title: Prevalence and clinical characteristics of metabolically healthy obese individuals and other obese/non-obese metabolic phenotypes in a working population: results from the Icaria study.
abstract: BACKGROUND
  Metabolically healthy obese (MHO) phenotype may present with distinct characteristics compared with those with a metabolically unhealthy obese phenotype. Epidemiologic data on the distribution of these conditions in the working population are lacking. We aimed to evaluate the prevalence and clinical characteristics of MHO and other obese/non-obese metabolic phenotypes in a working population.
  
  
  METHODS
  Cross-sectional analysis of all subjects who had undergone a medical examination with Ibermutuamur Prevention Society from May 2004 to December 2007. Participants were classified into 5 categories according to their body mass index (BMI); within each of these categories, participants were further classified as metabolically healthy (MH) or metabolically unhealthy (MUH) according to the modified NCEP-ATPIII criteria. A logistic regression analysis was performed to evaluate some clinically relevant factors associated with a MH status.
  
  
  RESULTS
  In the overall population, the prevalence of the MHO phenotype was 8.6%. The proportions of MH individuals in the overweight and obese categories were: 87.1% (overweight) and 55.5% (obese I-III [58.8, 40.0, and 38.7% of the obese I, II, and III categories, respectively]). When the overweight and obese categories were considered, compared with individuals who were MUH, those who were MH tended to be younger and more likely to be female or participate in physical exercise; they were also less likely to smoke, or to be a heavy drinker. In the underweight and normal weight categories, compared with individuals who were MH, those who were MUH were more likely to be older, male, manual (blue collar) workers, smokers and heavy drinkers. Among participants in the MUH, normal weight group, the proportion of individuals with a sedentary lifestyle was higher relative to those in the MH, normal weight group. The factors more strongly associated with the MUH phenotype were BMI and age, followed by the presence of hypercholesterolemia, male sex, being a smoker, being a heavy drinker, and lack of physical exercise.
  
  
  CONCLUSIONS
  The prevalence of individuals with a MHO phenotype in the working population is high. This population may constitute an appropriate target group in whom to implement lifestyle modification initiatives to reduce the likelihood of transition to a MUH phenotype.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital del Mar and Departament de Medicia, Universitat Autonoma Barcelona, CIBERobn, ISCIII, Barcelona, Spain. AGoday@parcdesalutmar.cat.
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.affiliation: Ibermutuamur, Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social n° 274, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Calvo
authors.affiliation: Eli Lilly and Company, Alcobendas, Spain.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Vázquez
authors.affiliation: Eli Lilly and Company, Alcobendas, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Caveda
authors.affiliation: Sociedad de Prevención de Ibermutuamur (Ibermutuamur Prevention Society), Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Margallo
authors.affiliation: Ibermutuamur, Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social n° 274, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Catalina-Romero
authors.affiliation: Eli Lilly and Company, Alcobendas, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Reviriego
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology*; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology; D010641:Phenotype; D015995:Prevalence; D057185:Sedentary Behavior; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology
chemical_list: D002784:Cholesterol
keywords: Metabolic risk factors; Metabolically healthy obesity; Prevalence; Working population