Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
Department of Biotechnology, University Institute of Biotechnology, Chandigarh University, Mohali, India.
Front Public Health. 2024 Jul 31;12:1371359. doi: 10.3389/fpubh.2024.1371359. eCollection 2024.
The metabolically healthy obesity (MHO) phenotype represents a complex and distinctive trait, the trends and characteristics of which remain unknown in the Saudi Arabian adult population. The present study aims to fill that gap. A combined total of 10,220 Saudi adults from 2 independent cohorts [2008-2019, = 7,896 (2,903 males and 4,993 females), and 2021-2023, = 2,324 (830 males and 1,494 females)] aged 19-70 years old was screened, of whom 9,631 (3,428 males and 6,203 females) were included. Anthropometric data were measured, and fasting blood samples were collected to assess glucose, lipids, adipocytokines and inflammatory markers using routine methods and commercially available assays. Obesity was defined as a body mass index (BMI) ≥30 kg/m. Screening for MHO was done using the empiric definition proposed by Zembic and colleagues and the by the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATPIII). Of the 3,949 (41.0%) participants with obesity, 33.4% (95% confidence interval, CI, 32-35) were considered MHO using the empiric definition, and 32.8% (95% CI, 31-34) using NCEP-ATPIII. The overall age and gender adjusted prevalence of MHO in the Saudi adult population was 31.6% (95% CI, 30-33) and 30.1% (29-31) by the two definitions, respectively. Females had a higher age-adjusted prevalence of MHO than males (OR = 1.22, 95% CI 1.1-1.4, = 0.009) as per the ATPIII criteria. MHO prevalence substantially increased over time from 2008 to 2023 ( < 0.001) for both definitions. Circulating leptin levels and insulin resistance were significantly higher in the MUO group than the MHO group independent of the definition used, suggesting the presence of a more severe form of leptin resistance in the MUO group which may explain the worse cardiometabolic profile as compared to the MHO group. In summary, the study highlights the first time the characteristics and trends of the MHO phenotype among Saudi Arabian adults. The pluripotent effects of leptin and its resistance may be central to MHO's progression, or lack thereof, to the MUO phenotype, and this needs further investigation.
代谢健康型肥胖（MHO）表型代表一种复杂而独特的特征，其趋势和特征在沙特阿拉伯成年人群中尚不清楚。本研究旨在填补这一空白。本研究共纳入了来自 2 个独立队列的 10220 名沙特成年人[2008-2019 年，n=7896（男性 2903 名，女性 4993 名）和 2021-2023 年，n=2324（男性 830 名，女性 1494 名）]，年龄在 19-70 岁之间，对其进行了筛查，其中 9631 名（男性 3428 名，女性 6203 名）符合纳入标准。测量了人体测量学数据，并采集了空腹血样，使用常规方法和商业上可获得的检测试剂盒评估了血糖、血脂、脂肪细胞因子和炎症标志物。肥胖定义为体重指数（BMI）≥30kg/m。使用 Zembic 及其同事提出的经验定义和国家胆固醇教育计划成人治疗专家组 III（NCEP ATPIII）对 MHO 进行筛查。在 3949 名（41.0%）肥胖参与者中，根据经验定义，有 33.4%（95%置信区间，CI，32-35）被认为是 MHO，根据 NCEP-ATPIII 标准，有 32.8%（95%CI，31-34）。在沙特成年人群中，MHO 的总体年龄和性别调整患病率分别为 31.6%（95%CI，30-33）和 30.1%（29-31），这两种定义分别为 31.6%（95%CI，30-33）和 30.1%（29-31）。根据 ATPIII 标准，女性的 MHO 患病率高于男性（OR=1.22，95%CI 1.1-1.4，=0.009）。从 2008 年到 2023 年，MHO 的患病率随着时间的推移显著增加（<0.001），两种定义均如此。根据使用的定义，MUO 组的循环瘦素水平和胰岛素抵抗均明显高于 MHO 组，这表明 MUO 组存在更严重的瘦素抵抗形式，这可能解释了与 MHO 组相比，MUO 组的代谢指标更差。总之，本研究首次揭示了沙特阿拉伯成年人中 MHO 表型的特征和趋势。瘦素及其抵抗的多效性可能是 MHO 向 MUO 表型发展或不发展的核心，这需要进一步研究。
