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Metabolic normality in overweight and obese subjects. Which parameters? Which risks?

Pataky, Z.; Makoundou, V.; Nilsson, Peter LU ; Gabriel, R. S.; Lalic, K.; Muscelli, E.; Casolaro, A.; Golay, A. and Bobbioni-Harsch, E. (2011) In International Journal of Obesity 35(9). p.1208-1215
Abstract
Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin... (More)
Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P = 0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P = 0.004), systolic (P = 0.0007) and diastolic (P = 0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P = 0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P = 0.002) and diastolic (P = 0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P = 0.04 and 0.003, respectively), LDL-cholesterol (P = 0.003 and 0.006, respectively) and triglycerides (P = 0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. International Journal of Obesity (2011) 35, 1208-1215; doi:10.1038/ijo.2010.264; published online 4 January 2011 (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
metabolic normality, insulin sensitivity, cardiometabolic risk factors
in
International Journal of Obesity
volume
35
issue
9
pages
1208 - 1215
publisher
Nature Publishing Group
external identifiers
  • wos:000294808700008
  • scopus:80052776606
ISSN
1476-5497
DOI
10.1038/ijo.2010.264
language
English
LU publication?
yes
id
cc5eb1d8-8737-4426-9479-27a0903b169a (old id 2186918)
date added to LUP
2011-11-01 07:52:34
date last changed
2017-10-22 03:07:29
@article{cc5eb1d8-8737-4426-9479-27a0903b169a,
  abstract     = {Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P&lt;0.0001. Ow/ob subjects showed increased fasting insulin (P = 0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P = 0.004), systolic (P = 0.0007) and diastolic (P = 0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P = 0.007), high-sensitivity C-reactive protein (P&lt;0.0001), systolic (P = 0.002) and diastolic (P = 0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P = 0.04 and 0.003, respectively), LDL-cholesterol (P = 0.003 and 0.006, respectively) and triglycerides (P = 0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. International Journal of Obesity (2011) 35, 1208-1215; doi:10.1038/ijo.2010.264; published online 4 January 2011},
  author       = {Pataky, Z. and Makoundou, V. and Nilsson, Peter and Gabriel, R. S. and Lalic, K. and Muscelli, E. and Casolaro, A. and Golay, A. and Bobbioni-Harsch, E.},
  issn         = {1476-5497},
  keyword      = {metabolic normality,insulin sensitivity,cardiometabolic risk factors},
  language     = {eng},
  number       = {9},
  pages        = {1208--1215},
  publisher    = {Nature Publishing Group},
  series       = {International Journal of Obesity},
  title        = {Metabolic normality in overweight and obese subjects. Which parameters? Which risks?},
  url          = {http://dx.doi.org/10.1038/ijo.2010.264},
  volume       = {35},
  year         = {2011},
}