Metabolically healthy obesity: a friend or foe?

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metabolic syndrome 5225 CVD [[6],[20]]. Therefore, the MHO definition needs to be standardized.In addition to components of metabolic syndrome and insulin resistance, physical fitness is a potential alternative means for defining MHO [[4]]. However,
obesity 68 Title: The Korean Journal of Internal MedicineMetabolically healthy obesity : a friend or foe?Chang Hee JungWoo Je LeeKee-Ho SongPublication date (ppub): 7/2017Publication date
obesity 444 cardiovascular disease, and several types of cancer. Much interest has recently focused on the concept of “all obesity is not created equally.” Obese individuals without the metabolic abnormalities that commonly accompany
obesity 618 abnormalities that commonly accompany excess adiposity, a condition known as metabolically healthy obesity (MHO), account for a substantial proportion of the obese adult population. Numerous possible mechanisms
obesity 965 controversial and considerably challenging. The lack of a standard definition for metabolic health and obesity as well as the dynamic properties of MHO may have contributed to these inconsistent results. This review
obesity 1302 mechanisms, and clinical implications in the context of patient prognosis.INTRODUCTIONThe prevalence of obesity has increased worldwide over the past 30 years, making it a major public health concern [[1]]. Obesity
obesity 1796 is a subset of healthy obese individuals, i.e., those exhibiting so-called “metabolically healthy obesity ” (MHO) [[3]-[6]]. MHO is characterized by the absence of metabolic abnormalities such as dyslipidemia,
obesity 2128 normal-weight individuals with abnormal metabolic parameters (those exhibiting metabolically unhealthy non- obesity [MUNO] or metabolically obese normal weight [MONW]) has also been suggested [[7]]. Thus, a range of
obesity 2400 phenotypes exists, which has been recognized since the 1980s (Fig. 1) [[5]].The prevention and treatment of obesity is an enormous medical and socioeconomic task that is not always successful [[8]]. Notably, different
obesity 2613 independent studies have shown that individuals with MHO may not be able to significantly reduce their obesity -related cardiovascular and metabolic risk using anti-obesity treatment strategies [[6],[9],[10]]. Moreover,
obesity 2674 be able to significantly reduce their obesity-related cardiovascular and metabolic risk using anti- obesity treatment strategies [[6],[9],[10]]. Moreover, the benefits of lifestyle interventions in these individuals
obesity 2872 these individuals are questionable [[6],[11]]. Thus, the “one size fits all” approach to tackle obesity may be ineffective, and there is a clear need to better understand obesity-associated metabolic health
obesity 2947 all” approach to tackle obesity may be ineffective, and there is a clear need to better understand obesity -associated metabolic health subtypes to improve the diagnosis of the type of obesity and reduce the
obesity 3032 better understand obesity-associated metabolic health subtypes to improve the diagnosis of the type of obesity and reduce the dependence on medical care. This review aimed to present several current issues regarding
obesity 3491 phenotype and its long-term metabolic fate is that of the inconsistent definition of metabolic health and obesity among studies [[3]-[6]]. To answer the question of whether individuals with MHO are really healthy,
obesity 3813 in Table 1 [[12]-[17]], several sets of criteria have been used to define MHO. In general, healthy obesity indicates the absence of metabolic disorders, including type 2 diabetes, dyslipidemia, and hypertension,
obesity 7807 percentage compared with approximately one-thirds using BMI [[24]] suggest that caution should be used when obesity is defined since so many body measures are available.IS MHO A TRANSIENT CONDITION?A subject’s health
obesity 8526 approximately one-thirds of individuals with MHO at baseline converted to a metabolically unhealthy obesity (MUO) phenotype after 5.5 to 10.3 years of follow-up, and a lower risk for type 2 diabetes was only
obesity 12033 subcutaneous adipose tissue and find biomarkers for determining the expansion limit and predicting obesity -associated complications [[31]]. In the FATe project, imaging techniques, metabolomics, and transcriptomics
obesity 12307 expansion of subcutaneous adipose tissue in a cohort of Caucasian individuals with varying degrees of obesity [[31]]. This approach seems to be very promising according to the results of another recent proteomics
obesity 12667 adipose tissue was proposed as another key factor that explains the metabolic alterations associated with obesity [[33]]. However, studies that compared the inflammatory status among individuals with MHO have yielded
obesity 15780 4), which suggests that measuring the degree of systemic inflammation (e.g., hsCRP) when assessing obesity phenotypes would be advantageous [[21]]. Furthermore, the risk of type 2 diabetes also varied according
obesity 16421 hypertension is one of the most important predictors of CVD [[48]], investigating the association between each obesity phenotype and the incidence of hypertension may provide useful information regarding the relationship
obesity 17193 Karelis, and HOMA criteria) [[50]]. This suggests that a consideration of both metabolic health and obesity status is important for assessing potential cardiovascular outcomes.Chronic kidney diseaseIn addition
obesity 17321 for assessing potential cardiovascular outcomes.Chronic kidney diseaseIn addition to the effects of obesity on the development of type 2 diabetes and CVD, the rapidly increasing prevalence of obesity worldwide
obesity 17413 effects of obesity on the development of type 2 diabetes and CVD, the rapidly increasing prevalence of obesity worldwide has also been linked to chronic kidney disease (CKD), and obesity is a known risk factor for
obesity 17489 increasing prevalence of obesity worldwide has also been linked to chronic kidney disease (CKD), and obesity is a known risk factor for progressive renal function loss [[51]]. In turn, CKD increases the risk of
obesity 17689 the risk of CVD, even with mild renal insufficiency [[52]]. However, it remains unclear whether it is obesity itself or the metabolic disturbances induced by obesity that are associated with CKD.To date, few longitudinal
obesity 17745 [[52]]. However, it remains unclear whether it is obesity itself or the metabolic disturbances induced by obesity that are associated with CKD.To date, few longitudinal studies have investigated the risk of CKD in
obesity 18672 factors in MHO participants [[53]], suggesting that metabolic health should be considered together with obesity when evaluating the risk of CKD. Although a potential mechanism directly linking obesity to kidney damage
obesity 18761 together with obesity when evaluating the risk of CKD. Although a potential mechanism directly linking obesity to kidney damage independently of metabolic risk factors has not been identified, hemodynamic factors
obesity 18929 not been identified, hemodynamic factors (excluding hypertension) might play a significant role in obesity -induced renal dysfunction [[38],[55],[56]]. This suggests that obesity places an extra burden on the
obesity 19000 might play a significant role in obesity-induced renal dysfunction [[38],[55],[56]]. This suggests that obesity places an extra burden on the nephrons, the number of which is set at birth and, thereby, promotes the
obesity 23912 debate and faces a considerable challenge. The lack of a standard definition for metabolic health and obesity , as well as the dynamic properties of MHO, may have contributed to these inconsistent results. Successfully
obesity 24778 warranted to define individuals with MHO.According to the World Health Organization, “overweight and obesity ” are defined as abnormal or excessive fat accumulation that may impair health [[71]], whereas “health”
obesity 25456 clinical risk and guide clinical management [[6],[73]]. Therefore, systematic studies on comorbidities of obesity other than metabolic cardiovascular disorders are necessary to assess more accurately whether MHO individuals
obesity 25733 to body fat on the basis of body mass index and metabolic health. MUNO, metabolically unhealthy non- obesity ; MONW, metabolically unhealthy normal weight; MUO, metabolically unhealthy obesity; MHNO, metabolically
obesity 25816 metabolically unhealthy non-obesity; MONW, metabolically unhealthy normal weight; MUO, metabolically unhealthy obesity ; MHNO, metabolically healthy non-obesity; MHO, metabolically healthy obesity.Figure 2.Proposed features
obesity 25857 metabolically unhealthy normal weight; MUO, metabolically unhealthy obesity; MHNO, metabolically healthy non- obesity ; MHO, metabolically healthy obesity.Figure 2.Proposed features of the preserved metabolic health in
obesity 25893 metabolically unhealthy obesity; MHNO, metabolically healthy non-obesity; MHO, metabolically healthy obesity .Figure 2.Proposed features of the preserved metabolic health in metabolically healthy obesity. Modified
obesity 25987 healthy obesity.Figure 2.Proposed features of the preserved metabolic health in metabolically healthy obesity . Modified from Samocha-Bonet et al. [[5]], with permission from John Wiley and Sons.Figure 3.Model for
obesity 26156 from John Wiley and Sons.Figure 3.Model for the distinction between “healthy” and “unhealthy” obesity based on the ability to expand subcutaneous fat depots. Modified from Bluher [[6]], with permission
obesity 26572 (B) Type 2 diabetes-free survival by Kaplan-Meier analysis according to baseline metabolic healthy, obesity state, and systemic inflammation (log-rank test, p < 0.001 for all three comparisons except metabolically
obesity 26698 systemic inflammation (log-rank test, p < 0.001 for all three comparisons except metabolically healthy non- obesity [MHNO] with metabolically healthy obesity [MHO] with low systemic inflammation; p = 0.744). Modified
obesity 26740 for all three comparisons except metabolically healthy non-obesity [MHNO] with metabolically healthy obesity [MHO] with low systemic inflammation; p = 0.744). Modified from Jung et al. [[21]], with permission
obesity 26912 Jung et al. [[21]], with permission from Oxford University Press. MUNO, metabolically unhealthy non- obesity ; MUO, metabolically unhealthy obesity; hsCRP, high-sensitivity C-reactive protein.Table 1.Current criteria
obesity 26950 from Oxford University Press. MUNO, metabolically unhealthy non-obesity; MUO, metabolically unhealthy obesity ; hsCRP, high-sensitivity C-reactive protein.Table 1.Current criteria used to define metabolically healthy
obesity 27064 hsCRP, high-sensitivity C-reactive protein.Table 1.Current criteria used to define metabolically healthy obesity VariableMeigs et al. (2006) [[15]]Stefan et al. (2008) [[17]]Aguilar-Salinas et al. (2008) [[12]]Karelis

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