Differences in glucose control, insulin sensitivity, and body composition between metabolically healthy and unhealthy people with obesity
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Obesity is a significant risk factor for cardiometabolic complications, including type 2 diabetes and cardiovascular disease. However, approximately 25% of individuals with obesity are seemingly protected from these complications (Wildman et al. Arch Intern Med, 168, 1617-24, 2008). The purpose of this study was to provide a careful characterization of body composition and metabolic function in people who are: (i) lean and metabolically normal (MNL); (ii) obese and metabolically-normal (MN)); and (iii) obese and metabolically-abnormal (MAO). (Introduction & study aims) Although the glycemic responses of MNL individuals demonstrate a "metabolically healthy" state, more rigorous measures of insulin sensitivity show insulin resistance in this population, demonstrating people with MNO are insulin-resistant with respect to glucose metabolism but are able to maintain normal glycemic control by increased insulin secretion. Adipose tissue distribution is a marker of metabolic health in people with obesity, as greater intra-abdominal adipose tissue volume and intrahepatic triglyceride content are associated with metabolic dysfunction.