Metabolic Features of Individuals with Obesity Referred for Bariatric and Metabolic Surgery: a Cohort Study
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The concept of metabolic obesity phenotypes has been proposed, but its relevance to metabolic features is unclear.
To determine a new definition of metabolic obesity phenotype, investigate the characteristics of expressing clustered normal and abnormal metabolic parameters, and analyze factors associated with metabolic abnormalities.
Materials and Methods
Characteristics of 600 patients were analyzed. The definition of metabolic obesity phenotype includes elevated blood pressure, glucose, lipid, and uric acid levels and abnormal lipoprotein levels. Independent sample t test and a general linear model with repeated measures were applied to investigate the differences in metabolic parameters.
A total of 108 (18.0%) participants were obese yet metabolically healthy, whereas 492 (82.0%) were obese and metabolically unhealthy. Body weight at baseline was significantly higher in metabolically unhealthy phenotype (P < 0.001). For non-phasic oral glucose tolerance test (OGTT) curve shape, 100% glucose, 100% C-peptide, and 95.8% insulin curves were found in the metabolically unhealthy group. Men had an increased risk for elevated lipid level than women (OR = 1.83, 1.21–2.77). Individuals with class II/III obesity had an increased risk for elevated blood pressure, glucose, and UA levels than did those with class I obesity (OR = 2.22, 1.43–3.44; OR = 1.73, 1.11–2.68; OR = 3.61, 2.29–5.69, respectively).
Approximately one-fifth of individuals with obesity had a metabolically healthy phenotype, and nearly one-third of individuals with class III obesity had this phenotype. Non-phasic OGTT curve shape is a meaningful predictive factor of metabolically unhealthy phenotype before bariatric surgery. Male sex and class II/III obesity are risk factors associated with specific metabolic abnormalities.
KeywordsMetabolic phenotype Obesity Bariatric and metabolic surgery
The authors would like to thank all of the involved study investigators, staffs, clinicians, nurses, and technicians for dedicating their time and skills to the completion of this study.
This study was supported by National Key Technologies R&D Program (Grant No. 2015BAI13B09), Research Foundation of Beijing Friendship Hospital, Capital Medical University (Grant No. yyqdkt 2017-31), Wu Jieping Medical Foundation (Grant No. 320.2710.1813), and Beijing Municipal Administration of Hospitals Incubating Program (Grant No. PX2018001).
Compliance with Ethical Standards
Conflict of Interests
The authors declare that they have no conflict of interest.
Statement of Informed Consent
Informed consent was obtained from all individual participants included in this study.
Statement of Human and Animal Rights
This study was performed in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committees of Beijing Friendship Hospital, Capital Medical University.
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