obese, were described. Although there is no standardized definition for these phenotypes or for metabolic health, the influence of lifestyle and early-life factors is undisputed. In this context, the ratio of muscle-to-fat tissue seems to play a crucial role. Both adipose tissue and skeletal muscle are highly heterogeneous endocrine organs secreting several hormones, with myokines and adipokines being involved in local autocrine/paracrine interactions and crosstalk with other tissues. Some of these endocrine factors are secreted by both tissues and are, therefore, termed adipo-myokines. High (cardiorespiratory) fitness as a surrogate parameter for an active lifestyle is epidemiologically linked to “better” metabolic health, even in the obese; this may be partly due to the role of adipo-myokines and the crosstalk between adipose and muscle tissue. Therefore, it is essential to consider (cardiovascular) fitness in the definition of metabolically healthy obese/metabolic health and to perform longitudinal studies in this regard. A better understanding of both the (early-life) lifestyle factors and the underlying mechanisms that mediate different phenotypes is necessary for the tailored prevention and personalized treatment of obesity.
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Christou KA, Christou GA, Karamoutsios A, Vartholomatos G, Gartzonika K, Tsatsoulis A, Tigas S. Metabolically Healthy Obesity Is Characterized by a Proinflammatory Phenotype of Circulating Monocyte Subsets. Metab Syndr Relat Disord 2019; 17:259-265. [PMID: 30864887 DOI: 10.1089/met.2018.0132] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Obesity is associated with macrophage infiltration in adipose tissue that induces insulin resistance and contributes to the development of metabolic syndrome (MS). The aim of this study was to investigate whether circulating monocyte subsets (macrophage precursors) differ among obese subjects with MS [metabolically unhealthy obese (MUO)], obese subjects without MS [metabolically healthy obese (MHO)], and metabolically healthy lean (MHL) individuals. Methods: Fifty-eight obese (33 MUO, 25 MHO) and 25 MHL individuals participated in the study. Absolute blood counts of classical (Mon1A), intermediate (Mon2A), and nonclassical (Mon3A) monocyte subsets were measured by flow cytometry. Results: Increased proinflammatory monocyte counts (Mon2A, Mon3A) were observed in obese compared with MHL individuals (P = 0.001 and P = 0.017 respectively). Mon2A count in MHO was lower compared with that in MUO subjects (P = 0.036) but higher compared with MHL controls (P = 0.032). Mon2A was positively associated with serum triglyceride levels (r = 0.328, P = 0.023) and mean blood pressure (BP) (r = 0.457, P = 0.001) in obese subjects. Among MS components, only the presence of elevated BP (≥130/85 mmHg) was independently associated with increased Mon2A in obese subjects (P < 0.001). Conclusions: Absolute counts of proinflammatory monocytes were lower in metabolically healthy compared with MUO individuals, but higher compared with healthy lean controls. The presence of low-grade inflammation suggests that "metabolically healthy" obesity is not a benign condition. ClinicalTrials.gov identifier: NCT03241394.
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Affiliation(s)
| | | | - Achilleas Karamoutsios
- 2 Laboratory of Haematology, Molecular Biology Unit, Ioannina University Hospital, Ioannina, Greece
| | - Georgios Vartholomatos
- 2 Laboratory of Haematology, Molecular Biology Unit, Ioannina University Hospital, Ioannina, Greece
| | - Konstantina Gartzonika
- 3 Laboratory of Immunology and Microbiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | | | - Stelios Tigas
- 1 Department of Endocrinology, University of Ioannina, Ioannina, Greece
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Abstract
BACKGROUND The prevalence of metabolically healthy obese (MHO) subjects among morbidly obese subjects is poorly described. AIM To describe the prevalence of metabolically healthy subjects in a group of morbidly obese referred for bariatric surgery. METHODS Descriptive cross-sectional study, 1209 subjects (825 women/384 men) mean body mass index (BMI) of 45.6 (range: 35-72.6) kg/m2 and mean age of 42.9 (range: 18-72) years were included. Metabolically unhealthy obese subjects had at least two metabolic risk factors: systolic blood pressure >130 mmHg or diastolic blood pressure >85 mmHg or use of antihypertensive medication, diagnosed diabetes with a HbA1c >6.5% (>48 mmol/mol) or use of antidiabetic medication, high plasma triglycerides or low plasma high-density lipoprotein, or use of lipid-lowering medication. MHO subjects had one or no metabolic risk factors. RESULTS Thirty-four percent (413/1209) were characterized as MHO subjects. The MHO stage was characterized by female sex, younger age, and lower neck and waist circumferences. The odds ratio of metabolic unhealthy was 1.12 (1.07-1.17, P < 0.001) and 1.02 (1.01-1.04, P < 0002) for every 1 cm increase in neck and waist circumferences, respectively, and 0.94 (0.91-0.97, P < 0.001) for every 1 U increase in BMI and 1.04 (1.03-1.05, P < 0.001) for every 1 year increase in age. CONCLUSIONS Among severely obese subjects, 34% were classified as having a metabolically healthy state, which was more likely to occur in females, younger individuals and was associated with a lower neck and waist circumferences, younger age, and higher BMI. Whether a group of MHO subjects will remain healthy lifelong is unknown.
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Affiliation(s)
- Dorte Worm
- 1 Department of Internal Medicine and Amager/Hvidovre Hospital, Copenhagen, Denmark
| | - Sten Madsbad
- 2 Department of Endocrinology, Amager/Hvidovre Hospital, Copenhagen, Denmark
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Menezes VP, Cohen C, Del-Rei J, Oigman W, Neves MF, Medeiros FJ. Evaluation of endothelial function and arterial stiffness in obese individuals with insulin resistance. Nutr Health 2019; 25:85-92. [PMID: 30614384 DOI: 10.1177/0260106018819374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Obesity is associated with metabolic imbalance, including insulin resistance and endothelial dysfunction. AIM We aimed to evaluate clinical and vascular parameters in obese with or without insulin resistance. METHODS Participants ( n=39) were divided into two groups according to Homeostasis Model Assessment - Insulin Resistance lower (group 1) or higher (group 2) than 2.7. All patients were submitted to clinical, anthropometric, biochemical, vascular structure and endothelial function assessment. RESULTS The mean age (53±9 vs. 52±7 years, p=0.784) and body mass index (34.3±4.1 vs. 35.2±3.9 kg/m2, p=0.464) were similar in both groups, and 74.4% were treated hypertensive subjects. Fasting glucose (84±7 vs. 97±18 mg/dl, p=0.004) and insulin (9.32±2.48 vs. 22.74±7.49 μU/ml, p<0.001) were higher in group 2. Group 2 presented lower HDL-cholesterol (59±14 vs. 42±12 mg/dl, p<0.001) and higher triglycerides (122±87 vs. 191±112 mg/dl, p=0.042) levels compared with group 1. HOMA-IR was correlated with abdominal circumference ( r=0.51, p=0.001), abdominal/hip ratio ( r=0.57, p<0.001) and triglycerides/HDL ratio ( r=0.53, p=0.001). Differences in brachial flow-mediated dilation did not reach statistical significance (10.2±6.2 vs. 7.9±4.7%, p=0.245). Carotid intima-media thickness, carotid-femoral pulse wave velocity (8.5±1.9 vs. 9.1±1.5 m/s, p=0.334) and central hemodynamic parameters were also similar between groups. CONCLUSION Obese individuals with insulin resistance have higher visceral adiposity associated with impaired glucose and lipid metabolism. Endothelial function and arterial stiffness were similar between the groups, perhaps because of antihypertensive treatment in most of these subjects.
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Affiliation(s)
- V P Menezes
- 1 Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - C Cohen
- 1 Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - J Del-Rei
- 2 Nutrition School, Federal University of the State of Rio de Janeiro, Brazil
| | - W Oigman
- 1 Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - M F Neves
- 1 Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Sukumar D, Becker KB, Cheung M, Diamond S, Duszak R, Aljahdali A, Volpe SL, Nasser JA. Can bone-regulating hormones and nutrients help characterize the metabolically healthy obese phenotype. Nutr Health 2018; 24:153-162. [PMID: 29950143 DOI: 10.1177/0260106018777336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Bone-regulating hormones and nutrients play an important role in influencing metabolic health. AIM: The aim of this study was to determine whether bone-regulating hormones and nutrients, such as parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), and magnesium (Mg) could be used to characterize the metabolically healthy obese (MHO) phenotype. METHODS: This study included 27 overweight or obese participants (14 men/13 women) classified as MHO ( n = 14) or metabolically unhealthy obese (MUO) ( n = 13) based on the presence or absence of metabolic abnormalities, determined by percentage body fat, percentage trunk fat, and waist circumference. Biochemical (serum concentrations of hormones and cytokines such as PTH, 25OHD, ionized Mg (iMg), cytokines, lipids, glycemic indices), physiological (percentage body fat, percentage trunk fat, blood pressure (BP)), and dietary intake (Mg intake, calcium intake) measurements were obtained. RESULTS: Serum PTH concentrations were significantly lower ( p = 0.005) in the MHO group (39.68 ± 11.06 pg/mL) compared with the MUO group (63.78 ± 25.82 pg/mL). Serum iMg concentrations were higher ( p = 0.052) in the MHO group (0.565 ± 0.41 mmol/L) than in the MUO group (0.528 ± 0.050 mmol/L). Serum concentrations of osteocalcin were also higher (10.37 ± 3.70 ng/mL) in the MHO compared with the MUO (6.51 ± 4.14 ng/mL) group ( p = 0.017). The MHO group had significantly lower serum insulin concentrations ( p = 0.006) and diastolic BP ( p = 0.035). Concentrations of serum 25OHD, total triglycerides, C-reactive protein and systolic BP did not differ between groups. CONCLUSIONS: These findings suggest that bone-regulating hormones and nutrients, especially serum PTH, osteocalcin concentrations, and dietary Mg intakes, can help to characterize the MHO phenotype.
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Affiliation(s)
- Deeptha Sukumar
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Kendra B Becker
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - May Cheung
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Samantha Diamond
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Rittane Duszak
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Abeer Aljahdali
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Stella L Volpe
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Jennifer A Nasser
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
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Bermudez V, Rojas J, Salazar J, Martinez MS, Olivar LC, Calvo MJ, Mindiola A, Añez R, Wilches-Duran S, Cerda M, Graterol M, Graterol R, Hernandez JD, Garicano C, Velasco M. Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela. F1000Res 2018; 7:230. [PMID: 35136588 PMCID: PMC8796010 DOI: 10.12688/f1000research.13897.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 04/06/2024] Open
Abstract
Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called "healthy obese". Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional sub-analysis of The Maracaibo City Metabolic Syndrome Prevalence Study, with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster being predictive variables: HOMA2-IR, HOMA2-βcell, triglycerides. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 43.9% (n=538) were healthy normal weight, 5.2% (n=64) unhealthy normal weight, 17.4% (n=217) healthy obese and 33.5% (n=411) unhealthy obese subjects. Atypical phenotypes, Metabolically Unhealthy Normal-Weight (MUNW) was more frequent in males (56.3%), whereas Metabolically Unhealthy Obese (MUO) was more frequent in females (51.3%). This phenotypes had a higher coronary event risk, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes are common in Maracaibo city. Related factors may include insulin resistance, basal glucose, and triglycerides levels. Lastly, obese subjects show a higher coronary event risk even those with normal metabolic status.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Sofia Martinez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Jose Calvo
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center (GRECC), U.S Department of Veterans Affairs, Miami, FL, USA
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Duran
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Juan Diego Hernandez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Manuel Velasco
- Department of Pharmacology, “JM Vargas” Medical School, Central University of Venezuela, Caracas, Venezuela
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Bermudez V, Rojas J, Salazar J, Martinez MS, Olivar LC, Calvo MJ, Mindiola A, Añez R, Wilches-Duran S, Cerda M, Graterol M, Graterol R, Hernandez JD, Garicano C, Velasco M. Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela. F1000Res 2018; 7:230. [PMID: 35136588 PMCID: PMC8796010 DOI: 10.12688/f1000research.13897.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 04/06/2024] Open
Abstract
Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called "healthy obese". Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional study with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 5.2% (n=64) corresponded to unhealthy lean subjects, and 17.4% (n=217) to healthy obese subjects. Metabolically unhealthy normal-weight (MUNW) phenotype was found in males in 53.3% in contrast to 51.3% of metabolically unhealthy obese (MUO) phenotype found in females. An association between metabolically unhealthy phenotypes and a higher risk of a coronary event was found, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes exist in Maracaibo city. Related factors may include insulin resistance, basal glucose levels, and triglycerides levels. Lastly, cardiovascular risk exhibited by healthy obese individuals should be classified in categories of major coronary risk related to lean subjects.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Sofia Martinez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Jose Calvo
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center (GRECC), U.S Department of Veterans Affairs, Miami, FL, USA
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Duran
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Juan Diego Hernandez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Manuel Velasco
- Department of Pharmacology, “JM Vargas” Medical School, Central University of Venezuela, Caracas, Venezuela
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Bermudez V, Rojas J, Salazar J, Martinez MS, Olivar LC, Calvo MJ, Mindiola A, Añez R, Wilches-Duran S, Cerda M, Graterol M, Graterol R, Hernandez JD, Garicano C, Velasco M. Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela. F1000Res 2018; 7:230. [PMID: 35136588 PMCID: PMC8796010 DOI: 10.12688/f1000research.13897.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called "healthy obese". Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional sub-analysis of The Maracaibo City Metabolic Syndrome Prevalence Study, with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster being predictive variables: HOMA2-IR, HOMA2-βcell, triglycerides. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 43.9% (n=538) were healthy normal weight, 5.2% (n=64) unhealthy normal weight, 17.4% (n=217) healthy obese and 33.5% (n=411) unhealthy obese subjects. Atypical phenotypes, Metabolically Unhealthy Normal-Weight (MUNW) was more frequent in males (56.3%), whereas Metabolically Unhealthy Obese (MUO) was more frequent in females (51.3%). This phenotypes had a higher coronary event risk, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes are common in Maracaibo city. Related factors may include insulin resistance, basal glucose, and triglycerides levels. Lastly, obese subjects show a higher coronary event risk even those with normal metabolic status.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Sofia Martinez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Maria Jose Calvo
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center (GRECC), U.S Department of Veterans Affairs, Miami, FL, USA
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Duran
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Juan Diego Hernandez
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Manuel Velasco
- Department of Pharmacology, “JM Vargas” Medical School, Central University of Venezuela, Caracas, Venezuela
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23
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Rodriguez-Garcia E, Ruiz-Nava J, Santamaria-Fernandez S, Fernandez-Garcia JC, Vargas-Candela A, Yahyaoui R, Tinahones FJ, Bernal-Lopez MR, Gomez-Huelgas R. Characterization of lipid profile by nuclear magnetic resonance spectroscopy (1H NMR) of metabolically healthy obese women after weight loss with Mediterranean diet and physical exercise. Medicine (Baltimore) 2017; 96:e7040. [PMID: 28682864 PMCID: PMC5502137 DOI: 10.1097/md.0000000000007040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Obesity is associated with an atherogenic lipid profile. No data exists on lipoprotein particle profiles in metabolically healthy obese (MHO) individuals. Our aim is to characterize lipoprotein size, particle, and subclass concentrations in MHO women after 3 months of weight loss through dietary restriction and physical exercise.A total of 115 nondiabetic women (aged 35-55 years) with a body mass index (BMI) of 30 to 40 kg/m and ≤1 of the following criteria: blood pressure ≤135/85 mm Hg, fasting plasma glucose ≤100 mg/dL, HDL-cholesterol ≤50 mg/dL, and triglycerides ≤150 mg/dL were included. After 3 months of intensive lifestyle modification (Mediterranean diet and physical exercise), they were classified according to their weight loss: <5%, ≥5% to <10%, and ≥10%. Lipoprotein size, particle, and subclass concentrations were measured using H NMR.The final sample, after dropouts, comprised 104 women (age: 44.4 ± 3.7 years, BMI: 36.3 ± 4.7 kg/m), of whom 47 (45.2%), 27 (26%), and 30 (28.8%) lost <5%, ≥5% to <10%, and ≥10% of baseline body weight, respectively. All participants experienced significant weight loss and decreases in BMI. The lipid profiles showed an increase in small, medium, and large very low density lipoprotein (VLDL) particles in all groups of study with the exception of small VLDL particles in women with ≥10% of weight loss, in which it decreased. The number of VLDL particles decreased in women who had ≥10% weight loss. On the other hand, we detected a decrease in all low density lipoprotein (cLDL) and high density lipoprotein (cHDL) concentrations.These results indicate that intensive lifestyle modification alters lipid profiles. In particular, it decreases small LDL and HDL particle numbers and does not increase medium or large HDL particles numbers.
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Affiliation(s)
- Enrique Rodriguez-Garcia
- Department of Clinical Analysis, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital), Universidad de Malaga
| | - Josefina Ruiz-Nava
- Department of Endocrinology and Nutrition, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Virgen de la Victoria Hospital)
| | - Sonia Santamaria-Fernandez
- Department of Internal Medicine, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital)
| | - Jose Carlos Fernandez-Garcia
- Department of Endocrinology and Nutrition, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Virgen de la Victoria Hospital)
- CIBERFisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Vargas-Candela
- Department of Internal Medicine, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital)
| | - Raquel Yahyaoui
- Department of Clinical Analysis, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital), Universidad de Malaga
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Virgen de la Victoria Hospital)
- CIBERFisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Rosa Bernal-Lopez
- Department of Internal Medicine, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital)
- CIBERFisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Ricardo Gomez-Huelgas
- Department of Internal Medicine, Institute of Biomedical Research in Málaga (IBIMA), Regional University Hospital of Málaga (Carlos Haya Hospital)
- CIBERFisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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24
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Park YMM, White AJ, Nichols HB, O'Brien KM, Weinberg CR, Sandler DP. The association between metabolic health, obesity phenotype and the risk of breast cancer. Int J Cancer 2017; 140:2657-2666. [PMID: 28268252 DOI: 10.1002/ijc.30684] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/16/2017] [Accepted: 02/28/2017] [Indexed: 12/16/2022]
Abstract
Beyond the current emphasis on body mass index (BMI), it is unknown whether breast cancer risk differs between metabolically healthy and unhealthy normal weight or overweight/obese women. The Sister Study is a nationwide prospective cohort study. Data came from 50,884 cohort participants aged 35 to 74 years enrolled from 2003 through 2009. Cox proportional hazards models were used to estimate multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CIs) for breast cancer risk. Metabolic abnormalities considered included: high waist circumference (≥88 cm); elevated blood pressure (≥130/85 mm Hg or antihypertensive medication); previously diagnosed diabetes or antidiabetic drug treatment; and cholesterol-lowering medication use. During follow-up (mean, 6.4 years), 1,388 invasive breast cancers were diagnosed at least 1 year after enrollment. Compared to women with BMI <25 kg/m2 with no metabolic abnormalities (metabolically healthy normal weight phenotype), women with a BMI <25 kg/m2 and ≥1 metabolic abnormality (metabolically unhealthy, normal weight phenotype) had increased risk of postmenopausal breast cancer (HR = 1.26, 95% CI: 1.01-1.56), as did women with a BMI ≥25 kg/m2 and no metabolic abnormalities (metabolically healthy overweight/obese phenotype) (HR = 1.24, 95% CI: 0.99-1.55). Furthermore, risk of postmenopausal breast cancer was consistently elevated in women with normal BMI and central obesity (normal weight central obesity phenotype) regardless of the criterion used to define central obesity, with HR for waist circumference ≥88 cm, waist circumference ≥80 cm, and waist-hip ratio ≥0.85 of 1.58, 95% CI: 1.02-2.46; 1.38, 95% CI: 1.09-1.75; and 1.38, 95% CI: 1.02-1.85, respectively. There was an inverse association between premenopausal breast cancer and metabolically healthy overweight/obese phenotype (HR = 0.71, 95% CI: 0.52-0.97). Our findings suggest that postmenopausal women who are metabolically unhealthy or have central adiposity may be at increased risk for breast cancer despite normal BMI.
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Affiliation(s)
- Yong-Moon Mark Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Katie M O'Brien
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Clarice R Weinberg
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
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25
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Stelmach-Mardas M, Walkowiak J. Dietary Interventions and Changes in Cardio-Metabolic Parameters in Metabolically Healthy Obese Subjects: A Systematic Review with Meta-Analysis. Nutrients 2016; 8:E455. [PMID: 27483307 DOI: 10.3390/nu8080455] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/14/2016] [Accepted: 07/25/2016] [Indexed: 11/27/2022] Open
Abstract
The aim of this systematic review was to assess the effect of diet on changes in parameters describing the body size phenotype of metabolically healthy obese subjects. The databases Medline, Scopus, Web of Knowledge and Embase were searched for clinical studies carried out between 1958 and June 2016 that reported the effect of dietary intervention on BMI, blood pressure, concentration of fasting triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting glucose level, the homoeostatic model assessment of insulin resistance (HOMA-IR) and high sensitivity C-Reactive Protein (hsCRP) in metabolically healthy, obese subjects. Twelve clinical studies met inclusion criteria. The combined analyzed population consists of 1827 subjects aged 34.4 to 61.1 with a BMI > 30 kg/m2. Time of intervention ranged from eight to 104 weeks. The baseline characteristics related to lipid profile were more favorable for metabolically healthy obese than for metabolically unhealthy obese. The meta-analyses revealed a significant associations between restricted energy diet and BMI (95% confidence interval (CI): −0.88, −0.19), blood pressure (systolic blood pressure (SBP): −4.73 mmHg; 95% CI: −7.12, −2.33; and diastolic blood pressure (DBP): −2.75 mmHg; 95% CI: −4.30, −1.21) and TG (−0.11 mmol/l; 95% CI: −0.16, −0.06). Changes in fasting glucose, HOMA-IR and hsCRP did not show significant changes. Sufficient evidence was not found to support the use of specific diets in metabolically healthy obese subjects. This analysis suggests that the effect of caloric restriction exerts its effects through a reduction in BMI, blood pressure and triglycerides in metabolically healthy obese (MHO) patients.
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26
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Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients 2016; 8:nu8050281. [PMID: 27187452 PMCID: PMC4882694 DOI: 10.3390/nu8050281] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023] Open
Abstract
Obesity and associated metabolic complications, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D), are in constant increase around the world. While most obese patients show several metabolic and biometric abnormalities and comorbidities, a subgroup of patients representing 3% to 57% of obese adults, depending on the diagnosis criteria, remains metabolically healthy. Among many other factors, the gut microbiota is now identified as a determining factor in the pathogenesis of metabolically unhealthy obese (MUHO) individuals and in obesity-related diseases such as endotoxemia, intestinal and systemic inflammation, as well as insulin resistance. Interestingly, recent studies suggest that an optimal healthy-like gut microbiota structure may contribute to the metabolically healthy obese (MHO) phenotype. Here, we describe how dietary medium chain triglycerides (MCT), previously found to promote lipid catabolism, energy expenditure and weight loss, can ameliorate metabolic health via their capacity to improve both intestinal ecosystem and permeability. MCT-enriched diets could therefore be used to manage metabolic diseases through modification of gut microbiota.
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Affiliation(s)
- Sabri Ahmed Rial
- BioMed Research Center, Biological Sciences Department, University of Quebec at Montreal, Montreal, QC H2X 1Y4, Canada.
| | - Antony D Karelis
- Department of Exercise Science, University of Quebec at Montreal, Montreal, QC H2X 1Y4, Canada.
| | - Karl-F Bergeron
- BioMed Research Center, Biological Sciences Department, University of Quebec at Montreal, Montreal, QC H2X 1Y4, Canada.
| | - Catherine Mounier
- BioMed Research Center, Biological Sciences Department, University of Quebec at Montreal, Montreal, QC H2X 1Y4, Canada.
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27
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Berstein LM, Poroshina TE, Turkevich EA, Vasilyev DA, Baltrukova AN, Kovalenko IM, Berlev IV. Features of endometrial cancer in patients with 'metabolically healthy' versus 'standard' obesity: the decreasing frequency of metabolically healthy obesity. Future Sci OA 2015; 1:FSO68. [PMID: 28031919 DOI: 10.4155/fso.15.68] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: As endometrial cancer (EC) prevalence increases with obesity, we aimed to determine whether EC characteristics depend upon obesity type: ‘standard’ (SO) or ‘metabolically healthy obesity’ (MHO). Patients & methods: 258 EC patients were included. Data on anthropometry, blood hormones, lipids and glucose, and tumor features were collected. Results: EC clinicopathologic characteristics and clinical stage correlate differently with BMI and obesity type. BMI is related inversely with tumor grade while SO patients are characterized by a more advanced clinical stage than those with MHO. Besides typical insulin resistance signs, EC patients with SO often display a higher serum leptin/adiponectin ratio compared with MHO patients. Historical data suggest a gradual increase in EC patient height and weight, and a decrease in MHO prevalence. Conclusion: It is currently unknown whether the latter observation reflects the evolution of EC, or obesity alongside the current epidemic. Regardless, the reduced MHO prevalence demonstrates the need for more intensive preventive measures aimed at obesity and obesity-associated conditions, including different EC subtypes. Worldwide prevalence of uterine body or endometrial cancer (EC) has increased notably. Recently, the WHO documented an obesity epidemic in several countries. Concurrently, many studies showed a high (37–66%) obesity rate in EC patients. There is currently no mention of a potentially distinctive correlation of EC with obesity types. In general, these types of obesity can be subdivided into ‘standard’ (SO; with metabolic disturbances, initially with insulin resistance signs) and ‘nonstandard’, or metabolically healthy obesity (MHO; without mentioned disturbances). The present paper concludes, first, that EC patients with SO (especially if BMI is ≥30) generally have more advanced tumor stage than patients with MHO. Second, in an EC group (2012–2014) a decrease in MHO frequency versus 1998–2000 group was observed. Altogether, this underlines the need for additional cancer preventive efforts in the obese female population.
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Abstract
Obesity is associated with multiple negative health consequences and current weight management guidelines recommend all obese persons to lose weight. However, recent evidence suggests that not all obese persons are negatively affected by their weight and that weight loss does not necessarily always improve health. The purpose of this review is not to trivialize the significant health risks associated with obesity, but to discuss subpopulations of obese people who are not adversely affected, or may even benefit from higher adiposity, and in who weight loss per se may not always be the most appropriate recommendation. More specifically, this review will take a devil's advocate position when discussing the consequences of obesity and weight loss for adults with established cardiovascular disease and type 2 diabetes, weight cyclers, metabolically healthy obese adults, youth, older adults and obese individuals who are highly fit.
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Affiliation(s)
- R E Brown
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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29
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Abstract
PURPOSE OF REVIEW New research supports the intuitive observation that many persons classified as obese are healthy, and should not be treated and categorized medically as diseased. There is increasing agreement that major blood biomarkers are often not discriminatory, as for example, the return to normal blood glucose levels in bariatric patients who do not have long-term benefits. Although weight loss is appreciated to improve metabolic and inflammatory parameters, the cellular and immune factors that couple obesity to cardiometabolic risk are only partially understood. RECENT FINDINGS Reduced BMI upon successful bariatric surgery does not always result in reduced pericardial fat; certain patients gain ectopic fat, which should be considered an adverse response. There is emerging evidence that pericardial fat volume and brown fat stores may provide individualized patient assessments. SUMMARY Some obese persons can be relieved of the additional stigma of classification in a major disease category, and unnecessary medical interventions and costs can be reduced. Other patients should be monitored more closely for unexpected adverse outcomes.
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Affiliation(s)
- Gerald V. Denis
- Cancer Research Center and Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, USA; Chair-Elect, Obesity and Cancer Section, The Obesity Society
| | - James A. Hamilton
- Department of Physiology and Biophysics, Department of Radiology, Boston University School of Medicine, Department of Biomedical Engineering Boston University, Boston, MA 02118, USA
- Corresponding author: James A. Hamilton PhD, Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, Boston, MA 02118, USA, Phone: 617-638-5048, Fax: 617-638-4041,
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30
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Tapscott D, Bernard MD, Mellman TA. Uncomplicated obesity in an African American population seeking medical weight loss. Ethn Dis 2013; 23:441-444. [PMID: 24392606 PMCID: PMC5175464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE Obesity is highly prevalent and adds greatly to the risk of cardiovascular and metabolic diseases. However, a subset of the obese has been identified who do not appear to carry this risk. Some studies suggest that anthropomorphic correlates of risk, such as waist circumference, differ between African Americans and Whites and features of uncomplicated obesity have not been well characterized in this population. The goal of our study was to determine the prevalence and associated features of uncomplicated obesity, including relationships to waist circumference and the achievement of weight loss in primarily African American patients. DESIGN A retrospective chart review. SETTING Outpatient medically supervised weight loss program located at a teaching hospital in Washington, DC. PARTICIPANTS Predominately adult African American females. RESULTS Thirty-one percent of our population had no documented metabolic or cardiovascular disease. This group was on average younger, but had similar waist circumference (44 +/- 13.8 vs 44 +/- 6.6 inches) and achieved similar mean weight loss at 3 months (9.9 +/- 10.4 vs 10.3 +/- 12.4 lbs.) as the group with comorbid conditions. CONCLUSIONS Waist circumference was not an indicator of risk among African American women and achieved weight loss did not depend on pre-existing comorbidities.
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Affiliation(s)
- Denia Tapscott
- Howard University College of Medicine, Department of Medicine, Washington, DC 20060, USA.
| | - Monet D Bernard
- Howard University College of Medicine,Washington, DC 20060, USA
| | - Thomas A Mellman
- Howard University College of Medicine, Department of Psychiatry, Washington, DC 20060, USA
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31
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Abstract
Evaluation of: Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J. Clin. Endocrinol. Metab. 97(7), 2482-2488 (2012). The health effects of different obesity phenotypes remain unclear. In this observational voluminous study with prospective linkage to mortality records, participants were classified as metabolically healthy (zero or one metabolic abnormality) or unhealthy (two or more metabolic abnormalities) based on blood pressure, HDL-cholesterol, diabetes, waist circumference and low-grade inflammation signs. Obesity was defined as a BMI of 30 kg/m2 or greater. The association between metabolically healthy obesity and risk of cardiovascular disease and all-cause mortality was examined after follow-up, on average, of more than 7.0 ± 3.0 years. Participants with 'standard' (metabolically unhealthy) obesity were at elevated risk of cardiovascular disease and all-cause mortality compared with their metabolically healthy obese counterparts. No significant difference in mortality has been found between metabolically healthy obese and referent group (metabolically healthy nonobese participants). By adding new information to the data collected previously, this important paper calls for further clarifications, including an analysis of mortality in cancer and diabetic patients with various obesity types.
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Affiliation(s)
- Lev M Berstein
- a Laboratory of Oncoendocrinology, NN Petrov Research Institute of Oncology, St Petersburg, 197758, Russia.
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32
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Abstract
PURPOSE OF REVIEW The exploding prevalence of insulin resistance and Type 2 diabetes (T2D) linked to obesity has become an alarming public health concern. Worldwide, approximately 171 million people suffer from obesity-induced diabetes and public health authorities expect this situation to deteriorate rapidly. An interesting clinical population of 'metabolically healthy but obese' (MHO) cases is relatively protected from T2D and its associated cardiovascular risk. The molecular basis for this protection is not well understood but is likely to involve reduced inflammatory responses. The inflammatory cells and pathways that respond to overnutrition are the primary subject matter for this review. RECENT FINDINGS The chance discovery of a genetic mutation in the Brd2 gene, which is located in the class II major histocompatibility complex and makes mice enormously fat but protects them from diabetes, offers revolutionary new insights into the cellular mechanisms that link obesity to insulin resistance and T2D. These Brd2-hypomorphic mice have reduced inflammation in fat that is normally associated with insulin resistance, and resemble MHO patients, suggesting novel therapeutic pathways for obese patients at risk for T2D. SUMMARY Deeper understanding of the functional links between genes that control inflammatory responses to diet-induced obesity is crucial to the development of therapies for obese, insulin-resistant patients.
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Affiliation(s)
- Anna C Belkina
- Boston Nutrition Obesity Research Center, Cancer Research Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA
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