James L Hopkins1, Paul N Hopkins1, Eliot A Brinton2, Ted D Adams1,3, Lance E Davidson1,4, M Nazeem Nanjee1, Steven C Hunt1,5. 1. 1 Cardiovascular Genetics, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah. 2. 2 The Utah Lipid Center and Utah Foundation for Biomedical Research , Salt Lake City, Utah. 3. 3 Intermountain Live Well Center , Intermountain Healthcare, Salt Lake City, Utah. 4. 4 Department of Exercise Sciences, Brigham Young University , Provo, Utah. 5. 5 Department of Genetic Medicine, Weill Cornell Medicine in Qatar, Doha, Qatar .
Abstract
BACKGROUND: The prevalence of metabolic syndrome (MetS) generally rises with increasing adiposity, but tends to plateau at the highest levels of body mass index (BMI) with some individuals, even with severe obesity, expressing few or no components of MetS. We examined factors associated with the expression of MetS in severely obese women participating in a large observational study. METHODS: Anthropometrics, including Heath equation-adjusted bioimpedance-determined fat-free mass (FFM) and fat mass (FM), lipids and related laboratory measurements, resting energy expenditure (REE), and respiratory quotient (RQ), were studied in 949 women with severe obesity. RESULTS: Even though the mean BMI was 45.7 kg/m2 and all participants met MetS criteria for increased waist circumference, 30% of subjects did not have MetS. Unadjusted FM (P = 0.0011), FFM (P < 0.0001), and REE (P < 0.0001) were greater in the women with MetS. Surprisingly, in multivariate logistic regression FFM was positively associated with MetS (P = 0.0002), while FM was not (P = 0.89). Moreover, FFM, not FM, was significantly associated with all five components of MetS except for triglyceride levels. REE and RQ were higher in those with MetS, and REE was strongly associated with multiple components of MetS. CONCLUSIONS: In women with severe obesity, higher FFM and REE were paradoxically associated with increased rather than decreased risk of MetS, while FFM-adjusted FM was unrelated to MetS.
BACKGROUND: The prevalence of metabolic syndrome (MetS) generally rises with increasing adiposity, but tends to plateau at the highest levels of body mass index (BMI) with some individuals, even with severe obesity, expressing few or no components of MetS. We examined factors associated with the expression of MetS in severely obesewomen participating in a large observational study. METHODS: Anthropometrics, including Heath equation-adjusted bioimpedance-determined fat-free mass (FFM) and fat mass (FM), lipids and related laboratory measurements, resting energy expenditure (REE), and respiratory quotient (RQ), were studied in 949 women with severe obesity. RESULTS: Even though the mean BMI was 45.7 kg/m2 and all participants met MetS criteria for increased waist circumference, 30% of subjects did not have MetS. Unadjusted FM (P = 0.0011), FFM (P < 0.0001), and REE (P < 0.0001) were greater in the women with MetS. Surprisingly, in multivariate logistic regression FFM was positively associated with MetS (P = 0.0002), while FM was not (P = 0.89). Moreover, FFM, not FM, was significantly associated with all five components of MetS except for triglyceride levels. REE and RQ were higher in those with MetS, and REE was strongly associated with multiple components of MetS. CONCLUSIONS: In women with severe obesity, higher FFM and REE were paradoxically associated with increased rather than decreased risk of MetS, while FFM-adjusted FM was unrelated to MetS.
Authors: H Yamanaka; Y Kawagoe; A Taniguchi; N Kaneko; S Kimata; S Hosoda; N Kamatani; S Kashiwazaki Journal: Metabolism Date: 1992-04 Impact factor: 8.694
Authors: Rachel P Wildman; Paul Muntner; Kristi Reynolds; Aileen P McGinn; Swapnil Rajpathak; Judith Wylie-Rosett; MaryFran R Sowers Journal: Arch Intern Med Date: 2008-08-11
Authors: Gladys W Strain; Jack Wang; Michel Gagner; Alfons Pomp; William B Inabnet; Steven B Heymsfield Journal: Obesity (Silver Spring) Date: 2008-06-12 Impact factor: 5.002
Authors: Richard J Johnson; Peter Stenvinkel; Sandra L Martin; Alkesh Jani; Laura Gabriela Sánchez-Lozada; James O Hill; Miguel A Lanaspa Journal: Obesity (Silver Spring) Date: 2013-04 Impact factor: 5.002