Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Characteristics of metabolically unhealthy lean people

02.08.2017

Compared to people who are of normal weight and metabolically healthy, subjects who are of normal weight but metabolically unhealthy (~20% of normal weight adults) have a more than three-fold higher risk of mortality and/or cardiovascular events. This risk is also higher than that of metabolically healthy obese subjects. DZD-Researcher have now addressed characteristics determining metabolic health in lean, overweight and obese people, showed that a reduced accumulation of fat in the lower body puts lean people at risk and highlighted implications of their findings for personalized prevention and treatment of cardiometabolic diseases.

It has now been established that a body-mass index (BMI) in the normal weight range (defined by WHO as a BMI of 18·5–<25·0 kg/m²) associates with the lowest all-cause mortality. However, does this assumption apply to all subjects in this BMI range? The research into the causes and consequences of metabolically healthy obesity (MHO) has shown that for a certain BMI, the risk of cardiometablic disease and death can vary substantially among subjects.


People who are of normal weight but metabolically unhealthy have a more than three-fold higher risk of mortality and/or cardiovascular events.

Image source: IDM

In this respect, large studies showed that, compared to metabolically healthy people in the normal weight range, subjects with MHO only have a moderate (~25%) higher risk of all-cause mortality and/or cardiovascular events, while the risk is much higher (~300%) in metabolically unhealthy lean people.

This raises four important question: 1. what phenotypes characterize these metabolically unhealthy lean people, 2. do these phenotypes differ from those which place obese subjects at increased risk, 3. what molecular mechanisms determine these phenotypes in lean and in obese subjects and 4. how can this knowledge be used to prevent and treat diseases?

The researchers from the Department of Internal Medicine IV of the University Hospital Tübingen and the Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich, a partner of the German Center for Diabetes Research (DZD), have now analyzed data from 981 subjects. After having defined metabolic health as having less than 2 risk parameters of the metabolic syndrome, they found that 18% of their lean subjects were metabolically unhealthy.

This number perfectly matches the numbers detected in larger studies that investigated the relationship of metabolic health with cardiovascular events and mortality. Stefan and colleagues now used magnetic resonance imaging and magnetic resonance spectroscopy to precisely determine body fat mass, fat distribution and deposition of fat in the liver.

Furthermore, they determined insulin sensitivity, insulin secretion, thickness of the carotid vessel wall and fitness. They found that among the fat compartments a low percentage leg fat mass was the strongest determinant of metabolic risk in lean subjects, while in obese subjects nonalcoholic fatty liver disease and increased intra-abdominal fat mass strongly determined this risk.

Based on these findings, and with support from animal data and genetic data from human studies, they concluded that in lean subjects the problem of storing fat in the leg may be a crucial factor placing lean people at increased risk of cardiometabolic diseases.

They further hypothesize that this phenotype resembles the phenotypes observed in some very rare diseases, called lipodystrophy. However, they highlight that this lipodystrophy-like phenotype has a much less severe form that the ones observed in these diseases.

In respect to the impact of their findings for routine clinical practice the researchers make the following points: First, in the case that a subject with normal weight may have two or more parameters of the metabolic syndrome in a clinical examination, and/or may have a low leg fat mass, it would be important to perform careful diagnostics to early detect metabolic diseases.

Second, if a cardiometabolic disease, such as type 2 diabetes or cardiovascular disease, is present in very lean people, pharmacological treatment resulting in an increase in subcutaneous fat mass may be beneficial for some patients. In this respect thiazolidinediones may be of major interest. Finally, applying well-defined phenotyping strategies in clinical trials to better separate the metabolic risk in lean and obese subjects may help to better tailor lifestyle and pharmacological intervention to accomplish the goal of providing personalized prevention and treatment to the patients.

Source
Stefan et al., Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans, Cell Metabolism (2017), http://dx.doi.org/10.1016/j.cmet.2017.07.008

Media contact for inquiries about the current publication
Prof. Dr. med. Norbert Stefan
Prof. Dr. Hans-Ulrich Häring
Universitätsklinikum Tübingen
Medizinische Klinik, Abteilung IV
Otfried-Müller-Straße 10, 72076 Tübingen
Phone 1: +49 (0)7071 29-80390
Phone 2: +49 (0)7071 29-85669
Phone 3: +49 (0)7071 29-83670
norbert.stefan@med.uni-tuebingen.de


Media Contact:
Birgit Niesing
German Center for Diabetes Research (DZD
Ingolstädter Landstraße 1
85764 Neuherberg
Germany
Phone: +49 (0)89-3187-3971
email: niesing@dzd-ev.de

The German Center for Diabetes Research (DZD) is one of six German Centers for Health Research. It brings together experts in the field of diabetes research and integrates basic research, epidemiology, and clinical applications. By adopting an innovative, integrative approach to research, the DZD aims to make a substantial contribution to the successful personalized prevention diagnosis and treatment of diabetes mellitus. The members of the DZD are Helmholtz Zentrum München – German Research Center for Environmental Health, the German Diabetes Center (DDZ) in Düsseldorf, the German Institute of Human Nutrition (DIfE) in Potsdam-Rehbrücke, the Institute of Diabetes Research and Metabolic Diseases of Helmholtz Zentrum München at the University of Tübingen, the Paul Langerhans Institute Dresden of Helmholtz Zentrum München at the Carl Gustav Carus University Hospital of TU Dresden, associated partners at the universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich, and other project partners. www.dzd-ev.de 

The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich and has about 2,300 staff members. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members. www.helmholtz-muenchen.de/en

Birgit Niesing | idw - Informationsdienst Wissenschaft

Further reports about: BMI Diabetes Helmholtz diseases magnetic resonance metabolic mortality phenotypes

More articles from Life Sciences:

nachricht New eDNA technology used to quickly assess coral reefs
18.04.2019 | University of Hawaii at Manoa

nachricht New automated biological-sample analysis systems to accelerate disease detection
18.04.2019 | Polytechnique Montréal

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Explosion on Jupiter-sized star 10 times more powerful than ever seen on our sun

A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter

  • Coolest and smallest star to produce a superflare found
  • Star is a tenth of the radius of our Sun
  • Researchers led by University of Warwick could only see...

Im Focus: Quantum simulation more stable than expected

A localization phenomenon boosts the accuracy of solving quantum many-body problems with quantum computers which are otherwise challenging for conventional computers. This brings such digital quantum simulation within reach on quantum devices available today.

Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. “A particularly promising application is the...

Im Focus: Largest, fastest array of microscopic 'traffic cops' for optical communications

The technology could revolutionize how information travels through data centers and artificial intelligence networks

Engineers at the University of California, Berkeley have built a new photonic switch that can control the direction of light passing through optical fibers...

Im Focus: A long-distance relationship in femtoseconds

Physicists observe how electron-hole pairs drift apart at ultrafast speed, but still remain strongly bound.

Modern electronics relies on ultrafast charge motion on ever shorter length scales. Physicists from Regensburg and Gothenburg have now succeeded in resolving a...

Im Focus: Researchers 3D print metamaterials with novel optical properties

Engineers create novel optical devices, including a moth eye-inspired omnidirectional microwave antenna

A team of engineers at Tufts University has developed a series of 3D printed metamaterials with unique microwave or optical properties that go beyond what is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

First dust conference in the Central Asian part of the earth’s dust belt

15.04.2019 | Event News

Fraunhofer FHR at the IEEE Radar Conference 2019 in Boston, USA

09.04.2019 | Event News

 
Latest News

New automated biological-sample analysis systems to accelerate disease detection

18.04.2019 | Life Sciences

Explosion on Jupiter-sized star 10 times more powerful than ever seen on our sun

18.04.2019 | Physics and Astronomy

New eDNA technology used to quickly assess coral reefs

18.04.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>