Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Asan Diabetes Center, Asan Medical Center, Seoul 05505, Korea.
Int J Mol Sci. 2022 Aug 25;23(17):9614. doi: 10.3390/ijms23179614.
Although obesity is commonly associated with numerous cardiometabolic pathologies, some people with obesity are resistant to detrimental effects of excess body fat, which constitutes a condition called "metabolically healthy obesity" (MHO). Metabolic features of MHO that distinguish it from metabolically unhealthy obesity (MUO) include differences in the fat distribution, adipokine types, and levels of chronic inflammation. Murine models are available that mimic the phenotype of human MHO, with increased adiposity but preserved insulin sensitivity. Clinically, there is no established definition of MHO yet. Despite the lack of a uniform definition, most studies describe MHO as a particular case of obesity with no or only one metabolic syndrome components and lower levels of insulin resistance or inflammatory markers. Another clinical viewpoint is the dynamic and changing nature of MHO, which substantially impacts the clinical outcome. In this review, we explore the pathophysiology and some murine models of MHO. The definition, variability, and clinical implications of the MHO phenotype are also discussed. Understanding the characteristics that differentiate people with MHO from those with MUO can lead to new insights into the mechanisms behind obesity-related metabolic derangements and diseases.
尽管肥胖通常与许多心血管代谢病理有关，但一些肥胖的人对过多体脂的有害影响具有抵抗力，这种情况被称为“代谢健康型肥胖”（MHO）。MHO 与代谢不健康型肥胖（MUO）的代谢特征区别在于脂肪分布、脂肪因子类型和慢性炎症水平的不同。现已有模拟人类 MHO 表型的小鼠模型，其具有更高的肥胖程度，但胰岛素敏感性得到保留。临床上尚未确定 MHO 的定义。尽管缺乏统一的定义，但大多数研究将 MHO 描述为一种肥胖的特殊情况，没有或只有一个代谢综合征成分，以及较低水平的胰岛素抵抗或炎症标志物。另一种临床观点是 MHO 的动态和变化性质，这对临床结果有重大影响。在这篇综述中，我们探讨了 MHO 的病理生理学和一些小鼠模型。还讨论了 MHO 表型的定义、可变性和临床意义。了解将 MHO 患者与 MUO 患者区分开来的特征，可以深入了解肥胖相关代谢紊乱和疾病背后的机制。
