Maybe you know someone in your family, a friend, or fellow worker which despite being obese seems jovial, active and in apparent good health. In the medical literature, these kinds of patients are known as “Metabolically healthy obese”.
This concept was first described in 2001 by A. Sims(1), and includes obese individuals without metabolic syndrome features and the cardiovascular risks are comparable to not obese individuals.
According to the International Diabetes Federation, one of the criteria to claim a person has metabolic syndrome is having an abdominal perimeter greater than 90 cm (35,4 in) in men plus two of the following criteria:
Up to now, people thought there was a type of obesity which did not imply cardiovascular threats such as diabetes. However, a research project carried out by a Universidad Nacional de Colombia (UNal) research group discovered this was not true. The project entitled, “Metabolically healthy obesity does not exist” the project verified that being obese is a risk in every case.
This group is headed by UNal Faculty of Medicine- Biochemistry Unite Head Dr. Jorge Eduardo Caminos and comprised of students, residents, master´s candidates and UNal professors including Dr. María Fernanda Garcés and collaborators of the National Cancer Institute such as Drs. Felipe Fierro and Alexander Carreño.
The research project analyzed clinical laboratory tests, weight, size, abdominal perimeter and body fat distribution in 30 men between 18 and 30 years of ages, distributed in two groups:
The first group was comprised of 16 individuals who did not meet the criteria for the metabolic syndrome and were deemed “metabolically healthy obese”.
In both groups, they discovered that the biochemical variables were altered in comparison to normal standards, but there were no significant differences between them.
These findings led them to conclude that health obesity does not exist, as both groups had resistance to insulin, high levels of reactive C-protein (an inflammation marker) and greater levels of visceral fat, a highly recognized factor for cardiovascular threat.
They also discovered low levels of adiponectin (a molecule released by adipose tissue) which has an inverse relationship to a cardiovascular threat. They also discovered high levels of leptin and galanin, peptides involved in energy metabolism regulation and weight control, which have been found to be altered in patients with diabetes mellitus.
The study also claims that the findings of insulin resistance, determined by the homeostatic model assessment (HOMA) insulin resistance (IR) and high levels of insulin before breakfast seem to be early markers of the disease than the alteration of other biochemical, anthropometric and clinic values. Maybe this is why the criteria for metabolic syndrome are insufficient to predict cardiovascular risk and metabolic disease.
The research project was showcased during the III Latin-American Congress on Endocrinology and VII International Course on Endocrinology, Diabetes and Metabolism, held recently in Cartagena and awarded as the best research project in the oral presentation category.
Obesity is considered as the epidemic of the twenty-first century, therefore researching its behavior allows having better tools to understand and fight it.
(1) Sims EA. Are there persons who are obese, but metabolically healthy? Metabolism. 2001; 50:1499± 150.
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