RESUMO
OBJECTIVE: To evaluate the plasma cytokine levels during T cell-mediated inflammatory responses and compare the metabolic markers between overweight and obese perimenopausal women without systemic diseases. METHODS: Sixty perimenopausal women were divided into two groups (overweight and obese). Participants in both groups had their waist-to-height ratio (WHtR) measured and blood samples collected for the evaluation of estradiol, fasting glucose, leptin, high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, IL-10, IL-17A levels, and lipid profile. RESULTS: In univariate analysis, women with obesity showed increased WHtR, fasting glucose, leptin, and IL-6 (p < 0.05) levels; however, significant differences were not observed in IL-10 or IL-17A (p > 0.05) levels. In the receiver operating characteristic curve, the highest areas under the curve were shown for leptin (0.856) and IL-6 (0.706). IL-6 levels correlated with both hs-CRP (r = 0.302, p = 0.020) and leptin (r = 0.294, p = 0.022). However, in multivariate analysis, IL-6 was not associated with a greater likelihood of obesity (OR = 1.61; 95% CI: 0.82-3.15; p = 0.16), when potential confounders were considered. CONCLUSION: IL-6 levels varied between overweight and obese perimenopausal women, and this association was weaker when adjusted for other clinical variables.
Assuntos
Citocinas/sangue , Obesidade Metabolicamente Benigna/sangue , Sobrepeso/sangue , Perimenopausa/sangue , Adulto , Índice de Massa Corporal , Brasil , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Interleucina-10/sangue , Interleucina-6/sangue , Leptina/sangue , Pessoa de Meia-IdadeRESUMO
Obesity negatively affects the relationship between markers and micronutrients of bone metabolism. Testing the hypothesis that the metabolically healthy obese phenotype might be protected by those alterations was the aim of this study. A cross-sectional study was carried out in adults with class III obesity classified in Metabolically Healthy Obese (MHO) and Metabolically Unhealthy Obese (MUHO), according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) criteria. Anthropometric, biochemical, and clinical variables were analyzed for sample characterization. To evaluate bone metabolism, markers (alkaline phosphatase and parathyroid hormone-PTH) and related nutrients (vitamin D, vitamin B12, calcium, phosphorus, magnesium, potassium and zinc) were analyzed. A total of 223 adults with class III obesity aged 41.20 ± 10.15 years were included. The MHO phenotype was identified in 32.73% of the sample. After logistic regression, it was observed that inadequacies of calcium (OR: 4.11; 95% CI: 2.33-6.66), phosphorus (OR: 3.03; 95% CI: 1.98-5.79), vitamin D (OR: 5.01; 95% CI: 2.92-6.71) and PTH (OR: 5.45; 95% CI: 4.49-6.74) were significantly higher in the MUHO group compared to the MHO Group. This study showed that the MHO phenotype does not protect adults from alterations in markers and micronutrients of bone metabolism. However, the MUHO phenotype presents a higher risk for alterations related to bone metabolism, which can favor the emergence of metabolic bone diseases.
Assuntos
Fosfatase Alcalina/sangue , Remodelação Óssea , Micronutrientes/sangue , Obesidade Metabolicamente Benigna/sangue , Hormônio Paratireóideo/sangue , Adulto , Antropometria , Biomarcadores/sangue , Cálcio/sangue , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade Metabolicamente Benigna/fisiopatologia , Fenótipo , Fósforo/sangue , Vitamina D/sangueRESUMO
OBJECTIVE: It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents. RESEARCH DESIGN AND METHODS: Data were available for 3,497 children and adolescents aged 6-17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center. RESULTS: In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58-3.32) for metabolically healthy overweight and 3.91 (2.46-6.21) for MHO. ORs for high cIMT were 1.44 (1.03-2.02) for unhealthy normal weight, 3.49 (2.51-4.85) for unhealthy overweight, and 6.96 (5.05-9.61) for unhealthy obesity. CONCLUSIONS: Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status.
Assuntos
Espessura Intima-Media Carotídea , Obesidade Metabolicamente Benigna/epidemiologia , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Adolescente , Pressão Sanguínea , Brasil , Criança , China , Estudos Transversais , Feminino , Seguimentos , Grécia , Nível de Saúde , Humanos , Itália , Modelos Logísticos , Masculino , Obesidade Metabolicamente Benigna/sangue , Sobrepeso/sangue , Obesidade Infantil/sangue , Prevalência , Fatores de Risco , EspanhaRESUMO
OBJECTIVE: The aim of this study was to verify the prevalence of metabolically healthy obese (MHO) phenotype and associated factors in South American adolescents who are overweight. METHODS: A cross-sectional study was carried out with 340 overweight adolescent boys and girls between 10 and 18 y of age. The participants were classified as MHO according to two definitions: absence of any metabolic syndrome component and absence of insulin resistance (IR). The MHO phenotype-associated factors analyzed were age, sex, nutritional status, waist circumference (WC), body composition, metabolic profile, and cardiorespiratory fitness. Multivariable logistic regression was used to determine predictors of MHO using odds ratios with 95% confidence intervals. RESULTS: The prevalence of MHO in South American overweight adolescents was 49.4% and 55.9% according to MS and IR criteria, respectively. Sex and WC were predictors of the MHO phenotype, considering MS classification criterion. For the IR criterion, age, WC, and triacylglycerol levels were independent predictors of MHO in adolescents. Cardiorespiratory fitness did not predict MHO phenotype in any of the criteria used. CONCLUSIONS: The prevalence of MHO in South American overweight adolescents was high and varied according to the definition used. Age, sex, WC, and triacylglycerolslevel were independent predictors of the MHO phenotype in this population.
Assuntos
Estado Nutricional , Obesidade Metabolicamente Benigna/epidemiologia , Obesidade Infantil/epidemiologia , Triglicerídeos/sangue , Circunferência da Cintura , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Resistência à Insulina , Modelos Logísticos , Masculino , Obesidade Metabolicamente Benigna/sangue , Obesidade Metabolicamente Benigna/fisiopatologia , Obesidade Infantil/sangue , Obesidade Infantil/fisiopatologia , Fenótipo , Prevalência , Fatores de RiscoRESUMO
Considering the inadequacy of some antioxidant nutrients in severely obese adolescents, this study aimed to assess the relationship between antioxidant micronutrients status and metabolic syndrome components in metabolically healthy obesity (MHO) and unhealthy obesity (MUO). We performed an observational study in severely obese adolescents (body mass index > 99th percentile) and they were classified into MHO or MUO, according to the criteria adapted for adolescents. Anthropometric, biochemical, and clinical variables were analyzed to characterize the sample of adolescents. The serum antioxidant nutrients assessed were retinol, ß-carotene, Vitamin E, Vitamin C, zinc and selenium. A total of 60 adolescents aged 17.31 ± 1.34 years were enrolled. MHO was identified in 23.3% of adolescents. The MHO group showed lower frequency of non-alcoholic fatty liver disease (14.3% vs. 78.3%, p < 0.001) when compared to MUO. A correlation was found between retinol and ß-carotene concentrations with glycemia (r = -0.372; p = 0.011 and r = -0.314; p = 0.034, respectively) and between Vitamin E with waist circumference (r = -0.306; p = 0.038) in the MUO group. The current study shows that some antioxidant nutrients status, specifically retinol, ß-carotene, and Vitamin E, are negatively associated with metabolic alterations in MUO. Further studies are necessary to determine the existing differences in the serum antioxidant profile of metabolically healthy and unhealthy obese adolescents.
Assuntos
Fenômenos Fisiológicos da Nutrição do Adolescente , Estado Nutricional , Obesidade Metabolicamente Benigna/metabolismo , Obesidade Mórbida/metabolismo , Estresse Oxidativo , Obesidade Infantil/metabolismo , Adolescente , Índice de Massa Corporal , Brasil/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade Metabolicamente Benigna/sangue , Obesidade Metabolicamente Benigna/fisiopatologia , Obesidade Mórbida/sangue , Obesidade Mórbida/fisiopatologia , Obesidade Infantil/sangue , Obesidade Infantil/fisiopatologia , Prevalência , Fatores de Risco , Selênio/sangue , Índice de Gravidade de Doença , Vitaminas/sangue , Circunferência da Cintura , Zinco/sangueRESUMO
INTRODUCTION: Obesity is a serious, worldwide and growing problem, with associated complications ranging from cardiovascular disease to cancer. It has been suggested that a subgroup of obese patients- the "metabolically healthy" (MH)- would constitute a phenotype whose cardiovascular risk would be closer to that of normal weight individuals and lower than that of obese patients with other risk factors. The definitions of MH obesity are heterogeneous, what makes the estimation of its prevalence quite difficult. Besides that, data are still controversial about the risk of incident cardiovascular disease in these patients and therefore this remains an unresolved matter. In parallel, the possibly lower risk of MH obesity may raise questions about the need for weight loss in MH obese patients. CONCLUSION: This issue should be carefully addressed, and evidence for a "benign" profile of MH obesity critically evaluated, as obesity is a risk factor for numerous health outcomes, and weight loss in obese people additionally offers protection against these nonmetabolic diseases.
Assuntos
Doenças Cardiovasculares , Obesidade Metabolicamente Benigna , Animais , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Metabolismo Energético , Nível de Saúde , Humanos , Incidência , Estado Nutricional , Obesidade Metabolicamente Benigna/sangue , Obesidade Metabolicamente Benigna/epidemiologia , Obesidade Metabolicamente Benigna/fisiopatologia , Obesidade Metabolicamente Benigna/terapia , Fenótipo , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Redução de PesoRESUMO
BACKGROUND: Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. SUBJECTS AND METHODS: Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. RESULTS: Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to 'at risk' obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). CONCLUSION: We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.
Assuntos
Peso Corporal Ideal , Metaboloma , Obesidade/metabolismo , Somatotipos , Adulto , Idoso , Antropometria , Glicemia/análise , Composição Corporal/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Obesidade/classificação , Obesidade Metabolicamente Benigna/sangue , Obesidade Metabolicamente Benigna/classificação , Fatores de Risco , Sérvia , Triglicerídeos/análiseRESUMO
ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Peso Corporal Ideal , Metaboloma , Obesidade/metabolismo , Somatotipos , Antropometria , Glicemia/análise , Composição Corporal/fisiologia , Estado Nutricional , Obesidade Metabolicamente Benigna/sangue , Obesidade Metabolicamente Benigna/classificação , Obesidade/classificação , Fatores de Risco , Sérvia , Triglicerídeos/análiseRESUMO
OBJECTIVE: The aim of this study was to identify metabolically healthy obese individuals (MHOs) and their characteristics, as well as to estimate cardiovascular risk using the Framingham score. METHOD: In all, 258 adult individuals, with body mass index ≥30 kg/m(2), and no report of diabetes mellitus or cardiovascular disease, were classified according to their metabolic state considering two criteria: rhe National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and the homeostasis model assessment (HOMA). Biochemical, anthropometric, and body composition characteristics were compared between MHOs and metabolically unhealthy obese (MUO) individuals according to each criterion. Cardiovascular risk was estimated using the Framingham score. RESULTS: MHOs exhibited smaller waist circumference and lower body fat percentage, as well as lower blood glucose, triacylglycerols, and insulin levels, in addition to higher high-density lipoprotein cholesterol concentration, when HOMA criterion (P < 0.05) and associated criteria were adopted. The estimated cardiovascular risk was similar between the two groups according to the HOMA index; however, the risk was significantly lower according to the ATP III guidelines. Obese individuals at intermediate and high risk showed higher body fat percentage compared with those individuals at low risk. CONCLUSIONS: MHOs had biochemical and anthropometric characteristics, such as lower body mass index, waist circumference, percent fat mass, glucose, triacylglycerols, and increased high-density lipoprotein, that made them different from those individuals classified as MUO. The latter exhibited increased risk for cardiovascular disease according to the Framingham score, when using the ATP III criterion alone or in conjunction with the HOMA index.