Normal-Weight Obesity: Implications for Cardiovascular Health

Current Atherosclerosis Reports

Volumn 16, Issue 12, 2014, Pages 1-8

  Jean, Nathalie ^a   Somers, Virend K ^a   Sochor, Ondrej ^a,b   Medina Inojosa, Jose ^a   Llano, Ernesto M ^c   Lopez Jimenez, Francisco ^a  

^a MAYO CLINIC   (United States)

^b ST ANNE S UNIVERSITY HOSPITAL   (Czech Republic)

^c UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

Adiposity; Body mass index; Cardiovascular diseases; Cardiovascular mortality; Central obesity; Metabolic syndrome; Normal weight obesity; Obesity; Sarcopenic obesity

Indexed keywords

BODY FAT DISTRIBUTION; BODY MASS; BODY WEIGHT; CARDIOVASCULAR DISEASE; CARDIOVASCULAR MORTALITY; CENTRAL OBESITY; DISEASE ACTIVITY; DISEASE ASSOCIATION; FAT CONTENT; HUMAN; METABOLIC DISORDER; NONHUMAN; NORMAL WEIGHT OBESITY; OBESITY; OUTCOME ASSESSMENT; REVIEW; RISK ASSESSMENT; SARCOPENIC OBESITY; WAIST CIRCUMFERENCE; ADULT; AGED; BODY COMPOSITION; CARDIOVASCULAR DISEASES; CLASSIFICATION; COMORBIDITY; FEMALE; HEALTH STATUS; LIFESTYLE; MALE; MIDDLE AGED; PATHOPHYSIOLOGY; REFERENCE VALUE;

ADULT; AGED; BODY COMPOSITION; BODY FAT DISTRIBUTION; BODY MASS INDEX; BODY WEIGHT; CARDIOVASCULAR DISEASES; COMORBIDITY; FEMALE; HEALTH STATUS; HUMANS; LIFE STYLE; MALE; MIDDLE AGED; OBESITY; REFERENCE VALUES; RISK ASSESSMENT;

EID: 84910632959     PISSN: 15233804     EISSN: 15346242     Source Type: Journal    
DOI: 10.1007/s11883-014-0464-7     Document Type: Review

References (50)

1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.
2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United States, 2011–2012. NCHS Data Brief. 2013;131:1–8.
3. Encyclopaedia Britannica Online. Obesity. 2010. Available from: http://www.britannica.com/EBchecked/topic/423747/obesity
4. Flegal KM, Kit BK, Orpana H. Association of all-cause mortality. JAMA. 2013;309:71–82.
5. Weigley ES. Average? Ideal? Desirable? A brief overview of height-weight tables in the United States. J Am Diet Assoc. 1984;84:417–23.
6. Quetelet MA. A treatise on man and the development of his faculties. William and Robert Chambers, eds. Edinburg 1842. 57–67.
7. Florey CV. The use and interpretation of ponderal index and other weight-height ratios in epidemiological studies. J Chronic Dis. 1970;23:93–103.
8. World Health Organisation (WHO). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ. Tech Rep Ser. 1995;854:1–452.
9. Mechanick JI, Garber AJ, Handelsman Y, Timothy Garvey W. American Association of Clinical Endocrinologists’ position statement on obesity and obesity medicine. Endocr Pract. 2012;5:642–8.
10. National Institutes Of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res. 1998;6:51S–209S.
11. National Institutes Of Health. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998;158:1855–67.
12. Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014;56:426–33. This is a very thorough review of normal weight obesity and its direct pathophysiological and clinical consequences including metabolic dysregulation and mortality.
13. Diaz-Melean CM, Somers VK, Rodriguez-Escudero JP, Singh P, Sochor O, Llano EM, et al. Mechanisms of adverse cardiometabolic consequences of obesity. Curr Atheroscler Rep. 2013;15:364.
14. Després J-P, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444:881–7.
15. Fu S, Watkins SM, Hotamisligil GS. The role of endoplasmic reticulum in hepatic lipid homeostasis and stress signaling. Cell Metab. 2012;5:623–34.
16. McGown C, Birerdinc A, Younossi ZM. Adipose tissue as an endocrine organ. Clin Liver Dis. 2014;18:41–58.
17. Yadav A, Kataria MA, Saini V, Yadav A. Role of leptin and adiponectin in insulin resistance. Clin Chim Acta. 2013;417:80–4.
18. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: Pathophysiology, evaluation, and effect of weight loss. Arterioscler, Thromb, Vasc Biol. 2006;26:968–76.
19. Lopez-Jimenez F. Speakable and unspeakable facts about BMI and mortality. Lancet Elsevier Ltd; 2009;373:1055–6.
20. Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083–96.
21. Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006;368:666–78.
22. Geliebter A, Atalayer D, Flancbaum L, Gibson CD. Comparison of body adiposity index (BAI) and BMI with estimations of % body fat in clinically severe obese women. Obesity (Silver Spring). 2013;21:493–8.
23. Lichtash CT, Cui J, Guo X, Chen Y-DI, Hsueh WA, Rotter JI, et al. Body adiposity index versus body mass index and other anthropometric traits as correlates of cardiometabolic risk factors. PLoS One. 2013;6:e65954.
24. De Schutter A, Lavie CJ, Gonzalez J, Milani RV. Body composition in coronary heart disease: how does body mass index correlate with body fatness? Ochsner J. 2011;11:220–5.
25. Ruderman N, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual revisited. Diabetes. 1998;47:699–713.
26. Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010;31:737–46.
27. Marques-Vidal P, Pcoud A, Hayoz D, Paccaud F, Mooser V, Waeber G, et al. Normal weight obesity: relationship with lipids, glycaemic status, liver enzymes and inflammation. Nutr Metab Cardiovasc Dis. 2010;20:669–75.
28. Ruderman NB, Schneider SH, Berchtold P. The “metabolically-obese”, normal-weight individual. Am J Clin Nutr. 1981;34:1617–21.
29. Batsis JA, Sahakyan KR, Rodriguez-Escudero JP, Bartels SJ, Somers VK, Lopez-Jimenez F. Normal weight obesity and mortality in United States subjects ≥60 years of age (from the Third National Health and Nutrition Examination Survey). Am J Cardiol. 2013;112:1592–8. This article studies the relationship between the normal weight obesity and cardiometabolic dysfunction and mortality in the elderly.
30. Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab. 2004;89:2569–75.
31. Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J Am Geriatr Soc. 2014;62:253–60.
32. Prado CMM, Wells JCK, Smith SR, Stephan BCM, Siervo M. Sarcopenic obesity: a critical appraisal of the current evidence. Clin Nutr. 2012;31:583–601.
33. Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci. 2000;904:437–48.
34. Succurro E, Marini MA, Frontoni S, Hribal ML, Andreozzi F, Lauro R, et al. Insulin secretion in metabolically obese, but normal weight, and in metabolically healthy but obese individuals. Obesity (Silver Spring). 2008;16:1881–6.
35. Ortega FB, Lee D-C, Katzmarzyk PT, Ruiz JR, Sui X, Church TS, et al. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013;34:389–97.
36. Pouliot MC, Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, et al. Regional variation in adipose tissue lipoprotein lipase activity: association with plasma high density lipoprotein levels. EurJ Clin Invest. 1991;21:398–405.
37. Terry RB, Stefanick ML, Haskell WL, Wood PD. Contributions of regional adipose tissue depots to plasma lipoprotein concentrations in overweight men and women: possible protective effects of thigh fat. Metabolism. 1991;40:733–40.
38. Ogorodnikova AD, Kim M, McGinn AP, Muntner P, Khan U, Wildman RP. Incident cardiovascular disease events in metabolically benign obese individuals. Obesity. 2012;20:651–9.
39. Mørkedal B, Vatten LJ, Romundstad PR, Laugsand LE, Janszky I. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals: HUNT (Nord-Trøndelag Health Study) Norway. J Am Coll Cardiol. 2014;63:1071–8.
40. Chang Y, Kim BB-K, Yun KE, Cho J, Zhang Y, Rampal S, et al. Metabolically healthy obesity and coronary artery calcification. J Am Coll Cardiol. 2014;63:24.
41. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, et al. Abdominal adiposity and coronary heart disease in women. Jama. 1998;280:1843–8.
42. Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, et al. Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation. 2007;116:2933–43.
43. Walker SP, Rimm EB, Ascherio A, Kawachi I, Stampfer MJ, Willett WC. Body size and fat distribution as predictors of stroke among US men. Am J Epidemiol. 1996;144:1143–50.
44. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105–20.
45. Gelber RP, Gaziano JM, Orav EJ, Manson JE, Buring JE, Kurth T. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol. 2008;52:605–15.
46. Coutinho T, Goel K, de Corrêa SD, Carter RE, Hodge DO, Kragelund C, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553–60. This article proves that patients with coronary artery disease and central obesity with normal weight have the highest long term mortality compared with other presentations of adiposity.
47. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS. Guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society World Wide Web at: 2013 AHA / ACC. 2013
48. Sahakyan K, Somers V, Juan RE, Thomas R, Sochor O, Singh P, et al. Normal-weight central obesity and cardiovascular mortality risk in hypertensive patients. J Am Coll Cardiol. 2013;61:E1399.
49. Yusuf S, Anand S. Body-mass index, abdominal adiposity, and cardiovascular risk. Lancet. 2011;378:226–7.
50. Coutinho T, Goel K, De Corrêa SD, Kragelund C, Kanaya AM, Zeller M, et al. Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. J Am Coll Cardiol. 2011;57:1877–86.