Metabolic status in normal-weight and obese young individuals
Authors: Chulkov V , Gavrilova ES , Chulkov VLS , Tkachenko PE , Lenets EA 
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction. The concept of metabolic health in obese and normal-weight individuals remains controversial. It is important to study cardiometabolic risk factors in various phenotypes of normal-weigth and overweight/obese young individuals, which may be a practical and important step towards personalised medicine.

Purpose. To estimate associations of cardiometabolic risk factors with adipokines in normal weight, overweight/obese young individuals.

Methods. Study design: cross-sectional study. The study included 251 patients. All patients were divided into 4 groups: group I - metabolically healthy individuals with normal-weight aged 24.5 [22-31] years (n = 62); group II - metabolically unhealthy individuals with normal-weight aged 28 [23-38] years (n = 57); group III - metabolically healthy overweight/obesity aged 30 [24-36] years (n = 16); group IV - metabolically unhealthy overweight/obesity aged 36 [28.5-41] years (n = 116). We perfomed clinical examination, measured lipids, serum concentrations of glucose, insulin, leptin, adipokines, fibrinogen, type I plasminogen activator inhibitor (PAI-1). Data analysis was performed using the statistical package MedCalc Saftware (Version 19.6). p &lt; 0.05 were taken as statistically significant. 

Results. The highest concentrations of glucose, insulin and the insulin resistance index HOMA-IR were found in groups with a metabolically unhealthy profile (group II and IV) compared to group I and III. The highest concentrations of triglycerides, LDL, fibrinogen and PAI-1, as well as the lowest values of HDL, were found in group IV vs group I, II, III. The concentration of leptin was higher in metabolically unhealthy overweigt/obesity individuals, as well as lower concentration of adiponectin in group III and IV compared to group I and II. In young individuals with a metabolically healthy phenotype, we obtained positive linear correlations between PAI-1 and systolic (r = 0.337, p = 0.04) and diastolic blood pressure (r = 0.314, p = 0.022), as well as negative associations between waist circumference and HDL (r= - 0.374, p = 0.003). In young individuals with a metabolically unhealthy phenotype, the most significant positive linear correlations were found between the concentrations of leptin and fibrinogen (r = 0.490, p = 0.003), as well as systolic blood pressure and HDL (r = 0.307, p = 0.02). In the group of young adults with metabolically healthy obesity the only negative correlation between waist circumference and HDL cholesterol (r= - 0,599, p = 0,031) was revealed. The most significant correlations among metabolically unhealthy obese individuals were obtained between diastolic blood pressure and fibrinogen (r = 0.346, p &lt; 0.001), as well as body mass index and leptin (r = 0.521, p &lt; 0.001). 

Conclusion. The most pronounced disorders of carbohydrate and lipid metabolism in combination with an imbalance of adipokines and prothrombotic changes in hemostasis were found in young individuals with metabolically unhealthy owerweight/obesity.