TY - JOUR
T1 - Metabolically healthy obesity
T2 - Misleading phrase or healthy phenotype?
AU - Tanriover, Cem
AU - Copur, Sidar
AU - Gaipov, Abduzhappar
AU - Ozlusen, Batu
AU - Akcan, Rustu E
AU - Kuwabara, Masanari
AU - Hornum, Mads
AU - Van Raalte, Daniel H
AU - Kanbay, Mehmet
N1 - Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
PY - 2023/5
Y1 - 2023/5
N2 - Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
AB - Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
KW - Body Mass Index
KW - Diabetes Mellitus, Type 2/epidemiology
KW - Diet
KW - Humans
KW - Metabolic Syndrome/epidemiology
KW - Obesity, Metabolically Benign/epidemiology
KW - Obesity/complications
KW - Phenotype
KW - Risk Factors
KW - Obesity
KW - Cardiometabolically healthy obesity
KW - GLP-1 analogs
KW - SGLT2 inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85150048473&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2023.02.025
DO - 10.1016/j.ejim.2023.02.025
M3 - Review
C2 - 36890010
VL - 111
SP - 5
EP - 20
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
ER -