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Metabolic phenotypes of obesity influence triglyceride and inflammation homoeostasis
Author(s) -
PerezMartinez Pablo,
AlcalaDiaz Juan F.,
DelgadoLista Javier,
GarciaRios Antonio,
GomezDelgado Francisco,
MarinHinojosa Carmen,
RodriguezCantalejo Fernando,
DelgadoCasado Nieves,
PerezCaballero Ana I.,
FuentesJimenez Francisco J.,
Camargo Antonio,
Tinahones Francisco J.,
Ordovas Jose M.,
PerezJimenez Francisco,
LopezMiranda Jose
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12339
Subject(s) - postprandial , medicine , endocrinology , overweight , triglyceride , polyunsaturated fatty acid , obesity , area under the curve , glucose homeostasis , cholesterol , chemistry , insulin resistance , fatty acid , biochemistry , insulin
Background We examined the degree of postprandial triglyceride ( TG ) response over the day, representing a highly dynamic state, with continuous metabolic adaptations, among normal‐weight, overweight and obese patients, according to their metabolically healthy or abnormal status. Materials and methods A total of 1002 patients from the CORDIOPREV clinical trial ( NCT 00924937) were submitted to an oral fat load test meal with 0·7 g fat/kg body weight (12% saturated fatty acids ( SFA ), 10% polyunsaturated fatty acids ( PUFA ), 43% monounsaturated fatty acids ( MUFA ), 10% protein and 25% carbohydrates). Serial blood test analysing lipid fractions and inflammation markers (high‐sensitivity C‐reactive protein (hs‐ CRP )) were drawn at 0, 1, 2, 3 and 4 h during postprandial state. We explored the dynamic response according to six body size phenotypes: (i) normal weight, metabolically healthy; (ii) normal weight, metabolically abnormal; (iii) overweight, metabolically healthy; (iv) overweight, metabolically abnormal; (v) obese, metabolically healthy; and (vi) obese, metabolically abnormal. Results Metabolically healthy patients displayed lower postprandial response of plasma TG and large triacylglycerol‐rich lipoproteins ( TRL s)‐ TG , compared with those metabolically abnormal, independently whether or not they were obese ( P < 0·001 and P < 0·001, respectively). Moreover, the area under the curve ( AUC ) of TG and AUC of large TRL s‐ TG were greater in the group of metabolically abnormal compared with the group of metabolically healthy ( P < 0·001 and P < 0·001, respectively). Interestingly, metabolically abnormal subjects displayed higher postprandial response of plasma hs‐ CRP than did the subgroup of normal, overweight and obese, metabolically healthy patients ( P < 0·001). Conclusions Our findings showed that certain types of the metabolic phenotypes of obesity are more favourable modulating phenotypic flexibility after a dynamic fat load test, through TG metabolism and inflammation homoeostasis. To identify, these phenotypes may be the best strategy for personalized treatment of obesity.