On Appropriate Phenotypes of Patients With Obesity

Abstract

Obesity has been associated with increased mortality in epidemiological studies. Accordingly, the current paradigm relies on body mass index (BMI) for risk stratification. Since there is a considerable interindividual variance in the BMI-associated cardiometabolic risk, a low cardiorespiratory fitness (CRF) related to obesity may exert a different influence. In the Journal of Clinical Endocrinology & Metabolism, the authors of the "Tubingen Diabetes Family Study" recently compared carotid intima-media thickness (cIMT) as a measure of early atherosclerosis with CRF in 412 normal weight, overweight, and obese subjects (1). Precise measurements of cIMT, body fat mass and distribution, CRF, and substrate metabolism reflected the high methodological standard of this study. As a result, the degree of cIMT was associated with metabolic disturbances while it was inversely related to physical fitness. The authors concluded that impaired metabolic health and low CRF independently determined the risk of atherosclerosis.