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2016 ; 44
(4
): 362-372
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Metabolic characterization of overweight and obese adults
#MMPMID27737609
Hirsch KR
; Smith-Ryan AE
; Blue MN
; Mock MG
; Trexler ET
; Ondrak KS
Phys Sportsmed
2016[Nov]; 44
(4
): 362-372
PMID27737609
show ga
OBJECTIVES: Traditional evaluations of metabolic health may overlook underlying
dysfunction in individuals who show no signs of insulin resistance or
dyslipidemia. The purpose of this study was to characterize metabolic health in
overweight and obese adults using traditional and non-traditional cardiometabolic
variables. A secondary purpose was to evaluate differences between
overweight/obese and male/female cohorts, respectively. METHODS: Forty-nine
overweight and obese adults (Mean ± SD; Age = 35.0 ± 8.9 yrs; Body mass
index = 33.6 ± 5.2 kg·m(-2); Percent body fat [%fat] = 36.7 ± 7.9%) were
characterized. Body composition (fat mass [FM], lean mass [LM], %fat) was
calculated using a 4-compartment model; visceral adipose tissue (VAT) was
quantified using B-mode ultrasound. Resting metabolic rate (RMR) and respiratory
exchange ratio (RER) were evaluated using indirect calorimetry. Fasted blood and
saliva samples were analyzed for total cholesterol (TC), high-density
lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TRG), glucose
(GLUC), insulin, leptin, estradiol, and cortisol. RESULTS: The prevalence of
individuals with two or more cardiometabolic risk factors increased from 13%,
using traditional risk factors (GLUC, TRG, HDL), to 80% when non-traditional
metabolic factors (VAT, LM, RMR, RER, TC, LDL, HOMA-IR) were considered. Between
overweight/obese, there were no significant differences in %fat (p = 0.152), VAT
(p = 0.959), RER (p = 0.493), lipids/GLUC (p > 0.05), insulin (p = 0.143), leptin
(p = 0.053), or cortisol (p = 0.063); obese had higher FM, LM, RMR, and estradiol
(p < 0.01). Males had greater LM, RMR, and TRG (p < 0.01); females had greater
%fat, and leptin (p < 0.001). There were no significant sex differences in RER,
estradiol, insulin, or cortisol (p > 0.05). CONCLUSIONS: Evaluating metabolic
health beyond BMI and traditional cardiometabolic risk factors can give
significant insights into metabolic status. Due to high variability in metabolic
health in overweight and obese adults and inherent sex differences,
implementation of body composition and visceral fat measures in the clinical
setting can improve early identification and approaches to disease prevention.
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