No metabolic derangement, insulin sensitivity preserved; fat on the macrometabolic level can look fit. Now, let's look deeper.
Fat may look fit on the metabolic surface, but the 2 studies summarized here look deeper.
Among the epidemic numbers of the obese found worldwide is a subgroup referred to, paradoxically, as the metabolically healthy obese, or MHO. These individuals are unique in that the increased abdominal adiposity that otherwise would qualify them as "unhealthy," they have no metabolic abnormalities and have preserved insulin sensitivity.
Overt cardiovascular events and other end organ injury related to obesity may take decades to present. Assessment of subclinical atherosclerosis, eg, coronary artery calcification and abnormal carotid intima-media thickness, have been used to evaluate the impact of obesity related factors in a far shorter window.
The slide show above highlights two recent studies that have done that and found that fat indeed is not always as fit as it may seem.
Take Home Points on Studies of Metabolically Healthy Obese
1. Chang Y, Kim BK, Yun KE, et al. Metabolically-healthy obesity and coronary artery calcification. J Am Coll Cardiol. 2014; 24;63:2679-86.
2. Kim TJ, Shin HY, Chang Y, et al. Metabolically healthy obesity and the risk for subclinical atherosclerosis. Atherosclerosis. 2017;262:191-197.