title: Metabolic phenotypes of obesity influence triglyceride and inflammation homoeostasis.
abstract: BACKGROUND
  We examined the degree of postprandial triglyceride (TG) response over the day, representing a highly dynamic state, with continuous metabolic adaptations, among normal-weight, overweight and obese patients, according to their metabolically healthy or abnormal status.
  
  
  METHODS
  A total of 1002 patients from the CORDIOPREV clinical trial (NCT00924937) were submitted to an oral fat load test meal with 0·7 g fat/kg body weight (12% saturated fatty acids (SFA), 10% polyunsaturated fatty acids (PUFA), 43% monounsaturated fatty acids (MUFA), 10% protein and 25% carbohydrates). Serial blood test analysing lipid fractions and inflammation markers (high-sensitivity C-reactive protein (hs-CRP)) were drawn at 0, 1, 2, 3 and 4 h during postprandial state. We explored the dynamic response according to six body size phenotypes: (i) normal weight, metabolically healthy; (ii) normal weight, metabolically abnormal; (iii) overweight, metabolically healthy; (iv) overweight, metabolically abnormal; (v) obese, metabolically healthy; and (vi) obese, metabolically abnormal.
  
  
  RESULTS
  Metabolically healthy patients displayed lower postprandial response of plasma TG and large triacylglycerol-rich lipoproteins (TRLs)-TG, compared with those metabolically abnormal, independently whether or not they were obese (P < 0·001 and P < 0·001, respectively). Moreover, the area under the curve (AUC) of TG and AUC of large TRLs-TG were greater in the group of metabolically abnormal compared with the group of metabolically healthy (P < 0·001 and P < 0·001, respectively). Interestingly, metabolically abnormal subjects displayed higher postprandial response of plasma hs-CRP than did the subgroup of normal, overweight and obese, metabolically healthy patients (P < 0·001).
  
  
  CONCLUSIONS
  Our findings showed that certain types of the metabolic phenotypes of obesity are more favourable modulating phenotypic flexibility after a dynamic fat load test, through TG metabolism and inflammation homoeostasis. To identify, these phenotypes may be the best strategy for personalized treatment of obesity.
authors.affiliation: Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Perez-Martinez
authors.forename: Juan F
authors.initials: JF
authors.lastname: Alcala-Diaz
authors.forename: Javier
authors.initials: J
authors.lastname: Delgado-Lista
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Rios
authors.forename: Francisco
authors.initials: F
authors.lastname: Gomez-Delgado
authors.forename: Carmen
authors.initials: C
authors.lastname: Marin-Hinojosa
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodriguez-Cantalejo
authors.forename: Nieves
authors.initials: N
authors.lastname: Delgado-Casado
authors.forename: Ana I
authors.initials: AI
authors.lastname: Perez-Caballero
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Fuentes-Jimenez
authors.forename: Antonio
authors.initials: A
authors.lastname: Camargo
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tinahones
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ordovas
authors.forename: Francisco
authors.initials: F
authors.lastname: Perez-Jimenez
authors.forename: Jose
authors.initials: J
authors.lastname: Lopez-Miranda
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D049628:Body Size / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D002940:Circadian Rhythm / Q000502:physiology; D003327:Coronary Disease / Q000178:diet therapy / Q000378:metabolism; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006949:Hyperlipidemias / Q000378:metabolism; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology; D050177:Overweight / Q000378:metabolism / Q000503:physiopathology; D010641:Phenotype; D019518:Postprandial Period / Q000502:physiology; D011446:Prospective Studies; D014280:Triglycerides / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D004041:Dietary Fats; D014280:Triglycerides; D002097:C-Reactive Protein
keywords: CORDIOPREV study; hs-CRP; metabolically healthy obesity; phenotypic flexibility; postprandial lipaemia; triglycerides