Endocrine Abstracts

Introduction: While the unfavourable metabolic consequences of obesity have been clearly demonstrated at a population level, there is a wealth of evidence indicating the existence of individuals somehow protected from developing complications, named ‘metabolically healthy obese’. The aim of our study was to identify clinical and biological parameters independently associated with ‘metabolically healthy’ status.

Patients and methods: 440 (303 women) extremely obese patients (mean BMI=45.33±8.82 kg/m²) were clinically (medical history, anthropometrics, blood pressure (BP)) and biologically (complete metabolic tests, adiponectin, CRP, TNF-α levels) in a research programme for bariatric surgery. Metabolically healthy obese status was alternatively defined using two criteria: i) absence of metabolic syndrome (ATPIII definition) and ii) insulin sensitivity (IS) – non-diabetic patients with HOMA <2.85 were considered IS+.

Results: Only 15.8% of patients (20.4% of women) fulfilled both criteria of metabolic health. Women were IS+ in a higher percentage than men (30.7% compared with 12.4%, P<0.001). IS+ patients showed a lower general (BMI) and visceral (WC, WC/HC) adiposity and more favourable parameters of lipid (HDL, triglycerides) and glucose metabolism. They also had lower BP, lower chronic inflammatory markers (TNF-α, CRP), but higher levels of adiponectin. Patients without metabolic syndrome were also younger, mostly women, had a higher insulin sensitivity, lower CRP level and increased concentration of adiponectin. In logistic regression analysis, adiponectin (P=0.011), VAI (P=0.012) and uric acid (P=0.031) remained significantly associated with insulin sensitivity. Area under ROC curve for the model was 0.815 (IC: 0.756–0.875; P<0.001). In a similar model, independent determinant of metabolic syndrome were: adiponectin (P=0.004), HOMA–IR (P=0.01) and age (P<0.001). Area under ROC curve for the model was 0.799 (0.744–0.853).

Conclusion: Adiponectin is an independent determinant of metabolically healthy obese status, disregarding the criteria used for its definition.

Disclosure: This work was partly supported by the Sectorial Operational Programme Human Resources Development (SOPHRD), financed by the European Social Fund and the Romanian Government under the contract number POSDRU 141531.