title: Morbidly "Healthy" Obese Are Not Metabolically Healthy but Less Metabolically Imbalanced Than Those with Type 2 Diabetes or Dyslipidemia.
abstract: BACKGROUND
  We have investigated the differences between metabolically "healthy" morbidly obese patients and those with comorbidities.
  
  
  METHODS
  Thirty-two morbidly obese patients were divided by the absence ("healthy": DM-DL-) or presence of comorbidities (dyslipidemic: DM-DL+, or dyslipidemic and with type 2 diabetes: DM+DL+). We have studied various plasma parameters and gene expression adipose tissue, before and after gastric bypass.
  
  
  RESULTS
  The group DM+DL+ tends to have lower values than the other two groups for anthropometric parameters. Regarding the satiety parameters, only leptin (p = 0.0024) showed a significant increase with comorbidities. Lipid parameters showed significant differences among groups, except for phospholipids and NEFA. For insulin resistance parameters, only glucose (p < 0.0001) was higher in DM+DL+ patients, but not insulin or homeostasis model assessment of insulin resistance (HOMA-IR). The gene expression of adiponectin, insulin receptor (INSR) and glucose receptor-4 (GLUT4), in the subcutaneous fat, decreased in all groups vs. a non-obese control. Interleukin-6 (IL6) and the inhibitor of plasminogen activator type 1 (PAI-1) genes decreased only in DM-DL+ and DM+DL+, but not in "healthy" patients. Leptin increased in all groups vs. the non-obese control. The visceral fat from DM+DL+ patients showed a sharp decrease in adiponectin, GLUT4, IL6 and PAI-1. All parameters mentioned above improved very significantly by surgery, independent of the occurrence of comorbidities.
  
  
  CONCLUSIONS
  The morbidly obese "healthy" individual is not really metabolically healthy, but morbidly obese individuals with diabetes and dyslipidemia are more metabolically imbalanced.
authors.affiliation: Biochemistry Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma De Barcelona, Barcelona, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Ferrer
authors.forename: Eva
authors.initials: E
authors.lastname: Pardina
authors.forename: Joana
authors.initials: J
authors.lastname: Rossell
authors.forename: Laura
authors.initials: L
authors.lastname: Oller
authors.forename: Anna
authors.initials: A
authors.lastname: Viñas
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Baena-Fustegueras
authors.forename: Albert
authors.initials: A
authors.lastname: Lecube
authors.forename: Víctor
authors.initials: V
authors.lastname: Vargas
authors.forename: José María
authors.initials: JM
authors.lastname: Balibrea
authors.forename: Enric
authors.initials: E
authors.lastname: Caubet
authors.forename: Oscar
authors.initials: O
authors.lastname: González
authors.forename: Ramón
authors.initials: R
authors.lastname: Vilallonga
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Fort
authors.forename: Julia
authors.initials: J
authors.lastname: Peinado-Onsurbe
mesh_terms: D052242:Adiponectin / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D050171:Dyslipidemias / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D005260:Female; D015390:Gastric Bypass; D051275:Glucose Transporter Type 4 / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism; D050152:Intra-Abdominal Fat / Q000378:metabolism / Q000473:pathology; D020738:Leptin / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000067329:Obesity, Metabolically Benign / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D009767:Obesity, Morbid / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D050151:Subcutaneous Fat / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D051275:Glucose Transporter Type 4; C508600:IL6 protein, human; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human