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Schulze, M.B.* ; Stefan, N.

Metabolically healthy obesity: From epidemiology and mechanisms to clinical implications.

Nat. Rev. Endocrinol., DOI: 10.1038/s41574-024-01008-5 (2024)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
The concept of metabolic health, particularly in obesity, has attracted a lot of attention in the scientific community, and is being increasingly used to determine the risk of cardiovascular diseases and diabetes mellitus-related complications. This Review assesses the current understanding of metabolically healthy obesity (MHO). First, we present the historical evolution of the concept. Second, we discuss the evidence for and against its existence, the usage of different definitions of MHO over the years and the efforts made to provide novel definitions of MHO. Third, we highlight epidemiological data with regard to cardiovascular risk in MHO, which is estimated to be moderately elevated using widely used definitions of MHO when compared with individuals with metabolically healthy normal weight, but potentially not elevated using a novel definition of MHO. Fourth, we discuss novel findings about the physiological mechanisms involved in MHO and how such knowledge helps to identify and characterize both people with MHO and those with metabolically unhealthy normal weight. Finally, we address how the concept of MHO can be used for risk stratification and treatment in clinical practice.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Body-mass Index; Coronary-heart-disease; Cardiovascular-disease; Adipose-tissue; Normal-weight; Risk; Metaanalysis; Individuals; People; Identification
ISSN (print) / ISBN 1759-5029
e-ISSN 1759-5037
Journal Nature Reviews - Endocrinology
Publisher Nature Publishing Group
Publishing Place New York, NY
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy (SOPHIA) project
German Centre of Diabetes Research (DZD)
German Federal Ministry of Education and Research (BMBF)