Abstract
Background
Obesity represents a global health crisis, yet a dichotomy is emerging with classification according to the metabolic state into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). This study aimed to identify distinctive systemic clinical/endocrinological parameters between MHO individuals, employing a comprehensive comparative analysis of 50 biomarkers. Our emphasis was on routine analytes, ensuring cost-effectiveness for widespread use in diagnosing metabolic health.
Subjects/methods
The study included 182 women diagnosed with obesity referred for bariatric surgery at the Endocrinology, Diabetes, and Metabolism Service of São João Hospital and University Centre in Portugal. MUO was defined by the presence of at least one of the following metabolic disorders: diabetes, hypertension, or dyslipidemia. Patients were stratified based on the diagnosis of these pathologies.
Results
Significantly divergent health-related parameters were observed between MHO and MUO patients. Notable differences included: albumin (40.1 ± 2.2 vs 40,98 ± 2.6 g/L, p value = 0.017), triglycerides (110.7 ± 51.1 vs 137.57 ± 82.6 mg/dL, p value = 0.008), glucose (99.49 ± 13.0 vs 119.17 ± 38.9 mg/dL, p value < 0.001), glycated hemoglobin (5.58 ± 0.4 vs 6.15 ± 1.0%, p value < 0.001), urea (31.40 ± 10.0 vs 34.61 ± 10.2 mg/dL, p value = 0.014), total calcium (4.64 ± 0.15 vs 4.74 ± 0.17 mEq/L, 1 mEq/L = 1 mg/L, p value < 0.001), ferritin (100.04 ± 129.1 vs 128.55 ± 102.1 ng/mL, p value = 0.005), chloride (104.68 ± 1.5 vs 103.04 ± 2.6 mEq/L, p value < 0.001), prolactin (13.57 ± 6.3 vs 12.47 ± 7.1 ng/mL, p value = 0.041), insulin (20.36 ± 24.4 vs 23.87 ± 19.6 μU/mL, p value = 0.021), c peptide (3.78 ± 1.8 vs 4.28 ± 1.7 ng/mL, p value = 0.003), albumin/creatinine ratio (15.41 ± 31.0 vs 48.12 ± 158.7 mg/g creatinine, p value = 0.015), and whole-body mineral density (1.27 ± 0.1 vs 1.23 ± 0.1 g/cm2, p value = 0.016).
Conclusions
Our findings highlight potential additional parameters that should be taken into consideration alongside the commonly used biomarkers for classifying metabolic health in women. These include albumin, urea, total calcium, ferritin, chloride, prolactin, c-peptide, albumin-creatinine ratio, and whole-body mineral density. Moreover, our results also suggest that MHO may represent a transitional phase preceding the development of the MUO phenotype.
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Data availability
The datasets generated during and/or analysed during the current study are not publicly available due to privacy or ethical restrictions.
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Acknowledgements
The authors would like to acknowledge the patients enrolled in this study. Carla Luís acknowledges FCT—Fundação para a Ciência e Tecnologia by a doctoral scholarship (SFRH/BD/146489/2019).
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Conceptualization: FM, CL; methodology: FM, CL; validation: RF, RS, ELC; formal analysis: FM, CL; resources and methodology: PS, TM, PF, IR, DF, JP, AV, AR; supervision: PF, RF, RS, ELC; Writing—original draft preparation: CL; writing—review, editing, and validation: FM; PS, TM, PF, IR, DF, JP, AV, AR, RF, RS, ELC, CL. All authors have read and agreed to the published version of the manuscript.
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Mendonça, F., Soares, P., Moreno, T. et al. Distinguishing health-related parameters between metabolically healthy and metabolically unhealthy obesity in women. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01519-1
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DOI: https://doi.org/10.1038/s41366-024-01519-1