Epidemiología, mecanismos y consecuencias clínicas | 14 OCT 13

Obesidad metabólicamente sana

Cierta proporción de personas obesas podría no sufrir las complicaciones metabólicas de la obesidad y su fenotipo es el de obesidad metabólicamente sana.
Autor: Dres. Norbert Stefan, Hans-Ulrich Häring, Frank B Hu, Matthias B Schulze Lancet Diabetes Endocrinol 2013; 1: 152–62.
INDICE:  1.  | 2. Referencias

1 Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011;377: 557–67.
2 Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med 2004; 351: 2694–703.
3 Malik VS, Willett WC, Hu FB. Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol 2013; 9: 13–27.
4 Pischon T, Boeing H, Hoff mann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008; 359: 2105–20.
5 McLaughlin T, Abbasi F, Lamendola C, Reaven G. Heterogeneity in the prevalence of risk factors for cardiovascular disease and type 2 diabetes mellitus in obese individuals: effect of differences in insulin sensitivity. Arch Intern Med 2007; 167: 642–48.
6 Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 2006; 91: 2906–12.
7 Stefan N, Kantartzis K, Machann J, Schick F, Haring HU. Global trends in body-mass index. Lancet 2011; 377: 1917.
8 Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med 2008; 168: 1609–16.
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: 1617–24.
10 Wormser D, Kaptoge S, Di Angelantonio E, et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 2011; 377: 1085–95.
11 Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 2004; 89: 2569–75.
12 Reaven G. All obese individuals are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals. Diab Vasc Dis Res 2005; 2: 105–12.
13 Sims EA. Are there persons who are obese, but metabolically healthy? Metabolism 2001; 50: 1499–504.
14 Odegaard JI, Chawla A. Pleiotropic actions of insulin resistance and infl ammation in metabolic homeostasis. Science 2013; 339: 172–77.
15 Saltiel AR, Kahn CR. Insulin signalling and the regulation of glucose and lipid metabolism. Nature 2001; 414: 799–806.
16 Leitzmann MF, Moore SC, Koster A, et al. Waist circumference as compared with body-mass index in predicting mortality from specifi c causes. PLoS One 2011; 6: e18582.
17 Kantartzis K, Thamer C, Peter A, et al. High cardiorespiratory fi tness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease. Gut 2009; 58: 1281–88.
18 Kuk JL, Ardern CI. Are metabolically normal but obese individuals at lower risk for all-cause mortality? Diabetes Care 2009; 32: 2297–99.
19 Arnlov J, Ingelsson E, Sundstrom J, Lind L. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation 2010; 121: 230–36.
20 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: 210–15.
21 Bo S, Musso G, Gambino R, et al. Prognostic implications for insulinsensitive and insulin-resistant normal-weight and obese individuals from a population-based cohort. Am J Clin Nutr 2012; 96: 962–69.
22 Durward CM, Hartman TJ, Nickols-Richardson SM. All-cause mortality risk of metabolically healthy obese individuals in NHANES III. J Obes 2012; 2012: 460321.
23 Hinnouho GM, Czernichow S, Dugravot A, Batty GD, Kivimaki M, Singh-Manoux A. Metabolically healthy obesity and risk of mortality: does the defi nition of metabolic health matter? Diabetes Care 2013; published online May 1. DOI:10.2337/dc12-1654.
24 Wei M, Kampert JB, Barlow CE, et al. Relationship between low cardiorespiratory fi tness and mortality in normal-weight, overweight, and obese men. JAMA 1999; 282: 1547–53.
25 Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol 2002; 156: 832–41.
26 Sui X, LaMonte MJ, Laditka JN, et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA 2007; 298: 2507–16.
27 Farrell SW, Fitzgerald SJ, McAuley PA, Barlow CE. Cardiorespiratory fitness, adiposity, and all-cause mortality in women. Med Sci Sports Exerc 2010; 42: 2006–12.
28 McAuley PA, Kokkinos PF, Oliveira RB, Emerson BT, Myers JN. Obesity paradox and cardiorespiratory fi tness in 12,417 male veterans aged 40 to 70 years. Mayo Clin Proc 2010; 85: 115–21.
29 Ortega FB, Lee DC, Katzmarzyk PT, et al. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fi tness. Eur Heart J 2013; 34: 389–97.
30 Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women‘s Ischemia Syndrome Evaluation (WISE) study. Circulation 2004; 109: 706–13.
31 Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J Clin Endocrinol Metab 2012; 97: 2482–88.
32 Choi KM, Cho HJ, Choi HY, et al. Higher mortality in metabolically obese normal weight people than in metabolically healthy obese subjects in elderly Koreans. Clin Endocrinol (Oxf) 2013; published online Jan 18. DOI: 10.1111/cen.12154.
33 Stefan N, Fritsche A, Haring HU. Letter by Stefan et al regarding article, “Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men”. Circulation 2010; 122: e456.
34 Appleton SL, Seaborn CJ, Visvanathan R, et al. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes Care 2013; published online Mar 14. DOI:10.2337/dc12-1971.
35 Kim JY, van de Wall E, Laplante M, et al. Obesity-associated improvements in metabolic profi le through expansion of adipose tissue. J Clin Invest 2007; 117: 2621–37.
36 Garg A. Lipodystrophies: genetic and acquired body fat disorders. J Clin Endocrinol Metab 2011; 96: 3313–25.
37 Kusminski CM, Holland WL, Sun K, et al. MitoNEET-driven alterations in adipocyte mitochondrial activity reveal a crucial adaptive process that preserves insulin sensitivity in obesity. Nat Med 2012; 18: 1539–49.
38 Herman MA, Peroni OD, Villoria J, et al. A novel ChREBP isoform in adipose tissue regulates systemic glucose metabolism. Nature 2012; 484: 333–38.
39 Denis GV, Obin MS. ‘Metabolically healthy obesity’: origins and implications. Mol Aspects Med 2013; 34: 59–70.
40 Kloting N, Fasshauer M, Dietrich A, et al. Insulin-sensitive obesity. Am J Physiol Endocrinol Metab 2010; 299: E506–15.
41 Fabbrini E, Magkos F, Mohammed BS, et al. Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity. Proc Natl Acad Sci USA 2009; 106: 15430–35.
42 Kantartzis K, Machann J, Schick F, Fritsche A, Haring HU, Stefan N. The impact of liver fat vs visceral fat in determining categories of prediabetes. Diabetologia 2010; 53: 882–89.
43 Tiikkainen M, Bergholm R, Vehkavaara S, et al. Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content. Diabetes 2003; 52: 701–07.
44 D’Adamo E, Cali AM, Weiss R, et al. Central role of fatty liver in the pathogenesis of insulin resistance in obese adolescents. Diabetes Care 2010; 33: 1817–22.
45 Liu J, Musani SK, Bidulescu A, et al. Fatty liver, abdominal adipose tissue and atherosclerotic calcifi cation in African Americans: the Jackson Heart Study. Atherosclerosis 2012; 224: 521–25.
46 Sung KC, Jeong WS, Wild SH, Byrne CD. Combined infl uence of insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes. Diabetes Care 2012; 35: 717–22.
47 Shibata M, Kihara Y, Taguchi M, Tashiro M, Otsuki M. Nonalcoholic fatty liver disease is a risk factor for type 2 diabetes in middle-aged Japanese men. Diabetes Care 2007; 30: 2940–44.
48 Kim CH, Park JY, Lee KU, Kim JH, Kim HK. Fatty liver is an independent risk factor for the development of Type 2 diabetes in Korean adults. Diabet Med 2008; 25: 476–81.
49 Bae JC, Rhee EJ, Lee WY, et al. Combined effect of nonalcoholic fatty liver disease and impaired fasting glucose on the development of type 2 diabetes: a 4-year retrospective longitudinal study. Diabetes Care 2011; 34: 727–29.
50 Sung KC, Kim SH. Interrelationship between fatty liver and insulin resistance in the development of type 2 diabetes. J Clin Endocrinol Metab 2011; 96: 1093–97.
51 Stefan N, Haring HU. The metabolically benign and malignant fatty liver. Diabetes 2011; 60: 2011–17.
52 Stefan N, Haring HU. The role of hepatokines in metabolism. Nat Rev Endocrinol 2013; 9: 144–52.
53 Pal D, Dasgupta S, Kundu R, et al. Fetuin-A acts as an endogenous ligand of TLR4 to promote lipid-induced insulin resistance. Nat Med 2012; published online July 29. DOI:10.1038/nm.2851.
54 Stefan N, Haring HU. Circulating fetuin-A and free fatty acids interact to predict insulin resistance in humans. Nat Med 2013; 19: 394–95.
55 Stefan N, Machicao F, Staiger H, et al. Polymorphisms in the gene encoding adiponectin receptor 1 are associated with insulin resistance and high liver fat. Diabetologia 2005; 48: 2282–91.
56 Doumatey AP, Bentley AR, Zhou J, Huang H, Adeyemo A, Rotimi CN. Paradoxical Hyperadiponectinemia is Associated With the Metabolically Healthy Obese (MHO) Phenotype in African Americans. J Endocrinol Metab 2012; 2: 51–65.
57 Cariou B, Charbonnel B, Staels B. Thiazolidinediones and PPARgamma agonists: time for a reassessment. Trends Endocrinol Metab 2012; 23: 205–15.
58 Lincoff AM, Wolski K, Nicholls SJ, Nissen SE. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA 2007; 298: 1180–88.
59 Karelis AD, Messier V, Brochu M, Rabasa-Lhoret R. Metabolically healthy but obese women: eff ect of an energy-restricted diet. Diabetologia 2008; 51: 1752–54.
60 Kantartzis K, Machann J, Schick F, et al. Effects of a lifestyle intervention in metabolically benign and malign obesity. Diabetologia 2011; 54: 864–68.
61 Janiszewski PM, Ross R. Eff ects of weight loss among metabolically healthy obese men and women. Diabetes Care 2010; 33: 1957–59.
62 Lempiainen P, Mykkanen L, Pyorala K, Laakso M, Kuusisto J. Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 1999; 100: 123–28.
63 Adams TD, Davidson LE, Litwin SE, et al. Health benefi ts of gastric bypass surgery after 6 years. JAMA 2012; 308: 1122–31.
64 Eckel RH. Clinical practice. Nonsurgical management of obesity in adults. N Engl J Med 2008; 358: 1941–50.
65 Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012; 307: 56–65.
66 Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial: a prospective controlled intervention study of bariatric surgery. J Intern Med 2013; 273: 219–34.
67 Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741–52.
68 Sjostrom L, Gummesson A, Sjostrom CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 2009; 10: 653–62.
69 Livingston EH. Inadequacy of BMI as an indicator for bariatric surgery. JAMA 2012; 307: 88–89.
70 NHLBI Obesity Education Initiative Expert Panel on the Identifi cation, Evaluation, and Treatment of Obesity in Adults (US). Executive summary of the clinical guidelines on the identifi cation, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998; 158: 1855–67.
71 Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368: 1279–90.
72 Weintraub WS, Daniels SR, Burke LE, et al. Value of primordial and primary prevention for cardiovascular disease: a policy statement from the American Heart Association. Circulation 2011; 124: 967–90.
73 Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient–2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery. Obesity (Silver Spring) 2013; 21 (suppl 1): S1–S27.
74 Despres JP. What is “metabolically healthy obesity”?: from epidemiology to pathophysiological insights. J Clin Endocrinol Metab 2012; 97: 2283–85.



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