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The metabolically obese, normal-weight individual revisited.

Published on May 1, 1998in Diabetes 7.27
· DOI :10.2337/diabetes.47.5.699
Neil B. Ruderman91
Estimated H-index: 91
Donald J. Chisholm62
Estimated H-index: 62
+ 1 AuthorsStephen H. Schneider29
Estimated H-index: 29
Nearly 20 years ago, it was suggested that individuals exist who are not obese on the basis of height and weight, but who, like people with overt obesity, are hyperinsulinemic, insulin-resistant, and predisposed to type 2 diabetes, hypertriglyceridemia, and premature coronary heart disease. Since then it has become increasingly clear that such metabolically obese, normal-weight (MONW) individuals are very common in the general population and that they probably represent one end of the spectrum of people with the insulin resistance syndrome. Available evidence also suggests that MONW individuals could account for the higher prevalence of type 2 diabetes, cardiovascular disease, and other disorders in people with a BMI in the 20-27 kg/m2 range who have gained modest amounts of weight (2-10 kg of adipose mass) in adult life. Specific factors that appear to predispose MONW, as well as more obese individuals, to insulin resistance include central fat distribution, inactivity, and a low VO2max. Because these factors are potentially reversible and because insulin resistance may contribute to the pathogenesis of many diseases, it is our premise that a compelling argument can be made for identifying MONW individuals and treating them with diet, exercise, and possibly pharmacological agents before these diseases become overt, or at least early after their onset. One reason for doing so is that disorders such as type 2 diabetes may be accompanied by irreversible consequences, e.g., ischemic heart disease and nephropathy, at the time of diagnosis or shortly thereafter. Another is that MONW individuals in general should be younger and more amenable and responsive to diet and exercise therapy than are obese patients with established disease. That long-term diet and exercise can work is suggested by two large studies in which, over 5-6 years, the incidence of diabetes was diminished in nonobese and minimally obese patients with impaired glucose tolerance. Based on these considerations and the emerging worldwide epidemic of type 2 diabetes, we believe that studies to assess whether therapies aimed at young MONW individuals can prevent the development of type 2 diabetes and other diseases, including perhaps obesity itself, are urgently needed.
  • References (26)
  • Citations (680)
Published on Jan 1, 1998in Diabetes Care 13.40
James R. Gavin4
Estimated H-index: 4
(American Diabetes Association),
K.G.M.M. Alberti6
Estimated H-index: 6
(American Diabetes Association)
+ 14 AuthorsHarry Keen1
Estimated H-index: 1
(American Diabetes Association)
9,184 Citations
Published on Oct 1, 1997in Human Molecular Genetics 4.90
Claude Bouchard133
Estimated H-index: 133
(Laval University),
Louis Pérusse77
Estimated H-index: 77
(Laval University)
+ 2 AuthorsDaniel Ricquier59
Estimated H-index: 59
(CNRS: Centre national de la recherche scientifique)
The recent cloning of a gene that codes for a novel uncoupling protein, UCP2, which is expressed in a wide range of adult human tissues, has raised the possibility that it may be involved in regulation of energy balance. To explore this concept we have investigated potential linkage relationships between three microsatellite markers which encompass the UCP2 gene location on 11q13 with resting metabolic rate (RMR), body mass index, percentage body fat (%FAT) and fat mass (FM) in 640 individuals f...
201 Citations Source Cite
Published on Oct 1, 1997in Diabetes 7.27
James B. Meigs124
Estimated H-index: 124
(Harvard University),
Ralph B. D'Agostino189
Estimated H-index: 189
(BU: Boston University)
+ 3 AuthorsDaniel E. Singer108
Estimated H-index: 108
(Harvard University)
Insulin resistance has been hypothesized to unify the clustering of hypertension, glucose intolerance, hyper-insulinemia, increased levels of triglyceride and decreased HDL cholesterol, and central and overall obesity. We tested this hypothesis with factor analysis, a statistical technique that should identify one factor if a single process underlies the clustering of these risk variables. From 2,458 nondiabetic subjects of the Framingham Offspring Study, we collected clinical data, fasting and ...
442 Citations Source Cite
Published on Aug 28, 1997in The New England Journal of Medicine 79.26
Gregory D. Curfman30
Estimated H-index: 30
Between 1967 and 1972, there was a serious outbreak of primary pulmonary hypertension in Western Europe.1 The incidence of the disorder among patients seen at major cardiac catheterization centers in Switzerland, Germany, and Austria increased by a factor of 10. This unusual epidemic was traced to the use of an appetite-suppressant drug, aminorex (Menocil), which had been introduced in Europe shortly before. The drug was quickly withdrawn from the market, but not before it had resulted in substa...
41 Citations Source Cite
Published on Jan 28, 1997in Diabetologia 6.02
J. Eriksson1
Estimated H-index: 1
Taimela S1
Estimated H-index: 1
(UH: University of Helsinki),
Veikko A. Koivisto52
Estimated H-index: 52
(UH: University of Helsinki)
221 Citations Source Cite
Published on Nov 1, 1996in Endocrine Research 1.52
Gordon H. Williams79
Estimated H-index: 79
(Harvard University),
Norman K. Hollenberg68
Estimated H-index: 68
(Harvard University)
+ 1 AuthorsXavier Jeunemaitre65
Estimated H-index: 65
(French Institute of Health and Medical Research)
13 Citations Source Cite
Published on Aug 1, 1996in International Journal of Obesity 5.16
David G Carey6
Estimated H-index: 6
Tuan V. Nguyen92
Estimated H-index: 92
+ 2 AuthorsPaul J. Kelly50
Estimated H-index: 50
INTRODUCTION : Recent studies of regional fat distribution have focused on the clinical importance of central abdominal obesity. Central adiposity is strongly related to insulin resistance, non-insulin dependent diabetes mellitus (NIDDM), dyslipidaemia and cardiovascular disease. While significant genetic influences on body mass index (BMI), total body and subcutaneous fat have been demonstrated, the inheritance of central abdominal obesity, has not been studied. OBJECTIVE : To assess genetic ef...
71 Citations
Published on Apr 11, 1996in The New England Journal of Medicine 79.26
Jean-Pierre Després110
Estimated H-index: 110
Benoît Lamarche61
Estimated H-index: 61
+ 4 AuthorsPaul-J. Lupien22
Estimated H-index: 22
Background Prospective studies suggest that hyperinsulinemia may be an important risk factor for ischemic heart disease. However, it has not been determined whether plasma insulin levels are independently related to ischemic heart disease after adjustment for other risk factors, including plasma lipoprotein levels. Methods In 1985 we collected blood samples from 2103 men from suburbs of Quebec City, Canada, who were 45 to 76 years of age and who did not have ischemic heart disease. A first ische...
1,527 Citations Source Cite
Published on Apr 1, 1996in Journal of Nutrition 4.40
Gilbert R. Upchurch3
Estimated H-index: 3
(Brigham and Women's Hospital),
George N. Welch16
Estimated H-index: 16
(BU: Boston University),
Joseph Loscalzo106
Estimated H-index: 106
(BU: Boston University)
45 Citations Source Cite
Published on Mar 1, 1996in The American Journal of Clinical Nutrition 6.55
William B. Kannel180
Estimated H-index: 180
(BU: Boston University),
Ralph B. D'Agostino189
Estimated H-index: 189
(BU: Boston University),
Janet L. Cobb13
Estimated H-index: 13
(BU: Boston University)
Involuntary weight gains worsen all elements of the cardiovascular risk profile, including dyslipidemia, hypertension, insulin-resistant glucose intolerance, left-ventricular hypertrophy, hyperuricemia, and elevated fibrinogen. On the basis of data from the Framingham Heart Study and from other studies, it can be concluded that the degree of overweight is related to the rate of development of cardiovascular disease. After 26 y of follow-up in the Framingham study, each SD increment in relative w...
175 Citations Source Cite
Cited By680
Published on Dec 1, 2019in Journal of Translational Medicine 4.20
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Published on May 2, 2019in International Journal of Gynecology & Obstetrics 2.07
Liangshan Mu1
Estimated H-index: 1
(PKU: Peking University),
Yue Zhao10
Estimated H-index: 10
(PKU: Peking University)
+ 3 AuthorsJie Qiao34
Estimated H-index: 34
(PKU: Peking University)
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Published on Apr 30, 2019in Journal of Obesity
Liang Feng16
Estimated H-index: 16
(NUS: National University of Singapore),
Aliya Naheed36
Estimated H-index: 36
(International Centre for Diarrhoeal Disease Research, Bangladesh)
+ 8 AuthorsSahar Senan (Aga Khan University)
We aimed to explore the cross-country variation in the prevalence of comorbid prediabetes or diabetes and determine the sociodemographic, lifestyle, and clinical factors, especially body mass index (BMI) and waist circumference, associated with comorbid diabetes in individuals with hypertension in rural South Asia. We analyzed cross-sectional data of 2426 hypertensive individuals of ≥40 years from 30 randomly selected rural communities in Bangladesh, Pakistan, and Sri Lanka. Prediabetes was defi...
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Published on Apr 22, 2019in bioRxiv
Queiroz Machado (Federal Fluminense University), Cristina Pereira-Silva (Federal Fluminense University)+ 1 AuthorsFernandes-Santos
Objectives: To investigate the early cardiometabolic abnormalities along with WAT and BAT remodeling in short-term fructose feeding mice model. Methods: Mice (n=10-11/group) were fed for four weeks with control diet (AIN93-M) or experimental diets rich in glucose or fructose. We investigated body weight, body adiposity, blood glucose, lipid and hepatic parameters, and white (WAT) and brown adipose tissue (BAT) histopathology. Results: Fructose feeding promoted neither weight gain nor hypertrophy...
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Published on Apr 20, 2019in International Journal of Molecular Sciences 3.69
Simona Marchisello1
Estimated H-index: 1
A. Di Pino11
Estimated H-index: 11
+ 4 AuthorsAgata Maria Rabuazzo19
Estimated H-index: 19
Nonalcoholic Fatty Liver Disease (NAFLD) represents the leading cause of liver disease in developed countries but its diffusion is currently also emerging in Asian countries, in South America and in other developing countries. It is progressively becoming one of the main diseases responsible for hepatic insufficiency, hepatocarcinoma and the need for orthotopic liver transplantation. NAFLD is linked with metabolic syndrome in a close and bidirectional relationship. To date, NAFLD is a diagnosis ...
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Published on Apr 1, 2019in Clinical Nutrition 5.50
Jadwiga Konieczna6
Estimated H-index: 6
(ISCIII: Instituto de Salud Carlos III),
A. Yañez (UIB: University of the Balearic Islands)+ 19 AuthorsE. Ros13
Estimated H-index: 13
(University of Barcelona)
Summary Background & aims Little is known about the impact of specific dietary patterns on the development of obesity phenotypes. We aimed to determine the association of longitudinal changes in adherence to the traditional Mediterranean diet (MedDiet) with the transition between different obesity phenotypes. Methods Data of 5801 older men and women at high cardiovascular risk from PREDIMED trial were used. Adherence to MedDiet was measured with the validated 14p-Mediterranean Diet Adherence Scr...
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Published on Apr 1, 2019in Diabetologia 6.02
Matthias B. Schulze67
Estimated H-index: 67
(University of Potsdam)
Cardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5–24.9 kg/m2). This review provides a summary of pr...
2 Citations Source Cite
Published on Mar 18, 2019in Nutrients 4.20
Anika Nier3
Estimated H-index: 3
Annette Brandt3
Estimated H-index: 3
+ 3 AuthorsIna Bergheim31
Estimated H-index: 31
Being overweight has been identified as the main risk factor for the development of metabolic disorders in adults and children. However, recent studies suggest that normal weight individuals are also frequently affected by metabolic abnormalities with underlying mechanisms not yet fully understood. The aim of the present study was to determine if dietary pattern and markers of intestinal permeability, as well as inflammation, differ between normal weight healthy children and normal weight childr...
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