Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela [version 3; peer review: 2 approved, 1 approved with reservations]
Modesto Graterol,
Marcos Cerda,
Carlos Garicano,
Rosemily Graterol,
Joselyn Rojas,
Valmore Bermudez,
Manuel Velasco,
Luis Carlos Olivar,
Maria Sofia Martinez,
Andres Mindiola,
Maria Jose Calvo,
Sandra Wilches-Duran,
Roberto Añez,
Juan Diego Hernandez,
Juan Salazar
Affiliations
Modesto Graterol
Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
Marcos Cerda
Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
Carlos Garicano
Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
Rosemily Graterol
Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
Joselyn Rojas
Endocrine and Metabolic Diseases Research Center, The University of Zulia, Maracaibo, Venezuela
Background: In 1980, Reuben Andresen observed that in certain individuals, obesity did not increase mortality, introducing an atypical phenotype called “healthy obese”. Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. Methods: A descriptive, cross-sectional sub-analysis of The Maracaibo City Metabolic Syndrome Prevalence Study, with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster being predictive variables: HOMA2-IR, HOMA2-βcell, triglycerides. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. Results: In the studied population, 43.9% (n=538) were healthy normal weight, 5.2% (n=64) unhealthy normal weight, 17.4% (n=217) healthy obese and 33.5% (n=411) unhealthy obese subjects. Atypical phenotypes, Metabolically Unhealthy Normal-Weight (MUNW) was more frequent in males (56.3%), whereas Metabolically Unhealthy Obese (MUO) was more frequent in females (51.3%). This phenotypes had a higher coronary event risk, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Conclusion: Individuals with atypical metabolic phenotypes are common in Maracaibo city. Related factors may include insulin resistance, basal glucose, and triglycerides levels. Lastly, obese subjects show a higher coronary event risk even those with normal metabolic status.
