title: Obesity, high-molecular-weight (HMW) adiponectin, and metabolic risk factors: prevalence and gender-specific associations in Estonia.
abstract: BACKGROUND
  The metabolic consequences of obesity are associated with an imbalance of adipocytokines, e.g. adiponectin. However, some obese subjects remain metabolically healthy and have adiponectin levels similar to normal body weight subjects. Current estimates of the prevalence of obesity in Estonia have relied only on self-report data.
  
  
  OBJECTIVE
  To estimate the prevalence of obesity in Estonia, to test for associations between HMW adiponectin and metabolic risk factors and to test if HMW adiponectin levels differentiate metabolically healthy and metabolically unhealthy subjects.
  
  
  METHODS
  We conducted a population-based cross-sectional multicentre study to gather history, examination and blood test results for 495 subjects aged 20-74. Metabolically healthy subjects were free from hypertension, dyslipidaemia, impaired glucose regulation and insulin resistance. Metabolically unhealthy subjects had at least one of these four metabolic abnormalities.
  
  
  RESULTS
  The prevalence of obesity was 29% in men and 34% in women. HMW adiponectin was positively correlated with HDL cholesterol and negatively correlated with triglycerides, obesity, insulin resistance and blood glucose. This effect was driven by metabolically unhealthy subjects in men, but by both metabolically healthy and metabolically unhealthy subjects in women. Metabolically healthy women had higher HMW adiponectin levels than metabolically unhealthy women. 12% of all obese subjects were metabolically healthy, and their HMW adiponectin levels were similar to normal weight subjects.
  
  
  CONCLUSIONS
  Obesity is more prevalent in Estonian adults than previously thought. HMW adiponectin levels were associated with various metabolic risk factors in metabolically healthy women but not in metabolically healthy men. For both genders, HMW adiponectin differentiates metabolically healthy obese subjects from metabolically unhealthy obese subjects.
authors.affiliation: Department of Internal Medicine, University of Tartu and Tartu University Hospital, Tartu, Estonia.
authors.forename: Triin
authors.initials: T
authors.lastname: Eglit
authors.forename: Inge
authors.initials: I
authors.lastname: Ringmets
authors.forename: Margus
authors.initials: M
authors.lastname: Lember
mesh_terms: D052242:Adiponectin / Q000097:blood* / Q000378:metabolism; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D014280:Triglycerides
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