ANTHROPOMETRIC AND BODY COMPOSITION PARAMETERS IN ADOLESCENTS WITH THE METABOLICALLY OBESE NORMAL WEIGHT PHENOTYPE

Objective: This study aimed to investigate the anthropometric and body composition parameters associated with the metabolically obese normal weight (MONW) phenotype. Desing: This is a cross-sectional study conducted with 506 adolescents between 10 and 19 years old, selected from schools in Viçosa, Brazil. The MONW phenotype was defined as eutrophy, as defined by body mass index (BMI), and at least one metabolic alteration. Waist and neck circumferences, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were measured. Dual-energy bone densitometry was used for body composition analysis and body composition indices were calculated. Crude and adjusted Poisson regression models with robust variance were used to estimate the associations. Results: The MONW phenotype was positively associated with waist circumference (male: PR=1.05; 95%CI 1.01-1.09; female: PR=1.06; 95%CI 1.02-1.09), WHtR (male: PR=1.26; 95% CI 1.07-1.49; female: PR=1.29; 95%CI 1.07-1.56) and android/gynoid fat ratio (male: PR=1.25; 95%CI 1.03-1.51; female: PR=1.39; 95%CI 1.20-1.62), in both sexes. Furthermore, there was a positive association of phenotype with WHR (PR=1.32; 95%CI 1.06-1.65) and trunk/arm fat ratio (PR=1.13; 95%CI 1.02-1.24) only in males, and with trunk/leg fat ratio (PR=2.84; 95%CI 1.46-5.53), BAIp (PR=1.06; 95%CI 1.01-1.12), FMI (PR=1.24; 95%CI 1.10-1.41) and regional IMLC (PR=1.29; 95%CI 1.09-1.53), in females. Conclusion: Anthropometric and body composition parameters indicative of central and total fat are associated with the MONW phenotype, and may be useful tools for early diagnosis of eutrophic adolescents by BMI with cardiometabolic risk. Furthermore, the phenotype was positively associated with regional load index and metabolic capacity.

Prevalence of Metabolically Obese, Normal-Weight Individuals and Its Dietary Patterns Characteristics: A Cross-Sectional Study in Thai Adults

Objectives Metabolically obese normal weight (MONW) individuals are subjects who have a normal body mass index (BMI), but manifest obesity-related metabolic syndrome (MetS). Nevertheless, the prevalence and correlation between MONW and dietary patterns have not been fully explored in Thais. This study aimed to investigate the national prevalence of MONW, determine which dietary patterns are consumed in Thai normal-weight adults and to identify whether those patterns were associated with the risk of MetS and its features. Methods Total 6899 Thais ≥18 years with normal BMI (18.5–22.9 kg/m2) were obtained from the Thai National Health Examination Survey IV. Sociodemographic, eating-habits, anthropometric, blood pressure and biochemical parameters were measured. MONW was diagnosed by the National Cholesterol Education Program/Adult Treatment Panel III within normal BMI. Dietary patterns were determined by means of factor analysis, and were evaluated by multiple logistic regressions for its association with MONW. Results Overall, the weighted prevalence of MONW was 9.9% (95% CI: 9.1–10.6%), particularly, the MONW prevalence was 7.2% (95% CI: 6.5–8.0%) and 13.1% (95% CI: 11.6–14.7%) in male and female respectively. Three major dietary patterns were distinguished: “westernized”, “healthy” and “carbohydrate” patterns. After controlling for potential confounders, compared with the lowest quartile, individuals in the highest quartile of the westernized and carbohydrate pattern were connected with the greater risk of MONW (adjusted odds ratio [OR]: 1.64, 95% CI: 1.25–2.17, P < 0.001) and (OR: 1.57, 95% CI: 1.19–2.08, P < 0.05) respectively, whereas subjects in the fourth quartile of healthy pattern reduce the risk of MONW and its components, except for elevated blood pressure and hyperglycemia (OR: 0.68, 95% CI: 0.50–0.92 for MONW, P < 0.05; OR: 0.43, 95% CI: 0.28–0.68 for abdominal obesity, P < 0.001; OR: 0.63, 95% CI: 0.49–0.81 for hypertriglyceridemia, P < 0.001; OR: 0.67, 95% CI: 0.54–0.82 for low high-density lipoprotein cholesterol [HDL-C], P < 0.01). Conclusions In Thai normal-weight adults, high consumption of whole grains, fruits, beans, juices, and dairy products is connected with a lower risk of metabolic syndrome and its features, i.e., lower risk of abdominal obesity, hypertriglyceridemia, and low HDL-C. Funding Sources This research received no funding.

Interaction between early environment and genetic predisposition instigates the metabolically obese, normal weight phenotype in children: findings from the BCAMS study

Objective A subset of normal-weight individuals appears predisposed to obesity-related cardiometabolic abnormalities. Studies of this metabolically obese, normal weight (MONW) phenotype in youth are scarce. We aimed to identify early environmental and genetic factors associated with MONW in children. Methods Overall, 1475 normal-weight Chinese children aged 6–18 were recruited from the Beijing Children and Adolescents Metabolic Syndrome study cohort. Birthweight, childhood lifestyle, socio-economic factors, and 20 genetic variants previously shown to be associated with BMI or glucose metabolism in East Asian adults were examined for their association with the MONW phenotype. MONW was defined by exhibiting any metabolic syndrome component. Results After adjusting for covariates including BMI, low birthweight and low levels of physical activity, fruit consumption, parental education and household income, as well as CDKAL1 rs2206734 genotype were independent predictors of the MONW phenotype (all P < 0.05). Moreover, rs2206734 interacted with birthweight to predict the MONW phenotype (Pinteraction = 0.0008). Among high (>75th percentile) birthweight individuals, each C allele at this locus was associated with a 62% reduced risk of MONW (OR = 0.38; 95% CI = 0.26-0.58; P = 5.71 × 10−6), while no such genetic associations were found in intermediate or low birthweight individuals (P > 0.1). This CDKAL1-MONW relationship in high birthweight individuals was especially strong in the presence of favorable childhood environmental factors (high levels of physical activity, fruit consumption, parental education and household income) (Pinteraction = 0.013). Conclusions Our findings provided the novel evidence that early environment (especially birthweight) and genetics, along with their interaction with one another, play important roles in predicting the MONW phenotype among children.

Obesity phenotypes and their adipocyte dysfunction among the attendants at outpatient department

<p>The present study was aimed to find out the frequency of obesity phenotypes and to correlate adipocyte dysfunction with different obesity phenotypes. A total of 1,507 apparently healthy adults attending the outpatient department were grouped into three based on body mass index which were then further categorized into six groups according to metabolically unhealthy or healthy phenotypes by the presence or absence of metabolic syndrome. Of them, metabolically obese normal weight, overweight, healthy obese and unhealthy obese groups were included as obesity phenotypes. Then by purposive sampling, leptin and adiponectin concentration of 184 subjects with different phenotypes were measured to find out the adipocyte dysfunction. Metabolically obese overweight followed by metabolically unhealthy obese were more prevalent i,e., 24.9% and 19.5%. All obesity phenotypes except metabolically obese normal weight were significantly documented with adipocyte dysfunction (p&lt;0.05).</p>

Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians

Type 2 diabetes in Asia occurs largely in the absence of obesity. The metabolically obese normal-weight (MONW) phenotype refers to lean subjects with metabolic dysfunction that is typically observed in people with obesity and is associated with increased risk for diabetes. Previous studies evaluated MONW subjects who had greater body mass index (BMI) or total body fat than respective control groups, making interpretation of the results difficult. We evaluated insulin sensitivity (hyperinsulinemic-euglycemic clamp); insulin secretion (mixed meal with oral minimal modeling); intra-abdominal, muscle, and liver fat contents (magnetic resonance); and fasting and postprandial glucose and insulin concentrations in 18 MONW subjects and 18 metabolically healthy controls matched for age (43 ± 3 and 40 ± 3 yr; P = 0.52), BMI (both 22 ± 1 kg/m2; P = 0.69), total body fat (17 ± 1 and 16 ± 1 kg; P = 0.33), and sex (9 men and 9 women in each group). Compared with controls, MONW subjects had an approximately twofold greater visceral adipose tissue volume and an approximately fourfold greater intrahepatic fat content (but similar muscle fat), 20–30% lower glucose disposal rates and insulin sensitivity, and 30–40% greater insulin secretion rates (all P < 0.05). The disposition index, fasting glucose, and HbA1c concentrations were not different between groups, whereas postprandial glucose and insulin concentrations were ~15% and ~65% greater, respectively, in MONW than control subjects (both P < 0.05). We conclude that the MONW phenotype is associated with accumulation of fat in the intra-abdominal area and the liver, profound insulin resistance, but also a robust β-cell insulin secretion response that compensates for insulin resistance and helps maintain glucose homeostasis.