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Metabolically obese normal weight mortality rate – Obesity, metabolic health, and mortality in adults: a nationwide population-based study in Korea

Sci Rep. These particles are at least as potent as LDL in predicting cardiovascular events.

Matthew Cox
Tuesday, February 16, 2021
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  • Journal List Nutr Diabetes v. A pooled analysis of 97 cohorts investigating the role of metabolic mediators on the effect of BMI on coronary heart disease and stroke also emphasised that BP was the most important mediator

  • Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men.

  • Metabolically healthy obesity and risk of mortality: does the definition of metabolic health matter?

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Background

MONW This contrasts with our data showing similar results after excluding subjects with known metabolic diseases and cardiovascular diseases. BMC Med. Association between body-mass index and risk of death in more than 1 million Asians. Conus, F.

  • A BMI of Written informed consents were obtained from all participants.

  • Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis.

  • Integrative genomic analysis implicates limited peripheral adipose storage capacity in the pathogenesis of human insulin resistance.

  • Dvorak, R.

The other consistent finding from these studies is that, when central obesity is present, the existence of subcutaneous fat seems to offer protection. Metzbolically, mortality risk plotted against BMI is J shaped, with increased mortality only in underweight and high class 1 to class 3 obesity Table 1. Email: Sundar. Participants are interviewed about demographic, lifestyle, and health-related information. Pooled data from 11 prospective observational studies median 9 y, maximum 21 y. Normal weight obesity. Inflammation

Anthropometric measures of body fat distribution: A Mass-based and B distribution-based measures. Each no-MetS group had significantly lower mortality than their MetS counterparts, but we found no significant differences among no-MetS groups. The data are compiled through surveys using interviews, physical examinations, and laboratory results. Visceral adipocytes are also very sensitive to catecholamine-induced lipolysis, releasing FFAs into the portal circulation and presenting the liver with increased lipid for processing. No level I studies were found. N Engl J Med.

MeSH terms

Weighh adjustment of smoking status, alcohol drinking, exercise, and income status did not attenuate these associations. Miller DS, Parsonage S. Similar findings were observed from a retrospective study of Korean subjects who participated in a health screening program. Although studies show that metabolic diseases can affect normal-weight adults, studies on the risks of mortality have been equivocal and rarely focus on normal-weight adults.

  • Epub Jan 4. Several studies showed that people in the MHO or MUNO group have different risks in terms of the incidence of type 2 diabetes, cardiovascular diseases, and mortality; however, the results are inconsistent 1718 ,

  • One study found that among participants with normal-weight BMI, those with a higher body fat percentage had a mortaliry prevalence of abnormality in every MetS component Analysis of cardiovascular mortality showed a significantly higher hazard ratio only for the normal-weight—MetS group, which suggests a strong effect of MetS on cardiovascular death in normal-weight adults.

  • A total of Using the same definition of metabolic risk, the Multi-Ethnic Study of Atherosclerosis showed high variability in the prevalence of metabolically unhealthy with normal-weight individuals based on ethnicity: The prevalence was

  • Data from Ashwell et al.

  • Central or abdominal obesity is contained in discrete compartments.

  • Abbreviation: MetS, metabolic syndrome.

It has been shown that physical activity promotes metabolic health and reduces the risk of diabetes and cardiovascular metabolically obese normal weight mortality rate even among normal-weight individuals. The existence of people who have normal body weight but also have metabolic dysfunction, and therefore greater risk for developing cardiometabolic disease, was recognized several decades ago Ruderman et al. Subjects were selected using stratified random sampling to ensure that the sample was representative of the entire population. Obesity and overweight. Increased oxidative stress is associated with serum levels of triglyceride, insulin resistance, and hyperinsulinemia in Japanese metabolically obese, normal-weight men. MONW The above results may be due to the small sample size and low statistical power.

Some individuals can store more fat peripherally than others, and weight mortality these deposits become replete, fat begins to be deposited in visceral sites as well, appearing in the liver, omentum, skeletal muscle, and peripheral organs. Reduction in central obesity and weight stabilization can be achieved with a Mediterranean-style eating pattern. Therefore, the difference in adiposity of 2 people of similar weight can result in different susceptibility to insulin resistance and MetS, and this difference cannot be determined by BMI values. The adjusted Cox regression model for cardiovascular mortality showed a significant hazard ratio only for the normal-weight—MetS group HR, 2. Many researchers argue that BMI is not a good indicator of weight status, because it does not differentiate among body compositions 26, Subcutaneous fat, particularly in the femorogluteal area, might provide a depot helping to prevent lipid deposition at intra-abdominal and visceral sites, where it might be more damaging.

Publication types

Recently, Kim et al. Metabolic health is a more important determinant for diabetes development than simple rrate a 4-year retrospective longitudinal study. The area under the curve value of the TyG index was significantly higher than that of TG 0. These populations are mostly absent in European studies, where normal-weight MetS was found to be a significant risk factor for cardiovascular disease and diabetes.

It is also debated whether mmetabolically itself increases the risk of mortality even in the absence of metabolic abnormalities, when compared to MHNO subjects. Article Google Scholar 42 Standl, E. Fourth, there were limited number of participants with morbid obesity; therefore, detailed analysis in this range was unavailable. Current smoking was defined as a person smoking at least one cigarette per day for at least 1 year.

Chinese have a relatively lower amount of alcohol intake compared to the Western population [ 29 ]. What are the implications for public health practice? Epub Oct Introduction Body mass index BMI is the most widely used measure of obesity, and higher BMI has been linked to the development of various metabolic diseases and their underlying pathophysiologies that could lead to increased mortality.

Introduction

John Bosomworth; e-mail moc. Body mass index A useful method for assessing metabolic health nrmal to determine the presence of metabolic syndrome MetSwhich is defined as having 3 of the following 5 criteria: central obesity, elevated blood glucose, elevated triglycerides, low levels of high-density lipoprotein cholesterol, and elevated blood pressure 4.

The analysis included 12, adults. SR of prospective observational studies and collaborative analysis 0. Conclusion A waist-to-height ratio exceeding 0. Epub Dec 8. Int J Obes Lond ; 36 11 —4.

  • Our study found that the normal-weight—MetS group had the highest risk of mortality among MetS and obesity categories — a risk that has not been previously identified in US adults.

  • Obesity Silver Spring ; 17 6 —9.

  • Adiposity in the relationship between serum vitamin D level and insulin resistance in middle-aged and elderly Korean adults: the Korea National Health and Nutrition Examination Survey Batsis, J.

  • Seoul 29— Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans.

Our study has several obesity. These populations are mostly absent in European studies, where normal-weight MetS was found to be a significant risk factor for cardiovascular disease and diabetes. In most cases these normal-weight participants have the highest mortality of any group combination of body mass and central fat distribution. There are pragmatic reasons for use of WHtR as well:. Cancel Continue. Obesity Silver Spring ; 17 Suppl 3 :S1—2. Durward et al found that only obese adults with MetS had a higher hazard ratio compared with the normal-weight—no-MetS group

A useful method for assessing metabolic health metabolically obese normal weight mortality rate to determine the presence of metabolic syndrome MetSwhich is defined as having 3 of the following 5 criteria: central obesity, elevated blood glucose, elevated triglycerides, low levels of high-density lipoprotein cholesterol, and elevated blood pressure 4. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Although they can be used as a substrate for energy production, they also contribute to insulin resistance, inhibiting glucose uptake by muscle and other organs, further contributing to hyperglycemia. The prevalence of MetS was The model for cancer mortality showed a significant hazard ratio for the overweight—MetS group HR, 1. Leisure-time running reduces all-cause and cardiovascular mortality risk.

Quality of evidence

Furthermore, to minimise reverse causality, we excluded participants with preexisting metabolic diseases, cardiovascular diseases, and malignancy. Peer Review reports. J Clin Endocrinol Metab. Asians with small builds have relatively low fat-free mass and high body fat [ 743 ]. Therefore, central obesity-associated indices such as WC, waist-hip ratio, and waist height ratio may be better markers for obesity evaluation.

Sign up for Nature Briefing. The normal-weight type 2 diabetes phenotype revisited. These individuals are often referred to as "metabolically-obese normal-weight" MONWand have increased risk for cardiometabolic disease despite their normal BMI and total body fat values. However, we found different distributions between men and women.

Am J Omrtality Nutr. Although obesity and MetS are related, several subsets of people who have a body mass index BMI within the normal range meet the criteria for MetS 3. The baseline investigation was a community-cluster study for the natural population in Zhejiang province. This finding suggests that the TyG index clearly discriminates individuals at metabolic risk among the normal weight population. Berrington de Gonzalez, A. Skip to main content.

Although BMI remains a useful index to assess overweight and obesity, it has limitations in differentiating body fat from lean mass, and central fat from peripheral fat [ 6 ]. JAMA71—82 The MONW distribution between men and women varied by age. Clin Endocrinol Oxf ; 82 —

Skip to main content Thank you for visiting nature. Consent for publication Not applicable. Similar pattern was noted for all-cause mortality in both non-smokers and current smokers data not shown. Epub Dec 9. Whole blood and serum samples, after a h overnight fast, were collected. Their definition excluded the criterion of central obesity and required only 2 conditions for diagnosis, which may have diluted the potent effect of MetS on all-cause mortality. Further studies with consensus on the defining criteria of metabolic health are required to clearly delineate the effect of metabolic health status on mortality.

Goldstein DJ. The prevalence of MONW positively correlated with age. Kuo, J. No statistically significant metabolicaly was found between cigarette smoking and metabolic status in normal weight individuals. Lastly, mortality risk was assessed, according to the presence of various combinations of metabolic disease components. A total of A participant recruitment flow chart is presented in Fig.

How useful is body mass index for comparison weight mortality rate body metabopically across age, sex, and ethnic groups? Abbreviation: MetS, metabolic syndrome. This article has been cited by other articles in PMC. Though there was no statistically significant difference found in individuals with a family history of obesity, dyslipidemia, type 2 diabetes, or coronary heart disease, the percentage of family histories tended to be higher in MONW individuals than in MNNW individuals in previous studies [ 3334 ].

However, MONW individuals are by definition lean, so recommending even moderate amounts of weight loss may not be a feasible therapeutic target Miller and Parsonage It is therefore important to better understand the metabolic effects of smaller amounts of weight loss. The associations were augmented in non-obese subjects, but attenuated in obese subjects. Diabetes Res Clin Pract.

Among the non-diabetic normal weight population, subjects in the MONW metabolidally were at a significantly higher risk of developing diabetes Table 4. Sedentary hours per week were calculated; participants were classified as short, moderate or long by their interquartile of sedentary hours. Eligibility Criteria. Article Google Scholar Download references. Article Google Scholar 36 Tobias, D.

In a further analysis, while accounting for the complex sampling design and controlling for the same covariates, to determine the incremental influence of MetS on mortality, we compared each MetS group with their metabolically obese normal weight mortality rate counterparts in each BMI group. Kramer et al, Mortality risk higher for central obesity in normal BMI range than in class 2 and 3 obesity. Body mass index versus waist circumference as predictors of mortality in Canadian adults. NHANES collects data for people older than 85 but does not report these extreme values to protect privacy. Effect of exercise Ross R, Janiszewski PM.

We used the 6-level BMI—MetS variable to find the hazard ratio of each group metabolicqlly with the normal-weight—no-MetS group for all-cause mortality, cardiovascular mortality, and cancer mortality. Benefits of sustained moderate weight loss in obesity. Arch Latinoam Nutr. The amount of fruit or milk intake was investigated by questionnaire-based interview and then classified into two groups, referenced as more or less, by the mean of intake amount. Some obese individuals exhibit lower degrees of insulin resistance and visceral adiposity and more favorable cardiovascular risk profiles despite their high BMI, and therefore are classified as having metabolically healthy obese MHO phenotype 11 ,

  • Introduction Body mass index BMI is the most widely used measure of obesity, and higher BMI has been linked to the development of various metabolic diseases and their underlying pathophysiologies that could lead to increased mortality. In addition, Asians use different cut-off values for BMI and are known to have higher percentage of body fat than Caucasians with a similar BMI 34which is a notable factor in interpreting the results.

  • You will be subject to the destination website's privacy policy when you follow the link. Each subsample was further weighted so that each represents the US population for the given year.

  • Anthropometric measurements were performed while the participants wore light clothing, and the body weight and height were measured to the nearest 0.

  • Article Google Scholar 43 Lu, Y. Effects of weight loss on insulin secretion and in vivo insulin sensitivity in obese diabetic and non-diabetic subjects.

Asia Pac J Clin Nutr. MONW J Clin Endocrinol Metab. Subjects Epidemiology Obesity Outcomes research. Their definition excluded the criterion of central obesity and required only 2 conditions for diagnosis, which may have diluted the potent effect of MetS on all-cause mortality. The sample was weighted to be representative of the US population for the given years using NHANES analytic guidelines for combining data across years WC significantly correlated with metabolic abnormality risk even after adjustment for BMI.

CMR eJournal. Epub Mar The model for cancer mortality showed a significant hazard ratio for the overweight—MetS group HR, 1. Initial analyses using SAS complex survey frequency and means procedures that take into account weighting, stratification, and clustering of the data generated the descriptive statistics.

Mortality risk higher for central obesity in normal BMI range than in class 2 and 3 obesity. Folsom et al, The differences in the results of our study and the results of those studies may be due to several factors. McCarty MF.

Prospective observational studies and related SRs and MAs of studies relating normal-weight central obesity to mortality. The risk of MetS among normal-weight people may be a more relevant public health problem now because of the increasing prevalence of MetS across all weight categories in recent years 5. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Our findings do not mean that being obese with MetS is beneficial compared with being normal weight with MetS. Coutinho et al, References 1.

Next, the prevalence of metabolic syndrome and its components according to the TyG index deciles were analyzed Figure 1. Cause of death was classified according to the diagnostic codes of the ICD Epub May In conclusion, poor metabolic health status contributed more to mortality than high BMI did, in Korean adults. Meigs, J. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. The differences in the results of our study and the results of those studies may be due to several factors.

A minimum of 10 years is suggested for observing the effects of MetS on mortality Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high normal weight mortality of cardiovascular disease: evidence and guidance for management. WC and WHR were both directly associated with mortality. Available prospective studies documenting all-cause mortality associated with increasing central obesity at any given BMI are presented in Table 3. This risk might equal or exceed that of centrally obese patients who are overweight or obese. Our study re-emphasizes that weight loss should continue to be encouraged among people who are obese.

The weight and metabolic condition of participants over multiple points as time-varying covariates metabolcally be needed to achieve a more comprehensive analysis than the one provided here. Only prospective cohort studies level II comparing participants with central obesity at normal weight with those at higher levels of body mass index BMI were found. Normal-weight central obesity and mortality risk in older adults with coronary artery disease. Epub Dec 8. Research that includes metabolically unhealthy normal-weight people shows equivocal results.

Conclusion A waist-to-height ratio exceeding 0. The simplest and most valid measure of central obesity is WHtR. Rates of obesity in North America have continued to rise since the s. We found a higher risk of mortality among normal-weight adults with metabolic syndrome than among other groups without metabolic syndrome.

  • Giovannucci, E.

  • A minimum of 10 years is suggested for observing the effects of MetS on mortality Cardiovasc Diabetol.

  • Survival curves were constructed with Kaplan-Meier estimates and compared using the log-rank test. Article Google Scholar 46 Lee, S.

  • Relation of central obesity and survival in adults of normal body weight.

Erratum in: Diabetes. Comparison with the euglycemic-hyperinsulinemic clamp. This novel criterion successfully reflected the metabolic phenotype of MONW and predicted the future development of diabetes. AGA technical review on obesity.

These populations are mostly absent in European studies, where normal-weight Aeight was found to be a significant risk factor for cardiovascular disease and diabetes. Author information Copyright and License information Disclaimer. Geneva, Switz: World Health Organization; Facebook Twitter LinkedIn Syndicate. Other studies on the effect of weight loss show a significant improvement in all risk factors and symptoms of MetS after weight loss Exercise with minimal weight loss can reduce visceral fat.

Medicine Baltimore 94e The MUNO group had a significantly higher risk of all-cause hazard ratio, 1. In contrast, the prevalence of other components of metabolic syndrome gradually increased according to the TyG index deciles. Ortega, F. Excessive adiposity at low BMI levels among women in rural Bangladesh.

  • J Diabetes Res. The area under the curve value of the TyG index was significantly higher than that of TG 0.

  • Overweight and obesity among adults: OECD indicators. Subsamples of participants were randomly selected to participate in various survey topics or laboratory testing.

  • However, inconsistent findings were found in previous studies [ 32 ]. Scientific Reports

  • The prevalence of MetS was

  • Experimental: Metabolically unhealthy Subjects classified as metabolically unhealthy MONW go on to participate in a calorie restriction intervention.

External link. Epub Apr Therefore, in addition to usually studied population subgroups, our study included information on a large proportion of African Americans and Hispanic Americans. Overweight and obesity among adults: OECD indicators. Figure 2. Toward a unifying hypothesis of metabolic syndrome.

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Results The prevalence of metabolic abnormality was Associations from this research should be further examined by future prospective study. Whitlock, G. Published : 22 July The sensitivity, specificity, positive predictive value and negative predictive value were

Rae differences in the results of our study and the results of those studies may be due to several factors. Epub Apr We performed all statistical analyses in using SAS version 9. Sci Rep. Overweight and obesity among adults: OECD indicators. The location of adipose tissue can also affect metabolic health. High body fat percentage and WC were associated with increased risk of metabolic syndrome.

Metabolic and behavioral characteristics of metabolically obese but normal-weight women. Further, the study was cross-sectional. Cancel Continue. In conclusion, we demonstrated different risks for mortality according to obesity measured as BMImetabolic health status, and their interactions in Korean adults using a nationwide population-based cohort. However, we found different distributions between men and women.

Added sugar in the packaged foods and beverages available metabolicallj a major Canadian retailer in a descriptive analysis. Waist-to-height ratio is more predictive of years of life lost than body mass index. Which comes first? Rates of obesity in North America have continued to rise since the s. Natarajan med. This phenotype is closely linked to atherogenic dyslipidemia, which predisposes one to the deposition of cholesterol in the vascular endothelium and resultant atherosclerosis.

Extreme metabolically obese normal weight mortality rate remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and ratf mortality in individuals from the general population. Insulin sensitivity Available prospective studies documenting all-cause mortality associated with increasing central obesity at any given BMI are presented in Table 3. For example, less than one-third of all participants were tested for fasting glucose or triglycerides. As such, greater attention must be given to normal-weight people who have MetS to provide early treatment and prevent future complications. Normal weight obesity.

The prevalence among Chinese was highly consistent between our findings in mainland China and the findings in America. The existence of people who have normal body weight but also have metabolic dysfunction, and therefore greater risk for developing cardiometabolic disease, was recognized several decades ago Ruderman et al. Ruderman, N. Subjects with a BMI

Their definition excluded the criterion of central obesity and required only 2 conditions for diagnosis, which may have diluted the metabolically obese normal weight mortality rate effect of MetS on all-cause mortality. The obese without cardiometabolic risk factor clustering kbese the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population NHANES Arch Intern Med. Hinnouho, G. The risk of MetS among normal-weight people may be a more relevant public health problem now because of the increasing prevalence of MetS across all weight categories in recent years 5. An interesting study by the Emerging Risk Factors Collaboration showed that associations of myocardial infarction, stroke, and diabetes with mortality are multiplicative 6.

Subsamples of participants were randomly selected to participate in various survey topics or laboratory testing. Measures of central obesity showed mefabolically linear association with mortality when adjusted for BMI. Function 15 Although several studies from around the world found an increased risk of diabetes or cardiovascular disease 6—11 among metabolically unhealthy normal-weight people, studies have not found an elevated risk of all-cause mortality in this group. Sahakyan et al,

Written informed consent was obtained from all participants, and the institutional review board at Weight mortality rate Catholic University of Korea approved this study No. We performed all statistical analyses in using SAS version 9. Associations of diabetes mellitus and ethnicity with mortality in a multiethnic Asian population: data from the Singapore National Health Survey. This study found that there is metabolic heterogeneity in normal-weight individuals in China. However, individuals in this study were recruited from a health examination center, and this may have led to selection bias due to the low representativeness of these individuals; hence, the results might be difficult to extrapolate. Ongoing investigations reveal that these metabolically obese but normal weight MONW individuals, also called metabolically abnormal normal weight or normal weight obesity, are not uncommon. About this article.

PLoS One. A deeper understanding of the Date phenotype, as proposed here, is important to dissect the metabolic abnormalities that are inherent to the phenotype from those merely associated with differences in total body fat. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults.

Characteristics of metabolically obese normal-weight MONW subjects. The location of adipose tissue can also affect metabolic health. Ann Intern Med. Therefore, MONW was defined as normal-weight individuals who had two or more metabolically abnormal traits. However, the different distribution of MONW prevalence between men and women varied by age.

These particles are large and contain predominantly TG, along with some cholesterol. References from appropriate retrieved papers were also scanned. The result is a smaller number of HDL particles, which cannot contain as much cholesterol for clearance from the vasculature Figure 1B. Obesity and weight management in the elderly. Sci Rep.

All included studies were observational, and pertinent prospective cohort studies or systematic reviews were selected. No consistent association with increased mortality. Metabolically obese normal weight mortality rate analyses of cause-specific mortality Figure 2we found that among total deaths, weighted, Prevalence of normal weight central obesity among Thai healthcare providers and their association with CVD risk: a cross-sectional study. The lack of significant differences in HRs between the normal-weight—MetS group and the normal-weight—no-MetS group in both studies was probably due to their small sample sizes.

Table 1 Baseline characteristics of the study subjects. Furthermore, although weight loss improves body composition and many of the cardiometabolic abnormalities in most obese patients, little is known about the qeight therapeutic effects of calorie restriction in MONW subjects. Some normal-weight individuals also have multiple cardio-metabolic disorders weight mortality rate as insulin resistance, and high levels of inflammation, triglycerides TGblood pressure Obseefasting plasma glucose FPGand decreased high-density lipoprotein cholesterol HDL-C [ 4 ], These individuals are typically referred to as metabolically obese but normal-weight MONW [ 67 ]. Though there was no statistically significant difference found in individuals with a family history of obesity, dyslipidemia, type 2 diabetes, or coronary heart disease, the percentage of family histories tended to be higher in MONW individuals than in MNNW individuals in previous studies [ 3334 ]. Definition of metabolic health status and cause of death Three metabolic disease components diabetes, hypertension and dyslipidaemia were used to define metabolic health status. An interesting study by the Emerging Risk Factors Collaboration showed that associations of myocardial infarction, stroke, and diabetes with mortality are multiplicative 6. Int J Cardiol.

Open in a separate window. Increased visceral adipose tissue accumulation is more strongly associated with risk of metabolic disorders than subcutaneous adipose tissue because of its location in the abdominal cavity and its morhality role in endocrine and inflammatory secretion Emphasis should be on small and achievable changes in behaviour. The simplest and most valid measure of central obesity is WHtR. We grouped data according to categories of body mass index normal [ The final analytic sample of 12, participants aged 20 to 85 had data for all variables examined in our study, eligible follow-up mortality data, and no preexisting frailty. Br J Sports Med.

Although obesity and MetS are related, several subsets meatbolically people who have a body mass index BMI within the normal range meet the criteria for MetS 3. Trends in mean waist circumference and abdominal obesity among US adults, — Increased BMI was associated with reduced risk in these patients. Clin Chem. References 1.

Epub Mar Other studies that examined groups of people of primarily European descent stratified by BMI and metabolic health criteria — usually MetS or insulin resistance — found similarly higher risks for cardiovascular disease and diabetes in the normal-weight but metabolically unhealthy group 6—11whereas 2 other studies found contradictory results 28, Correspondence: Dr N. Which comes first? Sahakyan et al, Body fat distribution and risk of cardiovascular disease: an update.

Abstract Cardiovascular complications are commonly associated with obesity. Folsom et al, Normal-weight central obesity and risk for mortality. Figure 2.

Am J Clin Nutr. From a large-scaled, nationwide, long-term follow-up study, we analysed the risk of mortality according to BMI and metabolic health status in the Korean population. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. Outcome studies to evaluate the predictability of this definition on CVD and mortality and confirmation in other cohort studies are warranted.

Lean, nondiabetic Asian Indians have decreased insulin sensitivity and insulin clearance, and raised leptin compared to Caucasians and Chinese megabolically. In analyses of cause-specific mortality Figure 2we found that among total deaths, weighted, Different characteristics of study population, longer duration of follow-up and more numbers of events in our study might explain the discrepancy between two studies. Owing to the lack of a consistent definition, there is some variability among studies in the phenotypic characterization of MONW subjects Teixeira et al. Although studies show that metabolic diseases can affect normal-weight adults, studies on the risks of mortality have been equivocal and rarely focus on normal-weight adults.

Epub Aug 8. The MUNO group had a significantly higher risk of all-cause hazard ratio, 1. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Received : 12 November Therefore, central obesity-associated indices such as WC, waist-hip ratio, and waist height ratio may be better markers for obesity evaluation. Resistance to slimming: adaptation or illusion?

  • Tobias, D. What are the implications for public health practice?

  • We further divided each weight group into 2 groups according to whether the participant met criteria for MetS. Subsamples of participants were randomly selected to participate in various survey topics or laboratory testing.

  • Effects of weight loss on insulin secretion and in vivo insulin sensitivity in obese diabetic and non-diabetic subjects. This distribution was similar with metabolically normal obesity in our previous study [ 15 ].

  • In a review of randomized and non-randomized trials primarily using exercise for weight control, 11 of 29 studies showed a significant reduction in visceral fat despite no clinically relevant weight loss. We further divided each weight group into 2 groups according to whether the participant met criteria for MetS.

Int J Cardiol. Short-term medical benefits and adverse effects of weight loss. Lee K. This inconsistency could be well explained by our findings. Article Google Scholar 43 Lu, Y. Figure 2: Mortality according to the combination of metabolic diseases.

Inflammation We then excluded participants if they had BMI less than At the same time, high-density lipoprotein HDL particles, which are involved in reverse cholesterol transport, tend to become TG rich and smaller, to the extent that some are lost in the urine. Minus Related Pages.

J Diabetes Sci Technol. Metabolicaly 3 The risk factors associated with metabolic abnormality in the normal-weight individuals Full size table. Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women. Body mass index, abdominal fatness, and heart failure incidence and mortality: a systematic review and dose-response meta-analysis of prospective studies.

  • Actual Primary Completion Date :. PLoS One 10e

  • Subsamples of participants were randomly selected to participate in various survey topics or laboratory testing.

  • Subjects not fulfilling these criteria were allocated in the metabolically healthy and normal weight MHNW group.

  • Lu, Y.

  • Kuk, J. Behavioral: Calorie restriction Calorie restriction with behavioral modification and provision of one catered, reduced calorie meal a day.

In this study, we aimed metanolically investigate MONW prevalence and its epidemiological determinants in a natural population in Zhejiang province in southeastern China. Subjects were selected using stratified random sampling to ensure that the sample was representative of the entire population. A similar pattern was noted for cancer and other-cause mortality. Diabetes Res Clin Pract. Lu, Y.

  • Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality.

  • Other studies that examined groups of people of primarily European descent stratified metabolidally BMI and metabolic health criteria — usually MetS or insulin resistance — found similarly higher risks for cardiovascular disease and diabetes in the normal-weight but metabolically unhealthy group 6—11whereas 2 other studies found contradictory results 28,

  • Biomarker-calibrated nutrient intake and healthy diet index associations with mortality risks among older and frail women from the Women's Health Initiative. Although the prevalence of metabolic syndrome among normal-weight adults is low, it is associated with high risk of mortality.

  • You can also search for this author in PubMed Google Scholar.

Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. Similar to our findings, Sahakyan metabolical,y al found higher mortality in the normal-weight-with-central-obesity group than in their normal-weight-no-central-obesity group Epub Jun Diabetes Care. Epub Feb 6. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. Case A, Deaton A.

Molecular insights into the role mftabolically white adipose tissue in metabolically unhealthy normal weight and metabolically metabolically obese normal weight mortality rate obese individuals. Methods A total of 17, normal-weight individuals were recruited from 37, individuals in Zhejiang province in southeastern China. Body-mass index and mortality among 1. The final analytic sample of 12, participants aged 20 to 85 had data for all variables examined in our study, eligible follow-up mortality data, and no preexisting frailty. Statistical analysis All statistical analyses were performed using the SAS 9.

Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. As avoidance of weight gain is metabolicaally objective along with reduction in visceral fat, the Mediterranean eating pattern could be a preferred option for those with normal-weight central obesity, particularly as it tends to be low in refined carbohydrate. Many researchers argue that BMI is not a good indicator of weight status, because it does not differentiate among body compositions 26, Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis.

Article Google Scholar 38 Kuo, J. Previous studies have reported that low physical activity levels and high sedentary behavior levels are associated with increased risks of metabolic abnormality and cardio-metabolic diseases [ 2526 ]. JAMA71—82 Ann Intern Med. Effects of bariatric surgery on glucose homeostasis and type 2 diabetes. In the test of the interaction between weight groups and MetS, the P value for the interaction term in the full model was. PLoS One.

Written informed consent was obtained from all participants, and the institutional review board at The Catholic University of Korea approved this study No. Are metabolically normal but obese individuals at lower risk for all-cause mortality? Journal List Nutr Diabetes v. Correspondence to Seung-Hwan Lee.

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