Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender
Objectives: We aimed to examine the relationships between body mass index (BMI) and metabolic syndrome (MS) components as a function of age and gender across weight categories. Methods: This cross-sectional study included 19,328 subjects who participated in a health-screening program. We analyzed 14...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Biology |
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| Online Access: | https://www.mdpi.com/2079-7737/12/5/719 |
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| author | Yonit Marcus Elad Segev Gabi Shefer David Eilam Galina Shenkerman Assaf Buch Shani Shenhar-Tsarfaty David Zeltser Itzhak Shapira Shlomo Berliner Ori Rogowski |
| author_facet | Yonit Marcus Elad Segev Gabi Shefer David Eilam Galina Shenkerman Assaf Buch Shani Shenhar-Tsarfaty David Zeltser Itzhak Shapira Shlomo Berliner Ori Rogowski |
| author_sort | Yonit Marcus |
| collection | DOAJ |
| description | Objectives: We aimed to examine the relationships between body mass index (BMI) and metabolic syndrome (MS) components as a function of age and gender across weight categories. Methods: This cross-sectional study included 19,328 subjects who participated in a health-screening program. We analyzed 14,093 apparently healthy subjects with a BMI ≥ 18.5 kg/m<sup>2</sup> (ranging from 18.5 to 46 kg/m<sup>2</sup>). Results: At a BMI of 18.5 kg/m<sup>2</sup>, 16% of subjects had one or more MS components (MS ≥ 1). The number of MS components increased linearly with BMI. The most prevalent components for MS1-4 were hypertension (in men) and increased waist circumference (in women). Among 6391 non-obese subjects with MS = 0, there was a linear increase in blood pressure, glucose, and triglycerides, as well as a decline in high-density lipoprotein cholesterol, as BMI increased. In 2087 subjects with a BMI ≥ 30 kg/m<sup>2</sup>, a true normometabolic state (MS = 0) was observed in only 7.5%, declining to less than 1% at a BMI ≥ 36 kg/m<sup>2</sup> (ATP criteria). Women were metabolically protected relative to men between the ages of 30 and 50 years. Conclusions: (A) MS components increase linearly with BMI from the lowest normal BMI and continue to increase with age and BMI; (B) metabolically healthy obesity is rare in subjects with a high BMI and declines with age; (C) hypertension is the most common component in men; and (D) in women, MS components are seen at older ages than in men for the same BMI. Metabolic health declines with age and BMI in nearly all subjects with obesity. |
| first_indexed | 2024-03-11T03:56:04Z |
| format | Article |
| id | doaj.art-bb7681b9a3ab4ac78fa8e6383b2220cd |
| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-11T03:56:04Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biology |
| spelling | doaj.art-bb7681b9a3ab4ac78fa8e6383b2220cd2023-11-18T00:33:25ZengMDPI AGBiology2079-77372023-05-0112571910.3390/biology12050719Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and GenderYonit Marcus0Elad Segev1Gabi Shefer2David Eilam3Galina Shenkerman4Assaf Buch5Shani Shenhar-Tsarfaty6David Zeltser7Itzhak Shapira8Shlomo Berliner9Ori Rogowski10The Sagol Center for Epigenetics of Metabolism and Aging, Sourasky Medical Center, Tel Aviv 6423906, IsraelThe Sagol Center for Epigenetics of Metabolism and Aging, Sourasky Medical Center, Tel Aviv 6423906, IsraelThe Sagol Center for Epigenetics of Metabolism and Aging, Sourasky Medical Center, Tel Aviv 6423906, IsraelSchool of Zoology, George S. Wise Faculty of Life-Sciences, Tel-Aviv University, Tel Aviv 6997801, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel-Aviv-Sourasky Medical Center, Tel Aviv 6423906, IsraelThe Sagol Center for Epigenetics of Metabolism and Aging, Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartments of Medicine and Preventive Medicine, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartments of Medicine and Preventive Medicine, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelObjectives: We aimed to examine the relationships between body mass index (BMI) and metabolic syndrome (MS) components as a function of age and gender across weight categories. Methods: This cross-sectional study included 19,328 subjects who participated in a health-screening program. We analyzed 14,093 apparently healthy subjects with a BMI ≥ 18.5 kg/m<sup>2</sup> (ranging from 18.5 to 46 kg/m<sup>2</sup>). Results: At a BMI of 18.5 kg/m<sup>2</sup>, 16% of subjects had one or more MS components (MS ≥ 1). The number of MS components increased linearly with BMI. The most prevalent components for MS1-4 were hypertension (in men) and increased waist circumference (in women). Among 6391 non-obese subjects with MS = 0, there was a linear increase in blood pressure, glucose, and triglycerides, as well as a decline in high-density lipoprotein cholesterol, as BMI increased. In 2087 subjects with a BMI ≥ 30 kg/m<sup>2</sup>, a true normometabolic state (MS = 0) was observed in only 7.5%, declining to less than 1% at a BMI ≥ 36 kg/m<sup>2</sup> (ATP criteria). Women were metabolically protected relative to men between the ages of 30 and 50 years. Conclusions: (A) MS components increase linearly with BMI from the lowest normal BMI and continue to increase with age and BMI; (B) metabolically healthy obesity is rare in subjects with a high BMI and declines with age; (C) hypertension is the most common component in men; and (D) in women, MS components are seen at older ages than in men for the same BMI. Metabolic health declines with age and BMI in nearly all subjects with obesity.https://www.mdpi.com/2079-7737/12/5/719metabolic syndromeobesityhypertensionmetabolically healthy obesitynormometabolic obesity |
| spellingShingle | Yonit Marcus Elad Segev Gabi Shefer David Eilam Galina Shenkerman Assaf Buch Shani Shenhar-Tsarfaty David Zeltser Itzhak Shapira Shlomo Berliner Ori Rogowski Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender Biology metabolic syndrome obesity hypertension metabolically healthy obesity normometabolic obesity |
| title | Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender |
| title_full | Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender |
| title_fullStr | Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender |
| title_full_unstemmed | Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender |
| title_short | Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender |
| title_sort | metabolically healthy obesity is a misnomer components of the metabolic syndrome linearly increase with bmi as a function of age and gender |
| topic | metabolic syndrome obesity hypertension metabolically healthy obesity normometabolic obesity |
| url | https://www.mdpi.com/2079-7737/12/5/719 |
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