The metabolically healthy but obese individual presents a favorable inflammation profile
Abstract
OBJECTIVE: The purpose of this study was to investigate the inflammatory state in obese women displaying the "metabolically healthy but obese" (MHO) phenotype. DESIGN: We examined the metabolic characteristics of 88 obese, sedentary postmenopausal women. Subjects were classified as MHO or as "at risk" based on the upper and lower quartiles of insulin sensitivity as measured by the hyperinsulinemic-euglycemic clamp technique. Thereafter, we determined 1) body composition, 2) body fat distribution, 3) plasma lipid and lipoprotein levels, 4) glucose homeostasis, 5) resting blood pressure, 6) peak oxygen consumption, and 7) inflammation markers as potential modulators of differences in the coronary risk profile. RESULTS: Twenty-two MHO women displayed high insulin sensitivity (15.35 +/- 2.3 mg/min.kg fat-free mass), and 22 at risk subjects with low insulin sensitivity (7.98 +/- 1.4 mg/min.kg fat-free mass) were identified. Despite comparable total body fatness between groups (47.7 +/- 4.8 vs. 45.5 +/- 4.4%; not significant), MHO individuals had significantly lower levels of visceral fat, fasting insulin, plasma triglycerides, high-sensitivity C-reactive protein (CRP), and alpha-1 antitrypsin levels and higher levels of high-density lipoprotein cholesterol than at risk individuals (P < 0.05). Stepwise regression analysis showed that CRP, fasting triglycerides, and the lean body mass index explained 19.5, 8.5, and 4.0%, respectively, of the variance observed in glucose disposal (total r(2) = 0.320; P < 0.001). CONCLUSION: Results of the present study indicate that postmenopausal women displaying the MHO phenotype also have a favorable inflammation profile as shown by lower CRP and alpha-1 antitrypsin levels compared with insulin-resistant women. This suggests that a lower inflammation state, as attested by low CRP levels, could play a role in the protective profile of the MHO individual, and this may be associated metabolically to a lower risk for cardiovascular disease.
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There is a correlation between a beneficial phenotype for metabolic outcomes and subcutaneous fat accumulation, whereas visceral fat accumulation, including omental adipocyte hypertrophy, leads to a decline in metabolic health.
“Demographics ranging between men, women, and postmenopausal women show that there is a correlation between a beneficial phenotype for metabolic outcomes and subcutaneous fat accumulation, whereas visceral fat accumulation, including omental adipocyte hypertrophy, leads to a decline in metabolic health (20–25).”
From Metabolic impact of endogenously produced estrogens by adipose tissue in females and males across the lifespan (2025) · cites this paper as [21]
The Results report less visceral fat in metabolically healthy obese women than in at-risk women, supporting an association in obese postmenopausal women. They also report no significant difference in superficial or deep subcutaneous fat. This study does not establish that visceral fat causes declining metabolic health, measure omental adipocyte hypertrophy, or extend its findings to men. (LLM, conf=0.88)
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Self-citation
- Authors
- Karelis, A. D., Faraj, M., Bastard, J.-P., St-Pierre, D. H., Brochu, M., Prud’homme, D., & Rabasa-Lhoret, R.
- Affiliations
- Université de Montréal (CA)
- Inserm (FR)
- Université de Sherbrooke (CA)
- University of Ottawa (CA)
- Corresponding author
- Karelis, Antony D.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-07
- Volume
- 90
- Issue
- 7
- Pages
- 4145-4150
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2115195372
- Cited by
- 579
- References
- 33
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 14 · 2023: 18 · 2022: 26 · 2021: 29 · 2020: 27 · 2019: 33 · 2018: 35 · 2017: 31 · 2016: 35 · 2015: 33 · 2014: 62 · 2013: 49 · 2012: 34
- FWCI
- 9.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- obesity, inflammation, C-reactive protein, alpha-1-antitrypsin, insulin sensitivity, insulin resistance, postmenopausal women, visceral fat, body composition, lipoproteins, triglycerides, glucose disposal, cardiovascular risk, coronary artery disease
- MeSH terms
- Adult, Aged, alpha 1-Antitrypsin, Body Composition, C-Reactive Protein, Cardiovascular Diseases, Female, Humans, Middle Aged, Obesity, Regression Analysis, Postmenopause
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