Identifying metabolically healthy but obese individuals in sedentary postmenopausal women.
The purpose of this study was to compare different methods to identify metabolically healthy but obese (MHO) individuals in a cohort of obese postmenopausal women. We examined the anthropometric and metabolic characteristics of 113 obese (age: 57.3 +/- 4.8 years; BMI: 34.2 +/- 2.7 kg/m(2)), sedentary postmenopausal women. The following methods were used to identify MHO subjects: the hyperinsulinemic-euglycemic clamp (MHO: upper quartile of glucose disposal rates); the Matsuda index (MHO: upper quartile of the Matsuda index); the homeostasis model assessment (HOMA) index (MHO: lower quartile of the HOMA index); having 0-1 cardiometabolic abnormalities (systolic/diastolic blood pressure > or =130/85 mm Hg, triglycerides (TG) > or =1.7 mmol/l, glucose > or =5.6 mmol/l, HOMA >5.13, high-sensitive C-reactive protein (hsCRP) >0.1 mg/l, high-density lipoprotein-cholesterol (HDL-C) <1.3 mmol/l); and meeting four out of five metabolic factors (HOMA < or =2.7, TG < or =1.7 mmol/l, HDL-C > or =1.3 mmol/l, low-density lipoprotein-cholesterol < or =2.6 mmol/l, hsCRP < or =3.0 mg/l). Thereafter, we measured insulin sensitivity, body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography scan), energy expenditure, plasma lipids, inflammation markers, resting blood pressure, and cardiorespiratory fitness. We found significant differences in body composition (i.e., peripheral fat mass, central lean body mass (LBM)) and metabolic risk factors (i.e., HDL-C, hsCRP) between MHO and at risk individuals using the different methods to identify both groups. In addition, significant differences between MHO subjects using the different methods to identify MHO individuals were observed such as age, TG/HDL, hsCRP, and fasting insulin. However, independently of the methods used, we noted some recurrent characteristics that identify MHO subjects such as TG, apolipoprotein B, and ferritin. In conclusion, the present study shows variations in body composition and metabolic profile based on the methods studied to define the MHO phenotype. Therefore, an expert consensus may be needed to standardize the identification of MHO individuals.
Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada.
Virginie
V
Messier
Antony D
AD
Karelis
Denis
D
Prud'homme
Vanessa
V
Primeau
Martin
M
Brochu
Rémi
R
Rabasa-Lhoret
D015502:Absorptiometry, Photon; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D004734:Energy Metabolism; D005260:Female; D015309:Glucose Clamp Technique; D006304:Health Status; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D010809:Physical Fitness; D017698:Postmenopause / Q000378:metabolism*; D057185:Sedentary Behavior; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002097:C-Reactive Protein