title: Are Obese Individuals with no Feature of Metabolic Syndrome but Increased Waist Circumference Really Healthy? A Cross Sectional Study.
abstract: OBJECTIVE
  Patients displaying the metabolically healthy but obese phenotype have an intermediate cardiometabolic prognosis compared to normal weight healthy and metabolically unhealthy obese subjects. We aimed to evaluate the proportion of patients with a definite metabolically healthy obese phenotype and better characterize them.
  
  
  METHODS
  Definite metabolically healthy obese phenotype was defined as having none of the International Diabetes Federation metabolic syndrome criteria, excluding waist circumference. We recruited 1 159 obese patients (body mass index 38.4±6.3 kg/m(2)) including 943 women, without known diabetes. Patients were characterized for cardiometabolic disorders.
  
  
  RESULTS
  As the 202 (17.4%) metabolically healthy obese individuals were younger and had lower body mass indexes than the 957 metabolically unhealthy obese patients, they were matched for gender, age and body mass index with 404 metabolically unhealthy obese patients. In addition to the features of metabolic syndrome, when compared to unhealthy subjects, definite metabolically healthy obese patients were less frequently found with either homeostasis model assessment of insulin resistance index>3 (23.6 vs. 38.9%, p<0.001), or abnormal oral glucose tolerance test (13.9 vs. 33.9%, p<0.001), or HbA1c value≥5.7% (43.9 vs. 54.2%, p<0.05) or pulse pressure≥60 mmHg (11.7 vs. 64.9%, p<0.001). However, there were no significant differences in the prevalence of microalbuminuria (11.1 vs. 12.3%), cardiac autonomic dysfunction (45.5 vs. 35.3%) and fatty liver index ≥ 60 (5.6 vs. 10.2%).
  
  
  CONCLUSIONS
  Our data do not support the characterization of metabolically healthy obesity, even definite, as really healthy, as many patients with this phenotype have abnormal cardiovascular markers and glucose or liver abnormalities. HbA1c measurement seems to be more sensitive than OGTT to detect dysglycemia in this population.
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: S
authors.initials: S
authors.lastname: Chiheb
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: E
authors.initials: E
authors.lastname: Cosson
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: I
authors.initials: I
authors.lastname: Banu
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: E
authors.initials: E
authors.lastname: Hamo-Tchatchouang
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: C
authors.initials: C
authors.lastname: Cussac-Pillegand
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: M T
authors.initials: MT
authors.lastname: Nguyen
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors.forename: P
authors.initials: P
authors.lastname: Valensi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology*; D055105:Waist Circumference / Q000502:physiology*