Obesity and body fat classification in the metabolic syndrome: Impact on cardiometabolic risk metabotype

Authors

  • Catherine M. Phillips,

    1. Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
    2. Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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  • Audrey C. Tierney,

    1. Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
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  • Pablo Perez-Martinez,

    1. Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Cordoba, Spain
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  • Catherine Defoort,

    1. INSERM, 476 Human Nutrition and Lipids, INRA, 1260, University Méditerranée Aix-Marseille 2, Marseille, France
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  • Ellen E. Blaak,

    1. Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht,The Netherlands
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  • Ingrid M. F. Gjelstad,

    1. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
    2. Department of Clinical Endocrinology, Oslo University Hospital Aker, Oslo, Norway
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  • Jose Lopez-Miranda,

    1. Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Cordoba, Spain
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  • Malgorzata Kiec-Klimczak,

    1. Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland
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  • Malgorzata Malczewska-Malec,

    1. Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland
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  • Christian A. Drevon,

    1. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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  • Wendy Hall,

    1. Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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  • Julie A. Lovegrove,

    1. Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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  • Brita Karlstrom,

    1. Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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  • Ulf Risérus,

    1. Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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  • Helen M. Roche

    Corresponding author
    1. Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
    • Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland;
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Abstract

Objective:

Obesity is a key factor in the development of the metabolic syndrome (MetS), which is associated with increased cardiometabolic risk. We investigated whether obesity classification by BMI and body fat percentage (BF%) influences cardiometabolic profile and dietary responsiveness in 486 MetS subjects (LIPGENE dietary intervention study).

Design and Methods:

Anthropometric measures, markers of inflammation and glucose metabolism, lipid profiles, adhesion molecules, and hemostatic factors were determined at baseline and after 12 weeks of four dietary interventions (high saturated fat (SFA), high monounsaturated fat (MUFA), and two low fat high complex carbohydrate (LFHCC) diets, one supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs)).

Results:

About 39 and 87% of subjects classified as normal and overweight by BMI were obese according to their BF%. Individuals classified as obese by BMI (≥30 kg/m2) and BF% (≥25% (men) and ≥35% (women)) (OO, n = 284) had larger waist and hip measurements, higher BMI and were heavier (P < 0.001) than those classified as nonobese by BMI but obese by BF% (NOO, n = 92). OO individuals displayed a more proinflammatory (higher C reactive protein (CRP) and leptin), prothrombotic (higher plasminogen activator inhibitor-1 (PAI-1)), proatherogenic (higher leptin/adiponectin ratio) and more insulin resistant (higher HOMA-IR) metabolic profile relative to the NOO group (P < 0.001). Interestingly, tumor necrosis factor-α (TNF-α) concentrations were lower post-intervention in NOO individuals compared with OO subjects (P < 0.001).

Conclusions:

In conclusion, assessing BF% and BMI as part of a metabotype may help to identify individuals at greater cardiometabolic risk than BMI alone.

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