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Please use this identifier to cite or link to this item: https://dspace.lboro.ac.uk/2134/19095

Title: Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity
Authors: Dobson, Rebecca
Burgess, Malcolm I.
Sprung, Victoria S.
Irwin, Andrew
Hamer, Mark
Jones, Julia
Daousi, Christina
Adams, Valerie
Kemp, Graham J.
Shojaee-Moradie, Fariba
Umpleby, Margot
Cuthbertson, Daniel J.
Issue Date: 2015
Publisher: © Macmillan Publishers Limited
Citation: DOBSON, R. ...et al., 2015. Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity. International Journal of Obesity, In Press.
Abstract: BACKGROUND: The term ‘metabolically healthy obese (MHO)’ is distinguished using body mass index (BMI), yet BMI is a poor index of adiposity. Some epidemiological data suggest that MHO carries a lower risk of cardiovascular disease (CVD) or mortality than being normal weight yet metabolically unhealthy. OBJECTIVES: We aimed to undertake a detailed phenotyping of individuals with MHO by using imaging techniques to examine ectopic fat (visceral and liver fat deposition) and myocardial function. We hypothesised that metabolically unhealthy individuals (irrespective of BMI) would have adverse levels of ectopic fat and myocardial dysfunction compared with MHO individuals. SUBJECTS: Individuals were categorised as non-obese or obese (BMI ⩾30 kgm− 2) and as metabolically healthy or unhealthy according to the presence or absence of metabolic syndrome. METHODS: Sixty-seven individuals (mean ± s.d.: age 49 ± 11 years) underwent measurement of (i) visceral, subcutaneous and liver fat using magnetic resonance imaging and proton magnetic resonance spectroscopy, (ii) components of metabolic syndrome, (iii) cardiorespiratory fitness and (iv) indices of systolic and diastolic function using tissue Doppler echocardiography. RESULTS: Cardiorespiratory fitness was similar between all groups; abdominal and visceral fat was highest in the obese groups. Compared with age- and BMI-matched metabolically healthy counterparts, the unhealthy (lean or obese) individuals had higher liver fat and decreased early diastolic strain rate, early diastolic tissue velocity and systolic strain indicative of subclinical systolic and diastolic dysfunction. The magnitude of dysfunction correlated with the number of components of metabolic syndrome but not with BMI or with the degree of ectopic (visceral or liver) fat deposition. CONCLUSIONS: Myocardial dysfunction appears to be related to poor metabolic health rather than simply BMI or fat mass. These data may partly explain the epidemiological evidence on CVD risk relating to the different obesity phenotypes.
Description: This paper is in closed access until 8th Mar 2016.
Sponsor: This paper was funded by The European Foundation for the Study of Diabetes (EFSD).
Version: Accepted for publication
DOI: 10.1038/ijo.2015.151
URI: https://dspace.lboro.ac.uk/2134/19095
Publisher Link: http://dx.doi.org/10.1038/ijo.2015.151
ISSN: 1476-5497
Appears in Collections:Closed Access (Sport, Exercise and Health Sciences)

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