Comparison of metabolic risk factors between severely and very severely obese patients.
OBJECTIVE
A prospective clinical intervention study was performed to estimate the metabolic risk factors in patients with very severe obesity (VSO) vs. severe obesity (SO).


METHODS
Two hundred twenty-eight VSO (BMI > or = 50 kg/m(2)) and 221 SO patients (BMI = 40 to 49.9 kg/m(2)) participated in the study (367 women and 82 men). Metabolic measurements included plasma lipids, glucose and insulin, hemoglobin A(1c), leptin, and sex hormones, as well as hepatic steatosis in a subgroup of patients. Subgroups of patients with non-insulin-dependent diabetes and hyperlipidemia (HLP) were examined.


RESULTS
The most unexpected result of our study was that VSO men showed significantly better lipid profiles than SO men. Furthermore, 18% of VSO men had no metabolic aberrations, whereas all SO men did. The advantageous metabolic status of VSO men was associated with sex hormone changes that favor gynoid fat distribution. The beneficial metabolic situation with VSO seems to be sex specific for men.


CONCLUSIONS
This study shows that the metabolic situation in VSO is not more severe than in the less obese cohort. These findings distinctly differ from the positive associations that have previously been reported between BMI, lipids, and other metabolic indices among individuals whose BMI is <40 kg/m(2).
Wolf
Anna M
AM
Department for Visceral and Transplantation Surgery, University Hospital Ulm, Ulm, Germany.
Buffington
Cynthia
C
Beisiegel
Ulrike
U
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D004958:Estradiol / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000378:metabolism*; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013739:Testosterone / Q000097:blood
D001786:Blood Glucose; D004958:Estradiol; D006442:Glycated Hemoglobin; D007328:Insulin; D020738:Leptin; D008055:Lipids; D011374:Progesterone; D013739:Testosterone