Metabolically healthy obesity - focus on endothelium and inflammation

The aim of the study was to evaluate the relationship of adipokines with markers of subclinical inflammation and endothelial dysfunction in patients with metabolic healthy obesity (MHO). Material and methods: our study included 50 persons aged of 25-50 years with obesity in the absence of metabolic disorders (IDF criteria, 2005, marked as MHO), the control group consisted of 50 healthy respondents without obesity. We investigated clinical and biochemical parameters, HOMA-IR index, levels of leptin, resistin, adiponectin, CRP-hs, TNFα, IL6, VEGF, endothelin-1 (ET-1), von Willebrand factor (VWF) in patients under study. Results: in MHO patients, independently of NOMA-IR index, there was an increase of leptin, resistin, VEGF, and IL6 levels. The concentration of CRP-hs and TNF-α was increased in MHO group with HOMA-IR ≥2.7 was increased. Systolic blood pressure correlated with leptin level (r=0,43, p<0,05), TNF-α (r=0,44; p<0,05) and IL6 (r=0,33; p<0,05); diastolic blood pressure - with leptin level (r=0,35, p<0,05). Links between high density lipoproteins and leptin (r=-0,55 and r=-0,60; p<0,01), resistin (r=0,32; p<0,05 and r=0,60; p<0,01) and VEGF (r=-0,70, p<0,01) were established. The VeGf level correlated with HOMA-IR (г=0,62; p<0,01), leptin (r=0,29; p<0,05), resistin (r=0,70; p<0,01), IL6 (r=0,74, p<0,01) and ET-1 (r=0,29; p<0,05). Conclusion: Obese patients without metabolic disorders, having normotension and normal insulin sensitivity, are less influenced to adverse cardiovascular risks due to less expressed hormonal and inflammatory activation of adipose tissue and, as a result, less pronounced endothelial dysfunction. While insulin resistance develops, cardiovascular risk increases due to activation of subclinical inflammation and angiogenic endothelial dysfunction.

obesity, adipokines, cytokines, endothelium