Metabolically healthy and unhealthy obese in the Lebanese Population, are they different? the role of traditional and non-traditional risk factors

Abstract

Background: Obesity prevalence is increasing worldwide, contributing significantly to the global burden of cardiovascular disease. A subset of obese subjects remains with a favorable metabolic profile labeled metabolically healthy obese. The prevalence and predictors of this group are not well defined in the literature and studies have shown mixed results concerning its cardiovascular and mortality outcomes. Objectives: The objectives of our study are to determine the prevalence of healthy non obese individuals, metabolically healthy obese and unhealthy obese in the Greater Beirut area. In addition we aim to assess differentials in demographics and socioeconomic factors and explore associations in the traditional and non-traditional cardiovascular risk factors between the different groups. Research design and Methods: This is a cross-sectional study involving secondary data analysis from a representative sample of 501 participants residing in Greater Beirut area. Data on BMI and metabolic health defined by the ATP III criteria contributed to the outcome variables. We divided the cohort into four mutually exclusive groups: healthy non-obese (BMI 30 Kg-m2, having one or none of the metabolic factors, referred thereafter as Healthy), unhealthy non-obese (BMI 30 Kg-m2 having two or more of the metabolic factors), metabolically healthy obese (BMI ≥30 Kg-m2, having one or none of the metabolic factors, referred thereafter as MHO), and metabolically unhealthy obese (BMI ≥30 Kg-m2, having two or more of the metabolic factors, referred thereafter as MUHO). However, for the objectives of this study, we focused attention on three groups and on comparisons made between MHO vs. Healthy and MHO vs. MUHO. Firstly, descriptive analysis was carried out to determine the prevalence of the three groups of interest. Then, we provided data on demographics, socioeconomics, lifestyle factors, medical history, and macronutrients intake and body composition. Laboratory data including glucose, lipids, HbA1C, CRP, microalbu