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Background. Among the obese, the so-called metabolically healthy obese (MHO) phenotype is thought to confer a lower CVD risk as compared to obesity with typical associated metabolic changes.The present study aims to determine the relationship of different subtypes of obesity with inflammatory-cardiometabolic abnormalities. Methods. We evaluated 5,519 healthy, Brazilian subjects (43 ± 10 years, 78% males), free of known cardiovascular disease. Those with <2 metabolic risk factors (MRF) were considered metabolically healthy, and thosewith BMI ≥ 25 kg/m2 and/or waist circumference meetingNCEP criteria for metabolic syndrome as overweight/obese (OW). High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and hepatic steatosis (HS) was determined via abdominal ultrasound. Results. Overall, 40% of OWindividuals were metabolically healthy, and 12% normal-weight had ≥2 MRF.The prevalence of elevated CRP (≥3mg/dL) and HS inMHO versus normal weight metabolically healthy group was 22% versus 12%, and 40%versus 8%respectively (𝑃 < 0.001). BothMHOindividuals andmetabolically unhealthy normal weight (MUNW) phenotypes were associated with elevated hsCRP and HS. Conclusion. Our study suggests that MHO and MUNW phenotypes may not be benign and physicians should strive to treat individuals in these subgroups to reverse these conditions.


Originally published in the Journal of Obesity.

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