Gonçalves Carolina G, Glade Michael J, Meguid Michael M
Department of Surgery, Positivo University, Curitiba, PR, Brazil 81280 to 330. Surgical Metabolism Laboratory, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil.
The Nutrition Doctor, Kailua Kona, HI, USA.
Nutrition. 2016 Jan;32(1):14-20. doi: 10.1016/j.nut.2015.07.010. Epub 2015 Aug 13.
Obesity is a significant quality of life-impairing health problem affecting industrialized nations. However, despite carrying a large fat mass, some very obese individuals exhibit normal metabolic profiles (metabolically healthy obesity). The physiological factors underlying their protective and favorable metabolic profiles remain poorly defined.
A search of the National Library of Medicine PubMed database was performed using the following keywords: Metabolically healthy obese, metabolically normal obese, insulin resistance, metabolically unhealthy normal weight, and uncomplicated obesity.
This article reviewed factors associated with severe obesity that lacks complications, and suggests putative activities by which these obese individuals avoid developing the clinical features of metabolic syndrome, or the metabolic complications associated with severe obesity.
Despite the knowledge that visceral fat deposition is the seminal factor that ultimately causes insulin resistance (IR) and the detrimental inflammatory and hormonal profile that contributes to increase risk for cardiovascular disease, it remains unknown whether metabolically healthy obesity (MHO) has genetic predisposing factors, and whether MHO ultimately succumbs to IR and the metabolic syndrome, indicating a need for prophylatic bariatric surgery.
肥胖是一个影响工业化国家生活质量的重大健康问题。然而，尽管一些极度肥胖者体内脂肪量很大，但他们仍表现出正常的代谢特征（代谢健康型肥胖）。其具有保护性和良好代谢特征的生理因素仍不清楚。
使用以下关键词在国立医学图书馆的PubMed数据库中进行检索：代谢健康型肥胖、代谢正常型肥胖、胰岛素抵抗、代谢不健康的正常体重以及单纯性肥胖。
本文综述了与无并发症的重度肥胖相关的因素，并提出了这些肥胖个体避免出现代谢综合征临床特征或与重度肥胖相关的代谢并发症的假定机制。
尽管已知内脏脂肪沉积是最终导致胰岛素抵抗（IR）以及有害的炎症和激素状态从而增加心血管疾病风险的关键因素，但代谢健康型肥胖（MHO）是否存在遗传易感性因素，以及MHO最终是否会发展为IR和代谢综合征仍不清楚，这表明有必要进行预防性减肥手术。
