Morbidly “Healthy” Obese Are Not Metabolically Healthy but Less Metabolically Imbalanced Than Those with Type 2 Diabetes or Dyslipidemia

Roser Ferrer, Eva Pardina, Joana Rossell, Laura Oller, Anna Viñas, Juan Antonio Baena-Fustegueras, Albert Lecube, Víctor Vargas, José María Balibrea, Enric Caubet, Oscar González, Ramón Vilallonga, Jose Manuel Fort, Julia Peinado-Onsurbe

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

© 2014, Springer Science+Business Media New York. Background: We have investigated the differences between metabolically “healthy” morbidly obese patients and those with comorbidities. Materials and Methods: Thirty-two morbidly obese patients were divided by the absence (“healthy”: DM−DL−) or presence of comorbidities (dyslipidemic: DM−DL+, or dyslipidemic and with type 2 diabetes: DM+DL+). We have studied various plasma parameters and gene expression adipose tissue, before and after gastric bypass. Results: The group DM+DL+ tends to have lower values than the other two groups for anthropometric parameters. Regarding the satiety parameters, only leptin (p = 0.0024) showed a significant increase with comorbidities. Lipid parameters showed significant differences among groups, except for phospholipids and NEFA. For insulin resistance parameters, only glucose (p < 0.0001) was higher in DM+DL+ patients, but not insulin or homeostasis model assessment of insulin resistance (HOMA-IR). The gene expression of adiponectin, insulin receptor (INSR) and glucose receptor-4 (GLUT4), in the subcutaneous fat, decreased in all groups vs. a non-obese control. Interleukin-6 (IL6) and the inhibitor of plasminogen activator type 1 (PAI-1) genes decreased only in DM−DL+ and DM+DL+, but not in “healthy” patients. Leptin increased in all groups vs. the non-obese control. The visceral fat from DM+DL+ patients showed a sharp decrease in adiponectin, GLUT4, IL6 and PAI-1. All parameters mentioned above improved very significantly by surgery, independent of the occurrence of comorbidities. Conclusions: The morbidly obese “healthy” individual is not really metabolically healthy, but morbidly obese individuals with diabetes and dyslipidemia are more metabolically imbalanced.
Original languageEnglish
Pages (from-to)1380-1391
JournalObesity Surgery
Volume25
Issue number8
DOIs
Publication statusPublished - 29 Aug 2015

Keywords

  • Bariatric surgery
  • Diabetes
  • Dyslipidemia
  • Healthy obese
  • Inflammation
  • Obesity

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