Cheng Dihe, Zhao Xue, Yang Shuo, Cui Haiying, Wang Guixia
Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Mar 4;14:991-1010. doi: 10.2147/DMSO.S294894. eCollection 2021.
The clinical manifestations of overweight/obesity are heterogeneous and complex. In contrast to metabolically unhealthy overweight/obese (MUO), a particular sub-group of obese patients who are considered as metabolically healthy overweight/obese (MHO), display favorable metabolic profiles characterized by high levels of insulin sensitivity, normal blood pressure, as well as favorable lipid, inflammation, hormone, liver enzyme, and immune profiles. While only a few available studies focused on the metabolic files underlying the obese phenotypes, the current review aimed to perform a systematic review of available studies focusing on describing the metabolomic signature between MUO and MHO. We did the systematic search for literature on MEDLINE (PubMed), the Cochrane Library, EMBASE, and searched for the references of relevant manuscripts from inception to 29 May 2020. After critical selection, 20 studies were eligible for this systematic review and evaluated by using QUADOMICS for quality assessment. Eventually, 12 of 20 studies were classified as "high quality". Branched-chain amino acids (isoleucine, leucine, and valine), aromatic amino acids (phenylalanine and tyrosine), lipids (palmitic acid, palmitoleic acid, oleic acid, eicosapentaenoic acid, and docosahexaenoic acid), and acylcarnitines (propionyl carnitine) levels might be elevated in MUO. The current results suggested that MHO showed a favorable trend in the overall metabolic signature. More longitudinal studies are needed to elaborate deeply on the metabolic pathway and the relationship between metabolic patterns and the occurrence of the disease.
超重/肥胖的临床表现具有异质性且复杂。与代谢不健康的超重/肥胖（MUO）患者相比，有一个特殊的肥胖患者亚组被认为是代谢健康的超重/肥胖（MHO），他们表现出良好的代谢特征，其特点是胰岛素敏感性高、血压正常，以及脂质、炎症、激素、肝酶和免疫指标良好。虽然仅有少数现有研究关注肥胖表型背后的代谢特征，但本综述旨在对现有研究进行系统综述，重点描述MUO和MHO之间的代谢组学特征。我们在MEDLINE（PubMed）、Cochrane图书馆、EMBASE上进行了文献系统检索，并检索了从创刊至2020年5月29日相关手稿的参考文献。经过严格筛选，有20项研究符合本系统综述的要求，并使用QUADOMICS进行质量评估。最终，20项研究中有12项被归类为“高质量”。MUO患者体内的支链氨基酸（异亮氨酸、亮氨酸和缬氨酸）、芳香族氨基酸（苯丙氨酸和酪氨酸）、脂质（棕榈酸、棕榈油酸、油酸、二十碳五烯酸和二十二碳六烯酸）以及酰基肉碱（丙酰肉碱）水平可能会升高。目前的结果表明，MHO在整体代谢特征方面呈现出良好的趋势。需要更多的纵向研究来深入阐述代谢途径以及代谢模式与疾病发生之间的关系。
