The metabolically normal but obese phenotype is associated with increased all-cause mortality risk
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Many subjects with normal weight exhibit features of the metabolic syndrome, whereas a subset of obese subjects appear metabolically healthy. The study was designed to examine the risk for all-cause mortality in metabolically normal obese subjects and metabolically abnormal obese subjects, metabolic abnormality being defined by insulin resistance (IR) or ≥2 metabolic syndrome criteria excluding enlarged waist. A total of 6011 men and women having participated in the National Health and Nutrition Examination Survey III, with public-access mortality data linkage, were included in the analysis. Overall, 30% of obese subjects were IR, and 38.4% had ≥2 metabolic syndrome factors, whereas only 6% were free from both IR and all metabolic syndrome factors. By metabolic syndrome factors or IR alone, metabolically normal obese patients and metabolically abnormal obese patients presented similar elevations in mortality risk when compared to metabolically normal, normal-weight patients. Thus, even in the absence of overt metabolic aberrations, obesity appears to be associated with increased all-cause mortality risk.
Abstract
