Metabolik Olarak Sağlıklı Obezite

Year 2024, , 40 - 45, 07.02.2024

Betül Koçak , Ayşenur Emirhüseyinoğlu , Müveddet Emel Alphan

https://doi.org/10.54270/atljm.2023.44

Abstract

Obezite, gün geçtikçe insidansı artan ve 21. yüzyılın pandemisi olarak kabul edilen bir hastalıktır. Obeziteye neden olan genetik faktörlerin yanı sıra esas nedenler yüksek enerjili besinleri içeren, doymuş yağ ve basit şekerden zengin beslenme tipi ve hareketsiz yaşam tarzıdır. Obezite, bireyi sadece fiziksel olarak etkilemez, birçok metabolik sorunu beraberinde getirir. Ancak, her obez bireyde metabolik sağlık sorunları görülmeyebilir. “Metabolik olarak sağlıklı obezite” olarak tanımlanan bu kavramın altında birçok faktör yatmakla birlikte hepsi tam olarak aydınlatılamamıştır. Genel geçer tanı kriterlerinin olmaması, metabolik olarak sağlıklı obezite prevalansı hakkında kesin bilgiye ulaşılmasını engellese de bu fenotipe sahip bireylerin kardiyometabolik risk açısından daha avantajlı olduğu bilinmektedir. Obezitesi olan tüm bireylerde erken ölüm, kardiyovasküler hastalıklar, tip 2 diyabet ve kanser riskini azaltmak için metabolik ve kardiyovasküler anormallikler göz önünde bulundurulmalıdır. Bu makalenin ele aldığı araştırmalar, metabolik sağlıklı obezlerden metabolik sağlıksız obezlere dönüşüm ve tezahürlerin daha iyi önlenmesi için belirleyicileri ve değiştirilebilir risk faktörlerini aydınlatmalıdır.

Keywords

obezite; metabolik olarak iyi huylu, metabolik sendrom, fazla kilolu

METABOLICALLY HEALTHY OBESITY

Abstract

Obesity is a disease whose incidence is increasing day by day and is accepted as the pandemic of the 21st century. In addition to genetic factors that cause obesity, the main causes are a diet containing high-energy foods, rich in saturated fat and simple sugar, and a sedentary lifestyle. Obesity does not only affect the individual physically, but also brings along many metabolic problems. However, metabolic health problems may not be seen in every obese individual. Although there are many factors underlying this concept, which is defined as "metabolically healthy obesity", not all of them have been fully elucidated. Although the lack of general diagnostic criteria prevents definitive information on the prevalence of metabolically healthy obesity, it is known that individuals with this phenotype are more advantageous in terms of cardiometabolic risk. Metabolic and cardiovascular abnormalities should be considered to reduce the risk of early death, cardiovascular diseases, type 2 diabetes and cancer in all individuals with obesity. Researches in this article should enlighten determinants and modifiable risk factors for better prevention of metabolic healthy obese to metabolic unhealthy obese conversions and manifestations.

Keywords

obesity; metabolically benign, metabolic syndrome, overweight

References

• Bray, G. A., et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity reviews 2017;18;715-723.
• Muñoz-Garach, A., et al. Does metabolically healthy obesity exist? . Nutrients 2016;8;320.
• Wu, H. J., & Wu, E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut microbes 2012;3;4-14.
• Raucci, R. R., et al. Functional and structural features of adipokine family. Cytokine 2013;61;1-14.
• van Vliet-Ostaptchouk, et al. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC endocrine disorders 2014;14;9.
• Phillips, C. Metabolically healthy obesity: Definitions, determinants and clinical implications. Rev Endocr Metab Disord, 2013;219-227.
• Karelis, A. D. Metabolically healthy but obese individuals. Lancet, 2008;372;1281-1283.
• Stefan, N. K., et al. Identification and characterization of metabolically benign obesity in humans. 2008;168;1609-1616.
• Sutherland, J. P., et al. The metabolic syndrome and inflammation. Metabolic syndrome and related disorders,, 2004;2;82-104.
• DeBoer, M. D. Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions. Nutrition, 2013;29;379-386.
• Phillips, C. M., & Perry, I. J.. Does inflammation determine metabolic health status in obese and nonobese adults? The Journal of Clinical Endocrinology & Metabolism, 2013;98;E1610-E1619.
• Blüher, S., & Schwarz, P. Metabolically healthy obesity from childhood to adulthood—does weight status alone matter? Metabolism, 2014;63;1084-1092.
• Lionetti, L., et al. From chronic overnutrition to insulin resistance: the role of fat-storing capacity and inflammation. Nutrition, Metabolism and Cardiovascular Diseases,, 2009;19;146-152.
• Arner, E., et al. Adipocyte turnover: relevance to human adipose tissue morphology. Diabetes, 2010;59;105-109.
• Virtue, S., & Vidal-Puig, A. It's not how fat you are, it's what you do with it that counts. PLoS biology, 2008;6;e237.
• Spalding, K. L., et al. Dynamics of fat cell turnover in humans. Nature, 2008;453;783-787.
• Arner, P., & Spalding, K. L. Fat cell turnover in humans. Biochemical and biophysical research communications, 2010;396;101-104.
• Blüher, S. et al. Who should we target for diabetes prevention and diabetes risk reduction? Current diabetes reports, 2012;12;147-156.
• Zhang, T. et al. Plasma miR-126 is a potential biomarker for early prediction of type 2 diabetes mellitus in susceptible individuals. BioMed research international. 2013.
• Achari, A. E., & Jain, S. K. Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. . International journal of molecular sciences, 2017;18;1321.
• Aguilar-Salinas, C., et al. High adiponectin concentrations are associated with the metabolically healthy obese phenotype. J Clin Endocrinol Metab., 2008;93;9.
• Katzmarzyk, P. T., et al. Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness. Diabetes care, 2005;28;391-397.
• Blüher, M. Metabolically Healthy Obesity. Endocrine reviews, 2020;41;405–420.
• Mongraw-Chaffin, et al. Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk. Journal of the American College of Cardiology, 2018;71;1857-1865.
• Nuotio, M. L., et al. The prevalence of Metabolic Syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocrine Disorders 2014.
• Kabat, G. C., et al. Metabolic phenotypes of obesity: frequency, correlates and change over time in a cohort of postmenopausal women. International Journal of Obesity, 2017;41;170-177.
• Appleton, S. L., et al. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes care,, 2013;36;2388-2394.
• Eckel, N., et al. Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90 257 women (the Nurses' Health Study): 30 year follow-up from a prospective cohort study. The lancet Diabetes & endocrinology, 2018;6;714-724.
• Lin, H., Zhang, L., Zheng, R., & Zheng, Y. (2017). The prevalence, metabolic risk and effects of lifestyle intervention for metabolically healthy obesity: a systematic review and meta-analysis: a PRISMA-compliant article. Medicine, 96(47).
• Meigs, J.,et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. 2006;91;12.
• Ärnlöv, J. et al.. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation, 2010;121;230-236.
• Kramer, C. K., et al. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Annals of internal medicine, 2013;159;758-769.
• Shaharyar, S., et al. Obesity and metabolic phenotypes (metabolically healthy and unhealthy variants) are significantly associated with prevalence of elevated C-reactive protein and hepatic steatosis in a large healthy Brazilian population. Journal of obesity, 2015.
• Stefan, N. K., Thamer, C., Rittig, K., & & Häring, H. U. (2008). Identification and characterization of metabolically benign obesity in humans. 168(15), 1609-1616.
• Karelis, A., et al. Can we identify metabolically healthy but obese individuals (MHO)? Diabetes Metab, 2004;30;72.
• Wildman, R., et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: Prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004). Arch Intern Med, 2008;168;24.
• Lynch, L., et al. Are natural killer cells protecting the metabolically healthy obese patient? Obesity (Silver Spring, Md), 2009;17;5.