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Cell Metab. 2017 Aug 1;26(2):292-300. doi: 10.1016/j.cmet.2017.07.008.

Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans.

Author information

1
Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany. Electronic address: norbert.stefan@med.uni-tuebingen.de.
2
Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Section of Experimental Radiology, University Hospital Tübingen, Tübingen, Germany.
3
Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany. Electronic address: Hans-Ulrich.Haering@med.uni-tuebingen.de.

Abstract

A BMI in the normal range associates with a decreased risk of cardiometabolic disease and all-cause mortality. However, not all subjects in this BMI range have this low risk. Compared to people who are of normal weight and metabolically healthy, subjects who are of normal weight but metabolically unhealthy (∼20% of the normal weight adult population) have a greater than 3-fold higher risk of all-cause mortality and/or cardiovascular events. Here we address to what extent major risk phenotypes determine metabolic health in lean compared to overweight and obese people and provide support for the existence of a lipodystrophy-like phenotype in the general population. Furthermore, we highlight the molecular mechanisms that induce this phenotype. Finally, we propose strategies as to how this knowledge could be implemented in the prevention and treatment of cardiometabolic diseases in different stages of adiposity in routine clinical practice.

KEYWORDS:

cardiometabolic diseases; insulin resistance; insulin secretion; leg fat mass; lipodystrophy-like phenotype; metabolic syndrome; metabolically healthy obesity; metabolically unhealthy normal weight; nonalcoholic fatty liver disease; visceral obesity

PMID:
28768170
DOI:
10.1016/j.cmet.2017.07.008
[Indexed for MEDLINE]
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