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Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors

The concept of heterogeneity among obese individuals in their risk for developing metabolic dysfunction and associated complications has been recognized for decades. At the origin of the heterogeneity idea is the acknowledgement that individuals with central obesity are more prone to developing type...

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Autores principales: Brandão, Inês, Martins, Maria João, Monteiro, Rosário
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074352/
https://www.ncbi.nlm.nih.gov/pubmed/32012784
http://dx.doi.org/10.3390/metabo10020048
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author Brandão, Inês
Martins, Maria João
Monteiro, Rosário
author_facet Brandão, Inês
Martins, Maria João
Monteiro, Rosário
author_sort Brandão, Inês
collection PubMed
description The concept of heterogeneity among obese individuals in their risk for developing metabolic dysfunction and associated complications has been recognized for decades. At the origin of the heterogeneity idea is the acknowledgement that individuals with central obesity are more prone to developing type 2 diabetes and cardiovascular disease than those with peripheral obesity. There have been attempts to categorize subjects according to their metabolic health and degree of obesity giving rise to different obese and non-obese phenotypes that include metabolically unhealthy normal-weight (MUHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Individuals belonging to the MHO phenotype are obese according to their body mass index although exhibiting fewer or none metabolic anomalies such as type 2 diabetes, dyslipidemia, hypertension, and/or unfavorable inflammatory and fribinolytic profiles. However, some authors claim that MHO is only transient in nature. Additionally, the phenotype categorization is controversial as it lacks standardized definitions possibly blurring the distinction between obesity phenotypes and confounding the associations with health outcomes. To add to the discussion, the factors underlying the origin or protection from metabolic deterioration and cardiometabolic risk for these subclasses are being intensely investigated and several hypotheses have been put forward. In the present review, we compare the different definitions of obesity phenotypes and present several possible factors underlying them (adipose tissue distribution and cellularity, contaminant accumulation on the adipose tissue, dysbiosis and metabolic endotoxemia imposing on to the endocannabinoid tone and inflammasome, and nutrient intake and dietary patterns) having inflammatory activation at the center.
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spelling pubmed-70743522020-03-20 Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors Brandão, Inês Martins, Maria João Monteiro, Rosário Metabolites Review The concept of heterogeneity among obese individuals in their risk for developing metabolic dysfunction and associated complications has been recognized for decades. At the origin of the heterogeneity idea is the acknowledgement that individuals with central obesity are more prone to developing type 2 diabetes and cardiovascular disease than those with peripheral obesity. There have been attempts to categorize subjects according to their metabolic health and degree of obesity giving rise to different obese and non-obese phenotypes that include metabolically unhealthy normal-weight (MUHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Individuals belonging to the MHO phenotype are obese according to their body mass index although exhibiting fewer or none metabolic anomalies such as type 2 diabetes, dyslipidemia, hypertension, and/or unfavorable inflammatory and fribinolytic profiles. However, some authors claim that MHO is only transient in nature. Additionally, the phenotype categorization is controversial as it lacks standardized definitions possibly blurring the distinction between obesity phenotypes and confounding the associations with health outcomes. To add to the discussion, the factors underlying the origin or protection from metabolic deterioration and cardiometabolic risk for these subclasses are being intensely investigated and several hypotheses have been put forward. In the present review, we compare the different definitions of obesity phenotypes and present several possible factors underlying them (adipose tissue distribution and cellularity, contaminant accumulation on the adipose tissue, dysbiosis and metabolic endotoxemia imposing on to the endocannabinoid tone and inflammasome, and nutrient intake and dietary patterns) having inflammatory activation at the center. MDPI 2020-01-27 /pmc/articles/PMC7074352/ /pubmed/32012784 http://dx.doi.org/10.3390/metabo10020048 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Brandão, Inês
Martins, Maria João
Monteiro, Rosário
Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title_full Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title_fullStr Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title_full_unstemmed Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title_short Metabolically Healthy Obesity—Heterogeneity in Definitions and Unconventional Factors
title_sort metabolically healthy obesity—heterogeneity in definitions and unconventional factors
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074352/
https://www.ncbi.nlm.nih.gov/pubmed/32012784
http://dx.doi.org/10.3390/metabo10020048
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