Cited by 243Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietAdipokines, Inflammation, and Metabolic Diseases

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Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women.

Dvorak, R V, DeNino, W F, Ades, P A, Poehlman, E T·1999·Diabetes

DOI 10.2337/diabetes.48.11.2210

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Abstract

Metabolically obese, normal-weight (MONW) individuals are a hypothesized subgroup of the general population. These normal-weight individuals potentially display a cluster of obesity-related features, although this has not been systematically tested in young women. We hypothesized that MONW young women would display higher levels of total and visceral fat and lower levels of physical activity than normal women. In a cohort of 71 healthy nonobese women (21-35 years old), we identified MONW women based on cut points for insulin sensitivity (normal = glucose disposal >8 mg x min(-1) x kg(-1) of fat-free mass [FFM], n = 58; impaired = glucose disposal <8 ml x min(-1) x kg(-1) of FFM, n = 13). Thereafter, we measured body composition (dual energy X-ray absorptiometry) and body fat distribution (computed tomography), cardiorespiratory fitness (VO2max on a treadmill), physical activity energy expenditure (doubly labeled water and indirect calorimetry), glucose tolerance (oral glucose tolerance test), serum lipid profile, and dietary intake. We found a higher body fat percentage (32 +/- 6 vs. 27 +/- 6%, P = 0.01) and higher subcutaneous (213 +/- 61 vs. 160 +/- 78 cm2, P = 0.03) and visceral (44 +/- 16 vs. 35 +/- 14 cm2, P < 0.05) abdominal adiposity in the MONW group versus the normal group. The MONW group showed a lower physical activity energy expenditure (2.66 +/- 0.92 vs. 4.39 +/- 1.50 MJ/day, P = 0.01), but no difference in cardiorespiratory fitness was noted between groups. In conclusion, despite a normal body weight, a subset of young, apparently healthy women displayed a cluster of risky phenotypic characteristics that, if left untreated, may eventually predispose them to type 2 diabetes and cardiovascular disease.

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“Our findings add to the existing strong evidence that central adiposity is a prominent body composition factor, which is associated with ‘‘metabolically obese’’ phenotypes, irrespective of BMI (4-6,12,34).”
BackgroundResult
Insulin Resistance in Type 2 Diabetes: Association with Truncal Obesity, Impaired Fitness, and Atypical Malonyl Coenzyme A Regulation
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“(32) recently reported that young normalweight and insulin-resistant women have increased total and visceral fat, compared with control women of similar weight and BMI but normal insulin sensitivity.”
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“The aim of this study was to explore the association amongMHO, MUNW, and markers of subclinical CVD burden as assessed by high sensitivity C-reactive protein (CRP) and hepatic steatosis (HS) in individuals without overt CVD.”
Influential
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“[6] reported that MONW women had a similar proportion of fat-free mass, but had a higher proportion of total fat mass and body fat percentage compared to metabolically healthy, normal weight (MHNW) women.”
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Background
Prognostic implications for insulin-sensitive and insulin-resistant normal-weight and obese individuals from a population-based cohort
Bo, S., Musso, G., Gambino, R., Villois, P., Gentile, L., Durazzo, M., Cavallo‐Perin, P., & Cassader, M. (2012) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.040006 · Cited by 52
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Background
Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight
Agius, R., Pace, N. P., & Fava, S. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3725 · Cited by 64
“14,22,30,51,52 Again, the use of consensus criteria to define MH should help to remove definition ‐ related variability.”
Background
Is adiposity at normal body weight relevant for cardiovascular disease risk?
Tanaka, S., Togashi, K., Rankinen, T., Përusse, L., Leon, A. S., Rao, D. C., Skinner, J. S., Wilmore, J. H., & Bouchard, C. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0801880 · Cited by 54
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BackgroundInfluential
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“However, it has previously been shown that the MUO phenotype also occurs in normalweight individuals and that a higher degree of obesity in children and adolescents is not always associated with a higher prevalence of prediabetes and/or the metabolic syndrome [19, 27].”
Background
The estimation of cardiovascular risk factors by body mass index and body fat percentage in Korean male adults
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Tanaka, S., Togashi, K., Rankinen, T., Përusse, L., Leon, A. S., Rao, D. C., Skinner, J. S., Wilmore, J. H., Després, J., & Bouchard, C. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802545 · Cited by 43
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“Moreover, visceral adipose tissue is well recognized to be significantly related to insulin resistance of obese type 2 diabetic patients and even patients with normal weight (4,5).”
Background
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Authors: Dvorak, R. V., DeNino, W. F., Ades, P. A., & Poehlman, E. T.
Affiliations: Department of Medicine, College of Medicine, University of Vermont, Burlington 05405, USA.
University of Vermont (US)
Venue: Diabetes
Publisher: American Diabetes Association
Published: 1999-11-01
Volume: 48
Issue: 11
Pages: 2210-2214
ISSN: 0012-1797 (ISSN-L)
1939-327X
DOI: 10.2337/diabetes.48.11.2210
OpenAlex: W2155025864
Cited by: 243
References: 0
Citations by year: 2026: 2 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 9 · 2021: 7 · 2020: 4 · 2019: 10 · 2018: 15 · 2017: 8 · 2016: 16 · 2015: 11 · 2014: 12 · 2013: 12 · 2012: 17
FWCI: 3.86
Type: journal article
Language: en
Open access: closed
Locations: Diabetes (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01ag015114-03)
National Institute on Aging (R01-AG15114)
National Institute of Dental and Craniofacial Research (DE 950226)
National Center for Research Resources (RR-00109)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Keywords: insulin resistance, visceral fat, subcutaneous abdominal fat, physical activity energy expenditure, cardiorespiratory fitness, body composition, glucose tolerance, type 2 diabetes risk, cardiovascular risk, young women
MeSH terms: Adipose Tissue, Adult, Blood Glucose, Blood Pressure, Body Constitution, Body Weight, Contraceptives, Oral, Diabetes Mellitus, Female, Glucose, Humans, Obesity, Phenotype, Reference Values, Body Mass Index

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Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women.

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