Тhe prevalence of metabolically healthy obesity: data from the epidemiological survey in of Novosibirsk

Background: Obesity is associated with numerous metabolic complications, such as type 2 diabetes mellitus (DM2), dyslipidemia, arterial hypertension (AH), cardiovascular diseases and some forms of cancer. Nevertheless, the literature describes a group of obese individuals who are more resistant to the development of metabolic disorders. At present, this phenomenon is known as "Metabolically healthy obesity", "metabolically healthy obesity" (MZO). Despite the presence of excess weight or obesity, a favorable metabolic profile can be observed in this cohort of patients, characterized by preserved insulin sensitivity, absence of arterial hypertension, normal lipid, hormonal profile, absence of inflammation and unchanged hepatic transaminases.

Aims: To study the prevalence of metabolically healthy obesity (MHO) and its characteristics in men and women at the age of 45–69 years in Novosibirsk.

Materials and methods: To study covered 3197 persons from the base of the international project HAPPIE. They had a body mass index (BMI ≥ 30 kg/m²). «Metabolically healthy obesity» was determined as obesity (BMI ≥ 30 kg/m², with 2 and fewer components of metabolic syndrome (MS) by criteria NCEP ATP III, 2001. Statistical analisys SPSS-13.

Results: The prevalence of metabolic healthy obesity (MHO) was 42% (38% for men and 43% for women). The examined people with MHO have reliably more favorable average level of TG, HDL-cholesterol, indicators of blood glucose, systolic arterial pressure and diastolic arterial pressure and less waist circumference. In the groups withMHO and MS abdominal obesity is common in men at 95 and 71%, in women at 99 and 90%; hyperTG – in men at 74 and 9%, in women at 72 and 5,5%; lower level HDL-cholesterol in 16 and 1% for men, and in 44,5% and 3% for women; AP in 96 and 77% and 94 and 71% in men and women respectively, the frequency fasting of hyperglycaemia 77 and 21% in men and 60 and 5% in women was markedly different. According to the data obtained by us, the frequency in the sample is high and amounted to 42%. In the subgroup the most commonly found is the MHO phenotype – 53%, than in the men -38%, р <0,001

Conclusions: According to our data, the frequency of metabolic healthy obesity in the sample is high and amounted to 42%. In the female subgroup, a metabolically healthy phenotype is more common 43% than in the male 38%, p <0.001. Metabolically healthy obese individuals are characterized by a significantly lower incidence of fasting hyperglycaemia and dyslipidemia.

the prevalence, obesity, metabolic syndrome, metabolically healthy obesity

1. Euro.who.int [Internet]. Global Health Observatory Data Repository. Report WHO. Geneva: World Health Organization, [cited 2015 Feb 12]. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/country-work/russian-federation2

2. Мустафина С.В., Малютина С.К., Рымар О.Д., и др. Эпидемиология ожирения и развитие нарушений углеводного обмена по данным проспективного исследования в Сибири // Ожирение и метаболизм. – 2015. – Т. 12. – №4. – С.24-28. [Mustafina SV, Malyutina SK, Rymar OD, et al. The epidemiology of obesity and the development of disorders of glucose metabolism according to a prospective study in Siberia. Obesity and metabolism. 2015;12(4):24-28. (In Russ).] doi: 10.14341/OMET2015424-28

3. Muñoz-Garach A, Cornejo-Pareja I, Tinahones FJ. Does Metabolically Healthy Obesity Exist? Nutrients. 2016;8(6):320. doi: 10.3390/nu8060320.

4. Brochu M, Tchernof A, Dionne IJ, et al. What are the physicallevel of obesity in postmenopausal women? The Journal of Clinical Endocrinology and Metabolism. 2001;86(3):1020–1025. doi: 10.1210/jcem.86.3.7365.

5. Karelis AD, Faraj M, Bastard JP, et al. The metabolically healthy but obeseindividual presents a favorable inflammation profile. The Journal of Clinical Endocrinology and Metabolism. 2005;90(7):4145–4150. doi: 10.1210/jc.2005-0482.

6. Aguilar-Salinas CA, Garcia EG, Robles L, et al. High adiponectin concentration sare associated with the metabolically healthy obese phenotype. The Journal of Clinical Endocrinology and Metabolism. 2008;93(10):4075–4079. doi: 10.1210/jc.2007-2724.

7. Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Archives of Internal Medicine. 2008;168(15):1609–1616. doi: 10.1001/archinte.168.15.1609.

8. Andres R. Effect of obesity on total mortality. International Journal of Obesity volume. 1980;4(4):381–386.

9. Primeau V, Coderre L, Karelis AВ, et al. Characterizing the profile of obese patients who are metabolically healthy. International Journal of Obesity. 2011;35(7):971–981. doi: 10.1038/ijo.2010.216.

10. Малютина С. К. Десятилетние тренды и когортное исследование конвенционных факторов риска сердечно-сосудистых заболеваний в городской сибирской популяции (по материалам проекта ВОЗ MONICA): Дис. … докт. мед. наук. – Новосибирск; 2001. [Malyutina SK. Desytiletnie trendy I kogortnoe issledovanie konvencionnyx faktorov riska serdechno-sosudistyx zabolevanii v gorodskoi sibirskoi populacii. [dissertation] Novosibirsk; 2001. (In Russ).]

11. Самородская И.В., Болотова Е.В., Бойцов С.А. Актуальные вопросы классификации ожирения // Кардиоваскулярная терапия и профилактика. 2015. – Т. 14. – №4. – С.103-110. [Samorodskaya IV, Bolotova EV, Boytsov SA. Current issues of obesity classification. Cardiovascular Therapy and Prevention. 2015;14(4):103-110. (In Russ.)] DOI:10.15829/1728-8800-2015-4-103-110

12. Samocha-Bonet D, Dixit VD, Kahn CR, et al. Metabolically healthy and unhealthy obese – the 2013 Stock Conference report. 13th Stock Conference of the International Association of the Study of Obesity; 2013 Oct 26-27; Punta Cana, Dominican republic. Obes Rev. 2014;15(9):697-708. doi: 10.1111/obr.12199

13. Vliet-Ostaptchouk J, Nuotio ML, Slagter SN, et al. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocrine Disorders. 2014;14(9). doi: 10.1186/1472-6823-14-9.

14. Rachel P, Wildman R, Muntner P, et al. The Obese Without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering prevalence and correlates of 2 phenotypes among the US Population (NHANES 1999-2004). Archives of Internal Medicine. 2008;168(15):1617-1624. doi:10.1001/archinte.168.15.1617

15. Островская Е.В., Романцова Т.И., Роик О.В. Анализ распространенности и характеристика фенотипа метаболически здорового ожирения / Сборник тезисов VII Всероссийского конгресса эндокринологов «Достижения персонализированной медицины сегодня – результаты практического здравоохранения завтра» с форумом «Хирургия эндокринных органов: междисциплинарное сотрудничество»; Москва, 2-5 марта 2016 год. – М.: УП Принт; 2016. – С.239. [Ostrovskaya EV, Romancova TI, Roik OV. Analiz rasprostranennosti i charakteristika phenotipa metabolicheski zdorovogo ozireniya. In: Proceedings of the VII All-Russian Congress of Endocrinologists "Achievements of personalized medicine today – the results of practical healthcare tomorrow" with the forum "Surgery of endocrine organs: interdisciplinary cooperation»; Moskow, 2-5 March 2016. UP Print; 2016. P. 239. (In Russ).]

16. Buscemi S, Chiarello P, Buscemi C, et al. Characterization of metabolically healthy obese people and metabolically unhealthy normal-weight people in a general population cohort of the ABCD Study. Journal of Diabetes Research. 2017;2017(9). doi.org/10.1155/2017/9294038.

17. Orgaz Gallego M.P, Bermejo López P, TricioArmero M.A, et al. Metabolic Syndrome and its components in Spanish postmenopausal woman. Nutricion Hospitalaria. 2015;32(2):656-66. doi: 10.3305/nh.2015.32.2.9211.

18. Marchi R., Dell'Agnolo CM, Lopes TCR. Prevalence of metabolic syndrome in pre- and postmenopausal woman. Archives of Endocrinology and Metabolism. 2017;61(2):160-166. doi:10.1590/2359-3997000000253.

19. Statista.com [Internet]. The Statistics Portal. Average life expectancy in Europe for those born in 2018, by gender and region (in years) [cited 2018 March 22]. Available from: https://www.statista.com/statistics/274514/life-expectancy-in-europe.

20. gks.ru [интернет]. Федеральная служба государственной статистики [доступ от 22.03.18]. Доступ по ссылке: http://www.gks.ru/wps/wcm/connect/rosstat_main/rosstat/ru/statistics/population/demography

21. Gerald VD, James A, Hamilton. Healthy obese persons: How can they be identified and do metabolic profiles stratify risk. Current Opinion in Endocrinology. Diabetes and Obesity. 2013;20(5):369–376. doi: 10.1097/01.med.0000433058.78485.b3.

22. Hamer M, Stamatakis E. Metabolically Healthy Obesity and Risk of All-Cause and Cardiovascular Disease Mortality. The Journal of Clinical Endocrinology and Metabolism. 2012;97(70):2482-2488. doi: 10.1210/jc.2011-3475.