Differences in body composition in metabolically healthy and unhealthy women with morbid obesity

Abstract

Differences in body composition may explain the defense to develop a metabolic unhealthy state MUO). The purpose of this study is to characterize body composition in women with BMI ≥40 kg/m2 categorized by the presence of metabolic alterations. Methodology: Body composition was determined by bioimpedance analysis (SECA mBCA 514 Medical Body Composition Analyzer). Fasting blood samples were obtained for quantification of glucose, glycated hemoglobin, lipid profile and liver transaminases. HOMA index was estimated as the fasting glucose (mg/ dL) multiplied by fasting insulin (μU/mL). MHO was defined as the presence of 1 or none of the following criteria: triglycerides 151-499 mg/dL or treatment for hypertriglyceridemia, fasting glucose 100-125 mg/ dL, 2-hour glucose after a 75-g load 140-199 mg/dL, glycated hemoglobin 5.6-6.4% and blood pressure >130/85 mmHg or treatment for hypertension. MUO was considered when 2 or more of these characteristics were present. Exclusion criteria included diabetes and treatment with hypoglycemic medications. Findings: We included 19 MHO and 32 MUO women, age was higher in the MUO group (33.5±13.8 vs. 43.8±10.1, p= 0.004). Fasting glucose, 2-hour glucose, glycated hemoglobin, triglycerides and HDLcholesterol were higher in the MUO group, as expected (p< 0.05). Fasting insulin, HOMA and liver transaminases were similar between groups. Weight (124.5±18 vs 124.7 ± 17.4 kg) and BMI (47.5 ±8.4 vs 49.9±5.5 kg/m2) were similar in the MHO and MUO groups. Percentage of fat mass (54.4±2.6 vs 55.0±2.9 %) and fat free mass (45.5±2.6 vs 44.9± 2.9%) were also similar. Remarkably, visceral adipose tissue was significantly higher in the MUO group (6.9±1.9 vs 5.6±2.1 L, p= 0.30). We postulate that visceral adipose tissue accumulation may be a driver for the presence of metabolic unhealthy profile independently of body weight and fat tissue amount.