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Identifying Metabolically Healthy but Obese Individuals in Sedentary Postmenopausal Women
Authors:Virginie Messier  Antony D Karelis  Denis Prud'homme  Vanessa Primeau  Martin Brochu  Rémi Rabasa‐Lhoret
Institution:1. Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada;2. Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada;3. Department of Kinanthropology, Université du Québec à Montréal, Montreal, Quebec, Canada;4. School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada;5. Endocrinology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada;6. Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada;7. Research Centre on Aging, Social Services and Health Centre–University Institute of Geriatrics of Sherbrooke, Sherbrooke, Quebec, Canada;8. Montreal Diabetes Research Centre, Montreal, Quebec, Canada
Abstract:The purpose of this study was to compare different methods to identify metabolically healthy but obese (MHO) individuals in a cohort of obese postmenopausal women. We examined the anthropometric and metabolic characteristics of 113 obese (age: 57.3 ± 4.8 years; BMI: 34.2 ± 2.7 kg/m2), sedentary postmenopausal women. The following methods were used to identify MHO subjects: the hyperinsulinemic–euglycemic clamp (MHO: upper quartile of glucose disposal rates); the Matsuda index (MHO: upper quartile of the Matsuda index); the homeostasis model assessment (HOMA) index (MHO: lower quartile of the HOMA index); having 0–1 cardiometabolic abnormalities (systolic/diastolic blood pressure ≥130/85 mm Hg, triglycerides (TG) ≥1.7 mmol/l, glucose ≥5.6 mmol/l, HOMA >5.13, high‐sensitive C‐reactive protein (hsCRP) >0.1 mg/l, high‐density lipoprotein‐cholesterol (HDL‐C) <1.3 mmol/l); and meeting four out of five metabolic factors (HOMA ≤2.7, TG ≤1.7 mmol/l, HDL‐C ≥1.3 mmol/l, low‐density lipoprotein‐cholesterol ≤2.6 mmol/l, hsCRP ≤3.0 mg/l). Thereafter, we measured insulin sensitivity, body composition (dual‐energy X‐ray absorptiometry), body fat distribution (computed tomography scan), energy expenditure, plasma lipids, inflammation markers, resting blood pressure, and cardiorespiratory fitness. We found significant differences in body composition (i.e., peripheral fat mass, central lean body mass (LBM)) and metabolic risk factors (i.e., HDL‐C, hsCRP) between MHO and at risk individuals using the different methods to identify both groups. In addition, significant differences between MHO subjects using the different methods to identify MHO individuals were observed such as age, TG/HDL, hsCRP, and fasting insulin. However, independently of the methods used, we noted some recurrent characteristics that identify MHO subjects such as TG, apolipoprotein B, and ferritin. In conclusion, the present study shows variations in body composition and metabolic profile based on the methods studied to define the MHO phenotype. Therefore, an expert consensus may be needed to standardize the identification of MHO individuals.
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