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Abstract Congresso Internazionale di Medicina Antiaging-Parigi 2014

POLIMENI Ascanio, MD Friday, October 24, 2014 - from 14:00 to 15:00
Beyond BMI index: unhealthy obesity and aging, two sides of the same coin Room 251

Obesity is a major health issue in developed as well as developing countries.While obesity is associated with relatively good health status in some individuals, it may become a health issue for others. Infact,a subgroup has emerged within the obese patients that do not display the typical metabolic disorders associated with obesity (METABOLICALLY UNHEALTHY OBESITY or MUO) and are hypothesized to have lower risk of complications (METABOLICALLY HEALTHY OBESITY or MHO).Obesity in the context of inflammation has been also studied extensively. However, whether obesity in its various forms has the same adverse effects is a matter of debate and requires further research. During its natural history, metabolically healthy obesity (MHO) converts into metabolically unhealthyobesity (MUO). What causes this transition to occur and what is the role of obesity-related mediators of inflammation during this transition is discussed in this paper.

Pubmed, Cochrane Library, and Web of Science were searched from their inception until December 2012. Studies were included which clearly defined the MHO group and the MUO groups using either insulin sensitivity and/or components of metabolic syndrome and obesity) and its association with either all cause mortality, CVD mortality, incident CVD, and/or subclinical CVD.All the studies that examined the potential role of inflammation in the progression of MHO torwards MUO were also examined.

A total of 20 studies were identified; 15 cohort and 5 cross-sectional. Eight studies used the NCEP Adult Treatment Panel III definition of metabolic syndrome to define "metabolically healthy", while another nine used insulin resistance. Seven studies assessed all-cause mortality, seven assessed CVD mortality, and nine assessed incident CVD. Different studies also showed that the progression from MHO torwards MUO is closed related to pathogenetic factors that activate inflammation pathways inside the visceral fat mass.

MHO is an important, emerging phenotype with a CVD risk between healthy, normal weight (Normal BMI) and unhealthy, obese individuals (MUO). Obesity in humans is so a unique form of low-grade inflammation and it has deep relationship with aging process(Normal BMI but metabolically unhealthy) and inflammaging. Infact,like aging process,in chronic obesity a low-grade activation of the innate immune system is provoked affecting metabolic homeostasis steadily. The progression of MHO torwards MUO is closed related to epigenetic factors that activates inflammation.

19 Agosto 2014