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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2018-02
Autores
Bermudez, Valmore
Rojas, Joselyn
Salazar, Juan
Martinez, Maria Sofia
Olivar, Luis
Calvo, Maria Jose
Mindiola, Andres
Añez, Roberto
Wilches-Duran, Sandra
Cerda, Marcos
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is published by F1000 Research Ltd
Resumen
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.
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Metabolic phenotypes, two-step cluster, Metabolically unhealthy lean, Metabolically healthy obese, Coronary risk