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Review
. 2022 Sep 13;58(9):1271.
doi: 10.3390/medicina58091271.

Factors of Obesity and Metabolically Healthy Obesity in Asia

Bryan J Mathis  1 , Kiyoji Tanaka  2 , Yuji Hiramatsu  1
Affiliations
Review

Factors of Obesity and Metabolically Healthy Obesity in Asia

Bryan J Mathis et al. Medicina (Kaunas). .

Abstract

The East Asian region (China, Japan, and South Korea) is comprised of almost 1.5 billion people and recent industrialization has brought with it a pandemic of rising obesity, even in children. As these countries are rapidly aging and functioning at sub-replacement birthrates, the burgeoning costs of obesity-related care may threaten socialized healthcare systems and quality of life. However, a condition called metabolically healthy obesity (MHO) has been found to be without immediate cardiopulmonary or diabetic risk. Thus, maintenance of the MHO condition for the obese in East Asia could buffer the burden of long-term obesity care on medical systems and knowledge of the biochemical, genetic, and physiological milieu associated with it could also provide new targets for intervention. Diverse physiological, psychological, environmental, and social factors play a role in obesogenesis and the transition of MHO to a metabolically unhealthy obesity. This review will give a broad survey of the various causes of obesity and MHO, with special emphasis on the East Asian population and studies from that region.

Keywords: body mass index; diabetes; metabolically healthy obesity; obesity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Sources and targets of reactive oxygen species damage in obesity. A multifactorial generation of reactive oxygen species comes from blood glucose dysregulation, reductions in detoxifying enzymes, and the adipocytes themselves. Targets include double-stranded DNA and the endothelial lining of blood vessels [21,23,24,25,29,32,33]. DSB = double-strand break Created in BioRender.com.
Figure 2
Figure 2
Hormonal Effects in MHO vs. MUHO. A delicate biochemical homeostasis between leptin, ghrelin, and adiponectin controls energy intake in addition to the action of insulin. Resistance to leptin signaling increases hunger by upregulating ghrelin while adiponectin may be increased in MHO vs. MUHO [75]. Created in BioRender.com.
Figure 3
Figure 3
Importance of barrier function in preventing obesity. Diverse symbiotic species of bacteria protect the digestive tract by crowding out pathogens as well as maintaining the mucus barrier and promoting immune tolerance by dendritic sampling. Pathogens, antibiotics, and loss of the mucus layer degrades the integrity of the epithelial barrier via lowered MyD88 and immune recruitment creates sustained inflammation that may promote obesity [115,117]. Created in BioRender.com.
See this image and copyright information in PMC

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