PREVALENCE OF METBOLICALLY HEALTHY OBESE (MHO) INDIVIDUALS

A WEIGHT MANAGEMENT CLINIC EXPERIENCE

Abstract

INTRODUCTION
Obesity remains a major health issue in Malaysia which is associated with metabolic syndrome. As per International Diabetes Federation (IDF) criteria, metabolic syndrome is defined as presence of central obesity; plus any 2 metabolic abnormalities such as raised systolic (>130 mmHg) and diastolic (>85 mmHg) blood pressure, raised fasting plasma glucose (FPG) (≥5.6 mmol/L), raised triglyceride (TG) level (≥1.7 mmol/L) and reduced high density lipoprotein (HDL) levels (<1.03 mmol/L in men and <1.29 mmol/L in women). However, there exists a population of obese individuals which do not fulfil the metabolic syndrome criteria. This is referred to as metabolically healthy obese (MHO) population.

METHODOLOGY
We performed a retrospective analysis of patients who were attending the University Teknologi MARA (UiTM) Weight Management Clinic. We studied patient records and assessed the prevalence of metabolic derangements indicative of metabolic syndrome in our obese population using the IDF criteria.

RESULTS
A total of 92 patients attended the clinic with a median body mass index (BMI) of 43.2±9.6 kg/m2. Normal TG level was seen in 79.5% of patients. 56.9% of men and 51.2% of women had appropriate HDL levels. FPG levels remained normal in 46.4% of patients. Thirty eight percent had SBP less than 130 mmHg while 75% had DBP less than 85 mmHg. In our cohort, 30 out of 92 patients (32.6%) had normal metabolic profile consistent with MHO individuals.

CONCLUSION
Prevalence of MHO individuals attending our weight management clinic is 32.6% and consistent with the reported prevalence in other populations. This falsely reassuring normal metabolic profile should be acted upon as MHO individuals have an increased risk of developing diabetes mellitus and cardiovascular disease. They should receive proper screening and advice on lifestyle modifications as preventive measures.