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Review
. 2022 Feb 15;13(2):70-84.
doi: 10.4239/wjd.v13.i2.70.

Metabolically healthy obesity: Is it really healthy for type 2 diabetes mellitus?

Qi Wu  1 , Ming-Feng Xia  1 , Xin Gao  1
Affiliations
Review

Metabolically healthy obesity: Is it really healthy for type 2 diabetes mellitus?

Qi Wu et al. World J Diabetes. .

Abstract

Metabolically healthy obese (MHO) individuals are reported to have a lower risk of developing cardiovascular diseases in comparison with individuals with metabolic syndrome. However, the association between MHO and type 2 diabetes (T2DM) is still controversial. Some studies indicated that MHO is a favorable phenotype for T2DM, but more studies showed that MHO individuals have an increased risk of developing T2DM compared with metabolically healthy normal-weight individuals, especially among those who would acquire metabolically unhealthy obesity. This has been supported by finding insulin resistance and low-grade inflammatory responses in MHO individuals with a tendency for impaired beta-cell dysfunction. Studies also showed that liver fat accumulation increased the risk of incidence of T2DM in MHO. Here, we reviewed current literature on the relationship between MHO and T2DM, discussed the determinants for the development of diabetes in MHO, and summarized the measures for the prevention of T2DM in MHO.

Keywords: Beta-cell dysfunction; Insulin resistance; Low-grade inflammatory status; Metabolically healthy obesity; Non-alcoholic fatty liver diseases; Type 2 diabetes.

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Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflict of interest for this article.

Figures

Figure 1
Figure 1
Possible mechanisms that contribute to the future incidence of type 2 diabetes mellitus in the transition from metabolically healthy obesity to metabolically unhealthy obesity. The presence of non-alcoholic fatty liver disease in metabolically healthy obesity is crucial to the incidence of type 2 diabetes mellitus. The possible mechanisms underlying the future development of type 2 diabetes mellitus in metabolically healthy obesity include beta-cell dysfunction, insulin resistance with impaired insulin action, adiponectin concentration reduction, as well as a chronic low-grade inflammatory status. MHO: Metabolically healthy obesity; MUO: Metabolically unhealthy obesity; NAFLD: Non-alcoholic fatty liver disease.
See this image and copyright information in PMC

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