Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]

Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called “healthy obese”. Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective...

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Autores:: Bermudez, Valmore
Rojas, Joselyn
Salazar, Juan
Martinez, Maria Sofia
Olivar, Luis
Calvo, Maria Jose
Mindiola, Andres
Añez, Roberto
Wilches-Duran, Sandra
Cerda, Marcos
Graterol, Modesto
Graterol, Rosemily
Hernandez, Juan Diego
Garicano, Carlos
Velasco, Manuel

Tipo de recurso:

Fecha de publicación:: 2018

Institución:: Universidad Simón Bolívar

Repositorio:: Repositorio Digital USB

Idioma:: eng

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dc.title.eng.fl_str_mv	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
title	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
spellingShingle	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review] Metabolic phenotypes two-step cluster Metabolically unhealthy lean Metabolically healthy obese Coronary risk
title_short	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
title_full	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
title_fullStr	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
title_full_unstemmed	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
title_sort	Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]
dc.creator.fl_str_mv	Bermudez, Valmore Rojas, Joselyn Salazar, Juan Martinez, Maria Sofia Olivar, Luis Calvo, Maria Jose Mindiola, Andres Añez, Roberto Wilches-Duran, Sandra Cerda, Marcos Graterol, Modesto Graterol, Rosemily Hernandez, Juan Diego Garicano, Carlos Velasco, Manuel
dc.contributor.author.none.fl_str_mv	Bermudez, Valmore Rojas, Joselyn Salazar, Juan Martinez, Maria Sofia Olivar, Luis Calvo, Maria Jose Mindiola, Andres Añez, Roberto Wilches-Duran, Sandra Cerda, Marcos Graterol, Modesto Graterol, Rosemily Hernandez, Juan Diego Garicano, Carlos Velasco, Manuel
dc.subject.eng.fl_str_mv	Metabolic phenotypes two-step cluster Metabolically unhealthy lean Metabolically healthy obese Coronary risk
topic	Metabolic phenotypes two-step cluster Metabolically unhealthy lean Metabolically healthy obese Coronary risk
description	Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called “healthy obese”. Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional study with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 5.2% (n=64) corresponded to unhealthy lean subjects, and 17.4% (n=217) to healthy obese subjects. Metabolically unhealthy normal-weight (MUNW) phenotype was found in males in 53.3% in contrast to 51.3% of metabolically unhealthy obese (MUO) phenotype found in females. An association between metabolically unhealthy phenotypes and a higher risk of a coronary event was found, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes exist in Maracaibo city. Related factors may include insulin resistance, basal glucose levels, and triglycerides levels. Lastly, cardiovascular risk exhibited by healthy obese individuals should be classified in categories of major coronary risk related to lean subjects.
publishDate	2018
dc.date.accessioned.none.fl_str_mv	2018-07-12T20:15:19Z
dc.date.available.none.fl_str_mv	2018-07-12T20:15:19Z
dc.date.issued.none.fl_str_mv	2018-02
dc.type.eng.fl_str_mv	article
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_6501
dc.identifier.issn.none.fl_str_mv	20461402
dc.identifier.uri.none.fl_str_mv	http://hdl.handle.net/20.500.12442/2176
identifier_str_mv	20461402
url	http://hdl.handle.net/20.500.12442/2176
dc.language.iso.eng.fl_str_mv	eng
language	eng
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional
rights_invalid_str_mv	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional http://purl.org/coar/access_right/c_abf2
dc.publisher.eng.fl_str_mv	is published by F1000 Research Ltd
dc.source.eng.fl_str_mv	F1000Research
dc.source.spa.fl_str_mv	Vol. 7, No.230 (2018)
institution	Universidad Simón Bolívar
dc.source.uri.eng.fl_str_mv	https://f1000research.com/articles/7-230/v1
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spelling	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacionalhttp://purl.org/coar/access_right/c_abf2Bermudez, Valmore6bcbb12f-5c0b-46ea-9a9a-e059644f7f4e-1Rojas, Joselyn2aa91570-0516-424d-8f76-25cd7b39be6e-1Salazar, Juanfbd053e7-5aea-424c-812f-92153ecb9181-1Martinez, Maria Sofia52450980-3f16-45c1-a053-8fad95d099c5-1Olivar, Luisf2fa2efd-f10f-4f8f-a731-c59a2c25964f-1Calvo, Maria Jose3eaa6575-9a65-486a-a367-98b35285534b-1Mindiola, Andres0205aea7-c0e9-4303-b053-6cc043914928-1Añez, Roberto0a8ecfdc-a89a-4435-9859-b66bba8947fa-1Wilches-Duran, Sandraf963f966-11ac-406d-bc8c-f80ae093f13f-1Cerda, Marcosf544118b-7bb4-4bf7-b8e8-fb4d2017eaf5-1Graterol, Modesto59713475-4607-4bff-90c1-a66ad9f0a173-1Graterol, Rosemily9e55a756-71ff-4945-99cf-ab0ecd38182f-1Hernandez, Juan Diego448c2d02-87fd-4311-916d-a1b7b75c519f-1Garicano, Carlos96ac943f-0dd6-4a77-a76d-9c0024646fe5-1Velasco, Manuel688b8ff6-51ce-4b65-b359-29f1098a0d1d-12018-07-12T20:15:19Z2018-07-12T20:15:19Z2018-0220461402http://hdl.handle.net/20.500.12442/2176Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called “healthy obese”. Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional study with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 5.2% (n=64) corresponded to unhealthy lean subjects, and 17.4% (n=217) to healthy obese subjects. Metabolically unhealthy normal-weight (MUNW) phenotype was found in males in 53.3% in contrast to 51.3% of metabolically unhealthy obese (MUO) phenotype found in females. An association between metabolically unhealthy phenotypes and a higher risk of a coronary event was found, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes exist in Maracaibo city. Related factors may include insulin resistance, basal glucose levels, and triglycerides levels. Lastly, cardiovascular risk exhibited by healthy obese individuals should be classified in categories of major coronary risk related to lean subjects.engis published by F1000 Research LtdF1000ResearchVol. 7, No.230 (2018)https://f1000research.com/articles/7-230/v1Metabolic phenotypestwo-step clusterMetabolically unhealthy leanMetabolically healthy obeseCoronary riskBiochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]articlehttp://purl.org/coar/resource_type/c_6501World Health Organization (WHO): Obesity and overweight: Fact Sheet. 2016; [cited 2017 Mar 20].Center for Disease Control and Prevention (CDC): Adult Obesity Causes & Consequences \| Overweight & Obesity. 2016; [cited 2017 Mar 20].Andres R: Effect of obesity on total mortality. Int J Obes. 1980; 4(4): 381–6.Ferrannini E, Natali A, Bell P, et al.: Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR). J Clin Invest. 1997; 100(5): 1166–73.Bernstein RS, Grant N, Kipnis DM: Hyperinsulinemia and enlarged adipocytes in patients with endogenous hyperlipoproteinemia without obesity or diabetes mellitus. Diabetes. 1975; 24(2): 207–13.Ruderman NB, Schneider SH, Berchtold P: The “metabolically-obese,” normalweight individual. Am J Clin Nutr. 1981; 34(8): 1617–21.Shaharyar S, Roberson LL, Jamal O, et al.: Obesity and metabolic phenotypes (metabolically healthy and unhealthy variants) are significantly associated with prevalence of elevated C-reactive protein and hepatic steatosis in a large healthy Brazilian population. J Obes. 2015; 2015: 178526.Bermúdez V, Marcano RP, Cano C, et al.: The Maracaibo city metabolic syndrome prevalence study: design and scope. 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Diabetes Care. 2010; 33(4): 920–2.Alberti KG, Eckel RH, Grundy SM, et al.: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120(16): 1640–5.Bermúdez V, Salazar J, Bello L, et al.: Coronary Risk Estimation According to a Recalibrated Framingham-Wilson Score in the Maracaibo City Metabolic Syndrome Prevalence Study. J Cardiol Photon. 2014; 107: 160–8.World Health Organization (WHO): Global action plan for the prevention and control of NCDs 2013–2020. 2013; [cited 2017 Nov 20].Hubert HB, Feinleib M, McNamara PM, et al.: Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983; 67(5): 968–77.Brochu M, Tchernof A, Dionne IJ, et al.: What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab. 2001; 86(3): 1020–5.Stefan N, Kantartzis K, Machann J, et al.: Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. 2008; 168(15): 1609–16.Aguilar-Salinas CA, García EG, Robles L, et al.: High adiponectin concentrations are associated with the metabolically healthy obese phenotype. J Clin Endocrinol Metab. 2008; 93(10): 4075–9.Martínez-Larrad MT, Corbatón Anchuelo A, Del Prado N, et al.: Profile of individuals who are metabolically healthy obese using different definition criteria. A population-based analysis in the spanish population. PLoS One. 2014; 9(9): e106641.Lee K: Metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) phenotypes in Koreans: characteristics and health behaviors. Asia Pac J Clin Nutr. 2009; 18(2): 280–4.Zheng R, Yang M, Bao Y, et al.: Prevalence and Determinants of Metabolic Health in Subjects with Obesity in Chinese Population. Int J Environ Res Public Health. 2015; 12(11): 13662–77.Calori G, Lattuada G, Piemonti L, et al.: Prevalence, metabolic features, and prognosis of metabolically healthy obese Italian individuals: the Cremona Study. Diabetes Care. 2011; 34(1): 210–5.Lopez-Garcia E, Guallar-Castillon P, Leon-Muñoz L, et al.: Prevalence and determinants of metabolically healthy obesity in Spain. Atherosclerosis. 2013; 231(1): 152–7.Hamer M, Bell JA, Sabia S, et al.: Stability of metabolically healthy obesity over 8 years: the English Longitudinal Study of Ageing. Eur J Endocrinol. 2015; 173(5): 703–8.Kuk JL, Ardern CI: Are metabolically normal but obese individuals at lower risk for all-cause mortality? Diabetes Care. 2009; 32(12): 2297–9.Wildman RP, Muntner P, Reynolds K, 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). Arch Intern Med. 2008; 168(15): 1617–24.Fanghänel-Salmón G, Gutiérrez-Salmeán G, Samaniego V, et al.: Obesity Phenotypes In Urban Middle-Class Cohorts; The Prit-Lindavista Merging Evidence In Mexico: The Opus Prime Study. Nutr Hosp. 2015; 32(1): 182–8.Bo S, Musso G, Gambino R, et al.: Prognostic implications for insulin-sensitive and insulin-resistant normal-weight and obese individuals from a populationbased cohort. Am J Clin Nutr. 2012; 96(5): 962–9.Hinnouho GM, Czernichow S, Dugravot A, et al.: Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. Eur Heart J. 2015; 36(9): 551–9.Yoo HK, Choi EY, Park EW, et al.: Comparison of Metabolic Characteristics of Metabolically Healthy but Obese (MHO) Middle-Aged Men According to Different Criteria. Korean J Fam Med. 2013; 34(1): 19–26.Schmiegelow MD, Hedlin H, Mackey RH, et al.: Race and ethnicity, obesity, metabolic health, and risk of cardiovascular disease in postmenopausal women. J Am Heart Assoc. 2015; 4(5): pii:e001695.Yang HK, Han K, Kwon HS, et al.: Obesity, metabolic health, and mortality in adults: a nationwide population-based study in Korea. Sci Rep. 2016; 6(6): 30329.Diniz Mde F, Beleigoli AM, Ribeiro AL, et al.: Factors associated with metabolically healthy status in obesity, overweight, and normal weight at baseline of ELSA-Brasil. Medicine (Baltimore). 2016; 95(27): e4010.Ortega FB, Lee DC, Katzmarzyk PT, et al.: The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013; 34(5): 389–97.Romero-Corral A, Somers VK, Sierra-Johnson J, et al.: Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010; 31(6): 737–46.Madeira FB, Silva AA, Veloso HF, et al.: Normal weight obesity is associated with metabolic syndrome and insulin resistance in young adults from a middle-income country. PLoS One. 2013; 8(3): e60673.Succurro E, Marini MA, Frontoni S, et al.: Insulin secretion in metabolically obese, but normal weight, and in metabolically healthy but obese individuals. Obes (Silver Spring). 2008; 16(8): 1881–6.Ogorodnikova AD, Kim M, McGinn AP, et al.: Incident cardiovascular disease events in metabolically benign obese individuals. Obes (Silver Spring). 2012; 20(3): 651–9.Hansen L, Netterstrøm MK, Johansen NB, et al.: Metabolically Healthy Obesity and Ischemic Heart Disease: A 10-Year Follow-Up of the Inter99 Study. J Clin Endocrinol Metab. 2017; 102(6): 1934–1942.Kim NH, Seo JA, Cho H, et al.: Risk of the Development of Diabetes and Cardiovascular Disease in Metabolically Healthy Obese People: The Korean Genome and Epidemiology Study. Medicine (Baltimore). 2016; 95(15): e3384.Durward CM, Hartman TJ, Nickols-Richardson SM: All-cause mortality risk of metabolically healthy obese individuals in NHANES III. J Obes. 2012; 2012: 460321.Shaharyar S, Roberson LL, Jamal O, et al.: Obesity and metabolic phenotypes (metabolically healthy and unhealthy variants) are significantly associated with prevalence of elevated C-reactive protein and hepatic steatosis in a large healthy Brazilian population. J Obes. 2015; 2015: 178526.Khan UI, Wang D, Thurston RC, et al.: Burden of subclinical cardiovascular disease in “metabolically benign” and “at-risk” overweight and obese women: the Study of Women’s Health Across the Nation (SWAN). Atherosclerosis. 2011; 217(1): 179–86.Bermudez V, Rojas J, Salazar J, et al.: Dataset 1 in: Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela. 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Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 1; referees: awaiting peer review]

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