title: Adiponectin Levels Differentiate Metabolically Healthy vs Unhealthy Among Obese and Nonobese White Individuals.
abstract: BACKGROUND
  Adiponectin levels (ADPN) are lower in individuals with central obesity and cardiometabolic diseases. Conversely, studies have shown paradoxical hyperadiponectinemia (HA) in metabolically healthy obese (MHO) individuals of non-European descent. Moreover, individuals with higher sc to visceral adipose tissue (ie, higher peripheral adiposity) distribution have higher ADPNs. However, it is not known whether metabolically healthy individuals have predominantly peripheral adiposity along with higher ADPNs.
  
  
  OBJECTIVE
  This study aimed to evaluate the association of ADPN and adiposity distribution with metabolic health in white individuals.
  
  
  METHODS
  This was a cross-sectional study of members of "Take Off Pounds Sensibly" weight loss club and their relatives.
  
  
  METHODS
  We recruited 2486 (72% women, 61% obese) individuals. They were defined as metabolically healthy by absence of hypertension, diabetes, and dyslipidemia; and they were further classified into metabolically healthy nonobese (MHNO), metabolically unhealthy nonobese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Waist-to-hip ratios (WHRs) were used as markers of adiposity distribution. Insulin resistance was measured using homeostasis model assessment.
  
  
  RESULTS
  Among the four groups, MHNO had the lowest WHRs (higher peripheral adiposity) and highest ADPN, and MUO had highest WHRs (higher central adiposity) and lowest ADPN (P < .001). Among both nonobese and obese, metabolically healthy individuals had higher ADPN than metabolically unhealthy individuals (P < .05) after adjustment for age, sex, and body mass index. MHNO also had lower WHRs compared with MUNO (P < .01). Although WHRs were lower among MHO compared with MUO, the difference was not significant. In addition, nonobese and obese individuals with HA (defined using sex-specific cutoffs) had lower homeostasis model assessment and dyslipidemia compared with individuals without HA.
  
  
  CONCLUSIONS
  Higher ADPN and lower WHRs (higher peripheral adiposity) are associated with better metabolic health in both nonobese and obese white individuals. These results suggest that ADPN and peripheral adiposity play a key role in determining the metabolic health independent of body mass index.
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Scott
authors.initials: S
authors.lastname: Ahl
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Guenther
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Shi
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Roland
authors.initials: R
authors.lastname: James
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Marks
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Aniko
authors.initials: A
authors.lastname: Szabo
authors.affiliation: Department of Medicine (S.A., M.G., R.J., J.M., S.K.), and Institute of Health and Society (S.Z., A.S.), Medical College of Wisconsin, Milwaukee, Wisconsin 53226.
authors.forename: Srividya
authors.initials: S
authors.lastname: Kidambi
mesh_terms: D052242:Adiponectin / Q000097:blood*; D050154:Adiposity; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000097:blood; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000628:therapy; D049629:Waist-Hip Ratio; D015431:Weight Loss; D044465:White People
chemical_list: D052242:Adiponectin; D016207:Cytokines; D008055:Lipids