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Background <p>Obesity is a heterogeneous condition. While Metabolically Healthy Obesity (MHO) is often considered to carry a lower risk of metabolic complications than Metabolically Unhealthy Obesity (MUO), findings on their differences remain inconsistent. This study examines for the first time the metabolic differences across obesity phenotypes in Saudi adults, addressing a literature gap in understudied populations with high obesity prevalence.</p> Materials and methods <p>This cross-sectional study included 450 Saudi adults classified as MHO, MUO, or metabolically healthy normal weight (MHNW) based on BMI (≥ 30&#xa0;kg/m²) and the presence of ≥ 3 metabolic abnormalities per National Cholesterol Education Program (NCEP) criteria. Anthropometric, metabolic, and inflammatory parameters were assessed. Age- and sex-adjusted logistic regression analyses were used to compare phenotypes.</p> Results <p>MUO individuals showed significantly higher adiposity indices, insulin resistance (HOMA-IR), and inflammatory markers compared to MHO individuals (p-values &lt; 0.001). MHO individuals also differed significantly from MHNW individuals. Adiponectin levels were comparable across groups; however, the Adiponectin/Leptin ratio (adpn/lep) was lowest in the MUO group, indicating adipose tissue dysfunction. MUO individuals had increased odds of elevated HOMA-IR (OR = 5.76, <i>p</i> &lt; 0.001) and CRP (OR = 2.64, <i>p</i> = 0.005) compared to MHO. While insulin resistance did not differ significantly between MHO and MHNW, MHO participants had higher odds of a low adpn/lep ratio (OR = 2.87, <i>p</i> &lt; 0.005).</p> Conclusion <p>MUO individuals exhibited greater metabolic risk than MHO, with marked insulin resistance and inflammation. However, the presence of adipokine imbalance and elevated inflammatory markers in MHO suggests that ‘metabolic health’ in obesity may be relative rather than absolute.</p>

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Exploring inflammation and adipose tissue dysfunction in metabolically healthy versus unhealthy obesity among Arab adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月2日

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  • Kaiser Wani,
  • Osama Emam,
  • Balvir Kumar,
  • Nasser M. Al-Daghri,
  • Shaun Sabico

摘要

Background

Obesity is a heterogeneous condition. While Metabolically Healthy Obesity (MHO) is often considered to carry a lower risk of metabolic complications than Metabolically Unhealthy Obesity (MUO), findings on their differences remain inconsistent. This study examines for the first time the metabolic differences across obesity phenotypes in Saudi adults, addressing a literature gap in understudied populations with high obesity prevalence.

Materials and methods

This cross-sectional study included 450 Saudi adults classified as MHO, MUO, or metabolically healthy normal weight (MHNW) based on BMI (≥ 30 kg/m²) and the presence of ≥ 3 metabolic abnormalities per National Cholesterol Education Program (NCEP) criteria. Anthropometric, metabolic, and inflammatory parameters were assessed. Age- and sex-adjusted logistic regression analyses were used to compare phenotypes.

Results

MUO individuals showed significantly higher adiposity indices, insulin resistance (HOMA-IR), and inflammatory markers compared to MHO individuals (p-values < 0.001). MHO individuals also differed significantly from MHNW individuals. Adiponectin levels were comparable across groups; however, the Adiponectin/Leptin ratio (adpn/lep) was lowest in the MUO group, indicating adipose tissue dysfunction. MUO individuals had increased odds of elevated HOMA-IR (OR = 5.76, p < 0.001) and CRP (OR = 2.64, p = 0.005) compared to MHO. While insulin resistance did not differ significantly between MHO and MHNW, MHO participants had higher odds of a low adpn/lep ratio (OR = 2.87, p < 0.005).

Conclusion

MUO individuals exhibited greater metabolic risk than MHO, with marked insulin resistance and inflammation. However, the presence of adipokine imbalance and elevated inflammatory markers in MHO suggests that ‘metabolic health’ in obesity may be relative rather than absolute.