title: Increased cardiometabolic risk factors and inflammation in adipose tissue in obese subjects classified as metabolically healthy.
abstract: OBJECTIVE
  It has been suggested that individuals with the condition known as metabolically healthy obesity (MHO) may not have the same increased risk for the development of metabolic abnormalities as their non-metabolically healthy counterparts. However, the validity of this concept has recently been challenged, since it may not translate into lower morbidity and mortality. The aim of the current study was to compare the cardiometabolic/inflammatory profile and the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes (T2D) in patients categorized as having MHO or metabolically abnormal obesity (MAO).
  
  
  METHODS
  We performed a cross-sectional analysis to compare the cardiometabolic/inflammatory profile of 222 MHO and 222 MAO patients (62% women) matched by age, including 255 lean subjects as reference (cohort 1). In a second cohort, we analyzed the adipokine profile and the expression of genes involved in inflammation and extracellular matrix remodeling in visceral adipose tissue (VAT; n = 82) and liver (n = 55).
  
  
  RESULTS
  The cardiometabolic and inflammatory profiles (CRP, fibrinogen, uric acid, leukocyte count, and hepatic enzymes) were similarly increased in MHO and MAO in both cohorts. Moreover, above 30%of patients classified as MHO according to fasting plasma glucose exhibited IGT or T2D [corrected]. The profile of classic (leptin, adiponectin, resistin) as well as novel (serum amyloid A and matrix metallopeptidase 9) adipokines was almost identical in MHO and MAO groups in cohort 2. Expression of genes involved in inflammation and tissue remodeling in VAT and liver showed a similar alteration pattern in MHO and MAO individuals.
  
  
  CONCLUSIONS
  The current study provides evidence for the existence of a comparable adverse cardiometabolic profile in MHO and MAO patients; thus the MHO concept should be applied with caution. A better identification of the obesity phenotypes and a more precise diagnosis are needed for improving the management of obese individuals.
authors.affiliation: Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Gómez-Ambrosi
authors.affiliation: Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Catalán
authors.affiliation: Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Andrada
authors.affiliation: Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ramírez
authors.affiliation: Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ibáñez
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Vila
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Romero
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: María A
authors.initials: MA
authors.lastname: Margall
authors.affiliation: Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Biochemistry, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Gil
authors.affiliation: Department of Anesthesiology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Moncada
authors.affiliation: Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Surgery, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Valentí
authors.affiliation: Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Camilo
authors.initials: C
authors.lastname: Silva
authors.affiliation: Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Salvador
authors.affiliation: Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain gfruhbeck@unav.es.
authors.forename: Gema
authors.initials: G
authors.lastname: Frühbeck
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D050152:Intra-Abdominal Fat / Q000276:immunology / Q000378:metabolism; D008099:Liver / Q000276:immunology / Q000378:metabolism; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000150:complications* / Q000453:epidemiology* / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult