Are There Differences in Hair Mineral Concentrations Between Metabolically Healthy and Unhealthy Obese Adults?


Obesity is a risk factor for metabolic syndrome, dyslipidemia, hypertension, insulin resistance, type 2 diabetes mellitus, and cardiovascular disease. However, obesity is not a homogenous state and not all subjects in an obese population are at an increased risk for metabolic abnormalities. Thus, obesity types can be subdivided into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) according to metabolic status. Body minerals are important and are involved in various metabolic processes that may be related to obesity. Thus, this study determined whether hair mineral concentrations differ between MHO and MUO adults. The associations between metabolic risk factors and hair mineral concentrations were analyzed in 141 obese Korean adults (62 MHO subjects and 79 MUO subjects). The MUO subjects showed significantly higher triglyceride levels, systolic blood pressure, waist circumference and body mass index, lower high-density lipoprotein cholesterol levels, and greater insulin resistance as reflected by the homeostasis model assessment-insulin resistance (HOMA-IR) index compared with MHO subjects. No significant differences in hair mineral concentrations were detected between MHO and MUO adults. Hair iron and cobalt concentrations were significantly negatively correlated with blood pressure in subjects with MHO. In addition, hair zinc concentration was associated with decreased systolic blood pressure. The results of this study suggest that mineral status in obese adults may play a role in metabolic abnormalities. Further studies with a larger number of subjects are warranted to identify the nature of the relationship between hair mineral status and metabolic risk in MHO and MUO subjects.

This is a preview of subscription content, log in to check access.


  1. 1.

    Bastien M, Poirier P, Lemieux I, Despres JP (2014) Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis 56:369–381

    Article  Google Scholar 

  2. 2.

    Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH (2006) Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 113:898–918

    Article  Google Scholar 

  3. 3.

    Meigs JB, Wilson PW, Fox CS, Vasan RS, Nathan DM, Sullivan LM, D'Agostino RB (2006) Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 91:2906–2912

    CAS  Article  Google Scholar 

  4. 4.

    Durward CM, Hartman TJ, Nickols-Richardson SM (2012) All-cause mortality risk of metabolically healthy obese individuals in NHANES III. J Obes 2012:460321

    CAS  Article  Google Scholar 

  5. 5.

    Hong HC, Lee JS, Choi HY, Yang SJ, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM (2013) Liver enzymes and vitamin D levels in metabolically healthy but obese individuals: Korean National Health and Nutrition Examination Survey. Metabolism 62:1305–1312

    CAS  Article  Google Scholar 

  6. 6.

    Stefan N, Kantartzis K, Machann J, Schick F, Thamer C, Rittig K, Balletshofer B, Machicao F, Fritsche A, Haring HU (2008) Identification and characterization of metabolically benign obesity in humans. Arch Intern Med 168:1609–1616

    Article  Google Scholar 

  7. 7.

    Poli VFS, Sanches RB, Moraes ADS, Fidalgo JPN, Nascimento MA, Bresciani P, Andrade-Silva SG, Cipullo MAT, Clemente JC, Caranti DA (2017) The excessive caloric intake and micronutrient deficiencies related to obesity after a long-term interdisciplinary therapy. Nutrition 38:113–119

    CAS  Article  Google Scholar 

  8. 8.

    Garcia OP, Long KZ, Rosado JL (2009) Impact of micronutrient deficiencies on obesity. Nutr Rev 67:559–572

    Article  Google Scholar 

  9. 9.

    Via M (2012) The malnutrition of obesity: micronutrient deficiencies that promote diabetes. ISRN Endocrinol 2012:103472

    Article  Google Scholar 

  10. 10.

    Fatani SH, Saleh SA, Adly HM, Abdulkhaliq AA (2016) Trace element alterations in the hair of diabetic and obese women. Biol Trace Elem Res 174:32–39

    CAS  Article  Google Scholar 

  11. 11.

    Skalnaya MG, Skalny AV, Grabeklis AR, Serebryansky EP, Demidov VA, Tinkov AA (2018) Hair trace elements in overweight and obese adults in association with metabolic parameters. Biol Trace Elem Res 186:12–20

    CAS  Article  Google Scholar 

  12. 12.

    Suliburska J, Bogdanski P, Pupek-Musialik D, Krejpcio Z (2011) Dietary intake and serum and hair concentrations of minerals and their relationship with serum lipids and glucose levels in hypertensive and obese patients with insulin resistance. Biol Trace Elem Res 139:137–150

    CAS  Article  Google Scholar 

  13. 13.

    Krol E, Bogdanski P, Suliburska J, Krejpcio Z (2018) The relationship between dietary, serum and hair levels of minerals (Fe, Zn, Cu) and glucose metabolism indices in obese type 2 diabetic patients. Biol Trace Elem Res

  14. 14.

    Miao X, Sun W, Fu Y, Miao L, Cai L (2013) Zinc homeostasis in the metabolic syndrome and diabetes. Front Med 7:31–52

    Article  Google Scholar 

  15. 15.

    Tang X, Shay NF (2001) Zinc has an insulin-like effect on glucose transport mediated by phosphoinositol-3-kinase and Akt in 3T3-L1 fibroblasts and adipocytes. J Nutr 131:1414–1420

    CAS  Article  Google Scholar 

  16. 16.

    Klevay LM, Bistrian BR, Fleming CR, Neumann CG (1987) Hair analysis in clinical and experimental medicine. Am J Clin Nutr 46:233–236

    CAS  Article  Google Scholar 

  17. 17.

    Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752

    Article  Google Scholar 

  18. 18.

    Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ (2007) Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 75:72–80

    Article  Google Scholar 

  19. 19.

    Jung CH, Lee MJ, Hwang JY, Jang JE, Leem J, Yang DH, Kang JW, Kim EH, Park JY, Kim HK, Lee WJ (2014) Association of metabolically healthy obesity with subclinical coronary atherosclerosis in a Korean population. Obesity (Silver Spring) 22:2613–2620

    Article  Google Scholar 

  20. 20.

    Medical Systems; Clinical Analyzer, Laboratory Automatic Systems, Service & Support. Accessed 15 Oct 2018

  21. 21.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    CAS  Article  Google Scholar 

  22. 22.

    Kim HN, Kim SH, Eun YM, Song SW (2018) Effects of zinc, magnesium, and chromium supplementation on cardiometabolic risk in adults with metabolic syndrome: a double-blind, placebo-controlled randomised trial. J Trace Elem Med Biol 48:166–171

    CAS  Article  Google Scholar 

  23. 23.

    Trace Elements Laboratory profiles. Accessed 15 Oct 2018

  24. 24.

    Choi WS, Kim SH, Chung JH (2014) Relationships of hair mineral concentrations with insulin resistance in metabolic syndrome. Biol Trace Elem Res 158:323–329

    CAS  Article  Google Scholar 

  25. 25.

    Wang Y, Wei J, Zeng C, Yang T, Li H, Cui Y, Xie D, Xu B, Liu Z, Li J, Jiang S, Lei G (2018) Association between serum magnesium concentration and metabolic syndrome, diabetes, hypertension and hyperuricaemia in knee osteoarthritis: a cross-sectional study in Hunan Province, China. BMJ Open 8:e019159

    Article  Google Scholar 

  26. 26.

    Maier JA (2003) Low magnesium and atherosclerosis: an evidence-based link. Mol Asp Med 24:137–146

    CAS  Article  Google Scholar 

  27. 27.

    Houston M (2011) The role of magnesium in hypertension and cardiovascular disease. J Clin Hypertens (Greenwich) 13:843–847

    CAS  Article  Google Scholar 

  28. 28.

    Pinhas-Hamiel O, Newfield RS, Koren I, Agmon A, Lilos P, Phillip M (2003) Greater prevalence of iron deficiency in overweight and obese children and adolescents. Int J Obes Relat Metab Disord 27:416–418

    CAS  Article  Google Scholar 

  29. 29.

    Nead KG, Halterman JS, Kaczorowski JM, Auinger P, Weitzman M (2004) Overweight children and adolescents: a risk group for iron deficiency. Pediatrics 114:104–108

    Article  Google Scholar 

  30. 30.

    Salonen JT, Nyyssonen K, Korpela H, Tuomilehto J, Seppanen R, Salonen R (1992) High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation 86:803–811

    CAS  Article  Google Scholar 

  31. 31.

    Fields M, Lewis CG (1999) Level of dietary iron, not type of dietary fat, is hyperlipidemic in copper-deficient rats. J Am Coll Nutr 18:353–357

    CAS  Article  Google Scholar 

  32. 32.

    Singh RB, Niaz MA, Rastogi SS, Bajaj S, Gaoli Z, Shoumin Z (1998) Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India. J Am Coll Nutr 17:564–570

    CAS  Article  Google Scholar 

  33. 33.

    Bergomi M, Rovesti S, Vinceti M, Vivoli R, Caselgrandi E, Vivoli G (1997) Zinc and copper status and blood pressure. J Trace Elem Med Biol 11:166–169

    CAS  Article  Google Scholar 

  34. 34.

    Kim J (2013) Dietary zinc intake is inversely associated with systolic blood pressure in young obese women. Nutr Res Pract 7:380–384

    CAS  Article  Google Scholar 

  35. 35.

    Canatan H, Bakan I, Akbulut M, Halifeoglu I, Cikim G, Baydas G, Kilic N (2004) Relationship among levels of leptin and zinc, copper, and zinc/copper ratio in plasma of patients with essential hypertension and healthy normotensive subjects. Biol Trace Elem Res 100:117–123

    CAS  Article  Google Scholar 

  36. 36.

    Chiplonkar SA, Agte VV, Tarwadi KV, Paknikar KM, Diwate UP (2004) Micronutrient deficiencies as predisposing factors for hypertension in lacto-vegetarian Indian adults. J Am Coll Nutr 23:239–247

    CAS  Article  Google Scholar 

  37. 37.

    Liang C, Wang J, Xia X, Wang Q, Li Z, Tao R, Tao Y, Xiang H, Tong S, Tao F (2018) Serum cobalt status during pregnancy and the risks of pregnancy-induced hypertension syndrome: a prospective birth cohort study. J Trace Elem Med Biol 46:39–45

    CAS  Article  Google Scholar 

  38. 38.

    Goncalves CG, Glade MJ, Meguid MM (2016) Metabolically healthy obese individuals: key protective factors. Nutrition 32:14–20

    CAS  Article  Google Scholar 

  39. 39.

    Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, Sowers MR (2008) The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med 168:1617–1624

    Article  Google Scholar 

  40. 40.

    Appleton SL, Seaborn CJ, Visvanathan R, Hill CL, Gill TK, Taylor AW, Adams RJ (2013) Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes Care 36:2388–2394

    Article  Google Scholar 

  41. 41.

    Arner P (2001) Regional differences in protein production by human adipose tissue. Biochem Soc Trans 29:72–75

    CAS  Article  Google Scholar 

  42. 42.

    Kramer CK, Zinman B, Retnakaran R (2013) Are metabolically healthy overweight and obesity benign conditions?: a systematic review and meta-analysis. Ann Intern Med 159:758–769

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Sang-Wook Song.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required. The study protocol was approved by the Catholic University of Korea St. Vincent’s Hospital Institutional Review Board (IRB approval number: VC18RESI0177).

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lee, Y., Kim, S., Kim, H. et al. Are There Differences in Hair Mineral Concentrations Between Metabolically Healthy and Unhealthy Obese Adults?. Biol Trace Elem Res 193, 311–318 (2020).

Download citation


  • Obesity
  • Metabolic syndrome
  • Hair minerals
  • Blood pressure