title: Dysmetabolic signals in "metabolically healthy" obesity.
abstract: CONCLUSIONS
  
  
  
  BACKGROUND
  Obesity is associated with decreased insulin sensitivity, atherogenic dyslipidemia and hypertension, but clinical studies have also identified a "metabolically healthy" obese phenotype.
  
  
  OBJECTIVE
  To compare the characteristics of so-called "metabolically healthy" obese (MHO), normal weight subjects (MHNW) and obese with insulin resistance in the United States National Health and Nutrition Examination Survey, 1999-2004 (NHANES).
  
  
  METHODS
  Insulin resistance was defined by a homeostatic model assessment (HOMA) value in the upper tertile for the entire NHANES cohort. "Metabolic health" was defined as the absence of diabetes, insulin resistance, metabolic syndrome, and lipid-lowering therapy. The study evaluated the 314 MHO, 1173 MHNW and 843 insulin-resistant obese from among the 6485 non-diabetic, non-pregnant adults aged 20-79 years.
  
  
  METHODS
  Demographic, metabolic, nutrition and physical activity features.
  
  
  RESULTS
  MHO and MHNW groups were similar regarding age, and fasting glucose and triglyceride levels. MHO had higher insulin (P < 0.0001), insulin resistance as measured with the homeostatic model (P < 0.0001), non-HDL cholesterol (P = 0.002 in females and P = 0.049 in males) and C-reactive protein levels (P < 0.0001 in females and P = 0.038 in males), and lower high-density lipoprotein cholesterol (HDL) levels (P < 0.002). In addition, MHO females had higher low-density lipoprotein (LDL) cholesterol levels (P = 0.012) and systolic blood pressure (P = 0.02), and lower intake of dietary fiber (P = 0.0009) and levels of physical activity (P = 0.002). Triglycerides levels were normal in the MHO group.
  
  
  CONCLUSIONS
  "Metabolically healthy" obese people have multiple dysmetabolic changes that may signal increased risk for coronary artery disease.
authors: Zucker Hillside Hospital, Glen Oaks, NY, United States. Electronic address:pmanu@nshs.edu.
authors: Peter
authors: P
authors: Manu
authors: University of Medicine and Pharmacy "C. Davila", Bucharest, Romania.
authors: Constantin
authors: C
authors: Ionescu-Tirgoviste
authors: Feinstein Institute for Medical Research, Manhasset, NY, United States.
authors: James
authors: J
authors: Tsang
authors: Feinstein Institute for Medical Research, Manhasset, NY, United States.
authors: Barbara A
authors: BA
authors: Napolitano
authors: Feinstein Institute for Medical Research, Manhasset, NY, United States.
authors: Martin L
authors: ML
authors: Lesser
authors: Feinstein Institute for Medical Research, Manhasset, NY, United States.
authors: Christoph U
authors: CU
authors: Correll