Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to d...

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Autores principales:	Luigi Barrea, Giovanna Muscogiuri, Gabriella Pugliese, Giulia de Alteriis, Annamaria Colao, Silvia Savastano
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	metabolically healthy obesity (MHO) metabolically unhealthy obesity (MUO) PCOS mediterranean diet body composition phase angle Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/a652d43169d2489a85cf4f7739eb7dc4
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spelling	oai:doaj.org-article:a652d43169d2489a85cf4f7739eb7dc42021-11-25T18:35:21ZMetabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition10.3390/nu131139252072-6643https://doaj.org/article/a652d43169d2489a85cf4f7739eb7dc42021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3925https://doaj.org/toc/2072-6643Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m<sup>2</sup> and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (<i>p</i> < 0.001), testosterone (<i>p</i> < 0.001), and insulin (<i>p</i> < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (<i>p</i> < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (<i>p</i> < 0.001) in spite of the same total energy intake (<i>p</i> = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, <i>p</i> < 0.001), more severe hyperandrogenism and cardio-metabolic indices (<i>p</i> < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, <i>p</i> < 0.001), and smaller PhAs (OR = 0.04, <i>p</i> < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (<i>p</i> < 0.001), followed by VAI (<i>p</i> < 0.001), and FLI (<i>p</i> = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (<i>p</i> < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.Luigi BarreaGiovanna MuscogiuriGabriella PuglieseGiulia de AlteriisAnnamaria ColaoSilvia SavastanoMDPI AGarticlemetabolically healthy obesity (MHO)metabolically unhealthy obesity (MUO)PCOSmediterranean dietbody compositionphase angleNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3925, p 3925 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	metabolically healthy obesity (MHO) metabolically unhealthy obesity (MUO) PCOS mediterranean diet body composition phase angle Nutrition. Foods and food supply TX341-641
spellingShingle	metabolically healthy obesity (MHO) metabolically unhealthy obesity (MUO) PCOS mediterranean diet body composition phase angle Nutrition. Foods and food supply TX341-641 Luigi Barrea Giovanna Muscogiuri Gabriella Pugliese Giulia de Alteriis Annamaria Colao Silvia Savastano Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
description	Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m<sup>2</sup> and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (<i>p</i> < 0.001), testosterone (<i>p</i> < 0.001), and insulin (<i>p</i> < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (<i>p</i> < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (<i>p</i> < 0.001) in spite of the same total energy intake (<i>p</i> = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, <i>p</i> < 0.001), more severe hyperandrogenism and cardio-metabolic indices (<i>p</i> < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, <i>p</i> < 0.001), and smaller PhAs (OR = 0.04, <i>p</i> < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (<i>p</i> < 0.001), followed by VAI (<i>p</i> < 0.001), and FLI (<i>p</i> = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (<i>p</i> < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.
format	article
author	Luigi Barrea Giovanna Muscogiuri Gabriella Pugliese Giulia de Alteriis Annamaria Colao Silvia Savastano
author_facet	Luigi Barrea Giovanna Muscogiuri Gabriella Pugliese Giulia de Alteriis Annamaria Colao Silvia Savastano
author_sort	Luigi Barrea
title	Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
title_short	Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
title_full	Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
title_fullStr	Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
title_full_unstemmed	Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition
title_sort	metabolically healthy obesity (mho) vs. metabolically unhealthy obesity (muo) phenotypes in pcos: association with endocrine-metabolic profile, adherence to the mediterranean diet, and body composition
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a652d43169d2489a85cf4f7739eb7dc4
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Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

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