Metabolic normality in overweight and obese subjects. Which parameters? Which risks
Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n=382) and overweight or obese (ow/ob,...
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| Published in | International Journal of Obesity Vol. 35; no. 9; pp. 1208 - 1215 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group
01.09.2011
Nature Publishing Group UK |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0307-0565 1476-5497 1476-5497 |
| DOI | 10.1038/ijo.2010.264 |
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| Abstract | Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. |
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| AbstractList | The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese.
Cross-sectional study conducted at 21 research centers in Europe.
Normal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants.
Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal.
Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively).
In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P = 0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P = 0.004), systolic (P = 0.0007) and diastolic (P = 0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P = 0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P = 0.002) and diastolic (P = 0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P = 0.04 and 0.003, respectively), LDL-cholesterol (P = 0.003 and 0.006, respectively) and triglycerides (P = 0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. International Journal of Obesity (2011) 35, 1208-1215; doi:10.1038/ijo.2010.264; published online 4 January 2011 Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique . On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established . Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P = 0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P = 0.004), systolic (P = 0.0007) and diastolic (P = 0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P = 0.007), high- sensitivity C-reactive protein (P<0.0001), systolic (P = 0.002) and diastolic (P = 0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P = 0.04 and 0.003, respectively), LDL-cholesterol (P = 0.003 and 0.006, respectively) and triglycerides (P = 0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile International Journal of Obesity (2011) 35, 1208-1215; doi: 10.1038/ijo.2010.264; published online 4 January 2011 Keywords: metabolic normality; insulin sensitivity; cardiometabolic risk factors Objectives: The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Design: Cross-sectional study conducted at 21 research centers in Europe. Subjects: Normal body weight (nbw, n =382) and overweight or obese (ow/ob, n =185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Main outcome measures: Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Results: Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P <0.0001. Ow/ob subjects showed increased fasting insulin ( P =0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) ( P =0.004), systolic ( P =0.0007) and diastolic ( P =0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein ( P =0.007), high-sensitivity C-reactive protein ( P <0.0001), systolic ( P =0.002) and diastolic ( P =0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol ( P =0.04 and 0.003, respectively), LDL-cholesterol ( P =0.003 and 0.006, respectively) and triglycerides ( P =0.02 and 0.001, respectively). Conclusion: In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese. Cross-sectional study conducted at 21 research centers in Europe. Normal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal. Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively). In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. Subjects: Normal body weight (nbw, n = 382) and overweight or obese (ow/ob, n = 185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants. International Journal of Obesity (2011) 35, 1208-1215; doi: 10.1038/ijo.2010.264; published online 4 January 2011 The objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese.OBJECTIVESThe objective of this study was to define metabolic normality and to investigate the cardiometabolic profile of metabolically normal obese.Cross-sectional study conducted at 21 research centers in Europe.DESIGNCross-sectional study conducted at 21 research centers in Europe.Normal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants.SUBJECTSNormal body weight (nbw, n=382) and overweight or obese (ow/ob, n=185) subjects free from metabolic syndrome and with normal glucose tolerance, were selected among the Relationship between Insulin Sensitivity and Cardiovascular Disease study participants.Insulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal.MAIN OUTCOME MEASURESInsulin sensitivity was assessed by the clamp technique. On the basis of quartiles in nbw subjects, the limits of normal insulin sensitivity and of normal fasting insulinemia were established. Subjects with normal insulin sensitivity and fasting insulin were defined as metabolically normal.Among ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively).RESULTSAmong ow/ob subjects, 11% were metabolically normal vs 37% among nbw, P<0.0001. Ow/ob subjects showed increased fasting insulin (P=0.0009), low-density lipoprotein cholesterol (LDL-cholesterol) (P=0.004), systolic (P=0.0007) and diastolic (P=0.001) blood pressure, as compared with nbw. When evaluating the contribution of body mass index (BMI), hyperinsulinemia and insulin resistance, BMI showed an isolated effect on high-density lipoprotein (P=0.007), high-sensitivity C-reactive protein (P<0.0001), systolic (P=0.002) and diastolic (P=0.008) blood pressures. BMI shared its influence with insulinemia on total cholesterol (P=0.04 and 0.003, respectively), LDL-cholesterol (P=0.003 and 0.006, respectively) and triglycerides (P=0.02 and 0.001, respectively).In obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile.CONCLUSIONIn obese subjects, fasting insulin should be taken into account in the definition of metabolic normality. Even when metabolically normal, obese subjects could be at increased risk for cardiometabolic diseases. Increased BMI, alone or with fasting insulin, is the major responsible for the less favorable cardio-metabolic profile. |
| Audience | Academic |
| Author | Lalic, K Golay, A Bobbioni-Harsch, E Pataky, Z Nilsson, P Gabriel, R.S Muscelli, E Makoundou, V Casolaro, A |
| Author_xml | – sequence: 1 fullname: Pataky, Z – sequence: 2 fullname: Makoundou, V – sequence: 3 fullname: Nilsson, P – sequence: 4 fullname: Gabriel, R.S – sequence: 5 fullname: Lalic, K – sequence: 6 fullname: Muscelli, E – sequence: 7 fullname: Casolaro, A – sequence: 8 fullname: Golay, A – sequence: 9 fullname: Bobbioni-Harsch, E |
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| Copyright | Macmillan Publishers Limited 2011 2015 INIST-CNRS COPYRIGHT 2011 Nature Publishing Group Copyright Nature Publishing Group Sep 2011 |
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| CorporateAuthor | the RISC Investigators Lunds universitet Profile areas and other strong research environments Department of Clinical Sciences, Malmö Lund University Strategiska forskningsområden (SFO) EpiHealth: Epidemiology for Health Faculty of Medicine Internmedicin - epidemiologi Strategic research areas (SRA) Medicinska fakulteten Profilområden och andra starka forskningsmiljöer Internal Medicine - Epidemiology Institutionen för kliniska vetenskaper, Malmö |
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| DOI | 10.1038/ijo.2010.264 |
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| Keywords | insulin sensitivity cardiometabolic risk factors metabolic normality Human Obesity Pancreatic hormone Nutrition Insulin sensitivity Body weight Nutrition disorder Cardiovascular disease Metabolic diseases Corporal biometry Metabolism Insulin Overweight Risk factor Cardiovascular risk Nutritional status |
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The GISIR database publication-title: Nutr Metab Cardiovasc Dis doi: 10.1016/j.numecd.2007.05.002 – volume: 286 start-page: 1195 year: 2001 end-page: 1200 ident: CR2 article-title: The continuing epidemics of obesity and diabetes in the United States publication-title: JAMA doi: 10.1001/jama.286.10.1195 – volume: 34 start-page: 416 year: 1991 end-page: 422 ident: CR10 article-title: Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome publication-title: Diabetologia doi: 10.1007/BF00403180 – volume: 92 start-page: 2885 year: 2007 end-page: 2892 ident: CR16 article-title: Insulin resistance, insulin response, and obesity as indicators of metabolic risk publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2007-0334 – volume: 67 start-page: 968 year: 1983 end-page: 977 ident: CR1 article-title: Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study publication-title: Circulation doi: 10.1161/01.CIR.67.5.968 – year: 1998 ident: CR17 publication-title: Non-invasive imaging of atherosclerosis – volume: 57 start-page: 2613 year: 2008 end-page: 2618 ident: CR27 article-title: Physical activity and insulin sensitivity: the RISC study publication-title: Diabetes doi: 10.2337/db07-1605 – volume: 18 start-page: 911 year: 2010 end-page: 917 ident: CR28 article-title: Identifying metabolically healthy but obese individuals in sedentary postmenopausal women publication-title: Obesity (Silver Spring) doi: 10.1038/oby.2009.364 – volume: 37 start-page: S544 year: 2005 end-page: S554 ident: CR21 article-title: Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables publication-title: Med Sci Sports Exerc doi: 10.1249/01.mss.0000185674.09066.8a – volume: 46 start-page: 663 year: 1995 end-page: 672 ident: CR18 article-title: ultrasonic parametric imaging of carotid atherosclerotic plaque by videodensitometric technique publication-title: Angiology doi: 10.1177/000331979504600804 – volume: 32 start-page: 2297 year: 2009 end-page: 2299 ident: CR23 article-title: Are metabolically normal but obese individuals at lower risk for all-cause mortality? publication-title: Diabetes Care doi: 10.2337/dc09-0574 – volume: 108 start-page: 82 year: 2008 end-page: 90 ident: CR6 article-title: Metabolically obese normal weight and phenotypically obese metabolically normal youths: the CASPIAN Study publication-title: J Am Diet Assoc doi: 10.1016/j.jada.2007.10.013 – volume: 61 start-page: 697 year: 2008 end-page: 706 ident: CR22 article-title: Clinical and laboratory diagnosis of the metabolic syndrome publication-title: J Clin Pathol doi: 10.1136/jcp.2007.048363 – volume: 237 start-page: E214 year: 1979 end-page: E223 ident: CR9 article-title: Glucose clamp technique: a method for quantifying insulin secretion and resistance publication-title: Am J Physiol – volume: 13 start-page: 1116 year: 2005 end-page: 1122 ident: CR24 article-title: Prevalence of uncomplicated obesity in an Italian obese population publication-title: Obes Res doi: 10.1038/oby.2005.130 – volume: 29 start-page: 404 year: 2006 end-page: 409 ident: CR25 article-title: The importance of waist circumference in the definition of metabolic syndrome: prospective analyses of mortality in men publication-title: Diabetes Care doi: 10.2337/diacare.29.02.06.dc05-1636 – volume: 86 start-page: 1020 year: 2001 end-page: 1025 ident: CR5 article-title: What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? publication-title: J Clin Endocrinol Metab – volume: 161 start-page: 223 year: 2009 end-page: 230 ident: CR12 article-title: Fasting insulin has a stronger association with an adverse cardio-metabolic risk profile than insulin resistance: the RISC study publication-title: Eur J Endocrinol doi: 10.1530/EJE-09-0058 – volume: 23 start-page: 469 year: 2006 end-page: 480 ident: CR13 article-title: Metabolic syndrome--a new world-wide definition. A consensus statement from the International Diabetes Federation publication-title: Diabet Med doi: 10.1111/j.1464-5491.2006.01858.x – volume: 67 start-page: 968 year: 1983 ident: BFijo2010264_CR1 publication-title: Circulation doi: 10.1161/01.CIR.67.5.968 – volume: 168 start-page: 1609 year: 2008 ident: BFijo2010264_CR4 publication-title: Arch Intern Med doi: 10.1001/archinte.168.15.1609 – volume: 286 start-page: 1195 year: 2001 ident: BFijo2010264_CR2 publication-title: JAMA doi: 10.1001/jama.286.10.1195 – volume: 13 start-page: 1116 year: 2005 ident: BFijo2010264_CR24 publication-title: Obes Res doi: 10.1038/oby.2005.130 – volume: 46 start-page: 663 year: 1995 ident: BFijo2010264_CR18 publication-title: Angiology doi: 10.1177/000331979504600804 – volume: 58 start-page: 828 year: 2004 ident: BFijo2010264_CR26 publication-title: Eur J Clin Nutr doi: 10.1038/sj.ejcn.1601928 – volume: 109 start-page: 433 year: 2004 ident: BFijo2010264_CR7 publication-title: Circulation doi: 10.1161/01.CIR.0000111245.75752.C6 – volume: 86 start-page: 1020 year: 2001 ident: BFijo2010264_CR5 publication-title: J Clin Endocrinol Metab – volume: 161 start-page: 223 year: 2009 ident: BFijo2010264_CR12 publication-title: Eur J Endocrinol doi: 10.1530/EJE-09-0058 – volume: 340 start-page: 14 year: 1999 ident: BFijo2010264_CR14 publication-title: N Engl J Med doi: 10.1056/NEJM199901073400103 – volume: 18 start-page: 911 year: 2010 ident: BFijo2010264_CR28 publication-title: Obesity (Silver Spring) doi: 10.1038/oby.2009.364 – volume: 32 start-page: 2297 year: 2009 ident: BFijo2010264_CR23 publication-title: Diabetes Care doi: 10.2337/dc09-0574 – volume-title: Non-invasive imaging of atherosclerosis year: 1998 ident: BFijo2010264_CR17 – volume: 23 start-page: 469 year: 2006 ident: BFijo2010264_CR13 publication-title: Diabet Med doi: 10.1111/j.1464-5491.2006.01858.x – volume: 47 start-page: 566 year: 2004 ident: BFijo2010264_CR15 publication-title: Diabetologia doi: 10.1007/s00125-004-1335-5 – volume: 57 start-page: 2613 year: 2008 ident: BFijo2010264_CR27 publication-title: Diabetes doi: 10.2337/db07-1605 – volume: 37 start-page: S544 year: 2005 ident: BFijo2010264_CR21 publication-title: Med Sci Sports Exerc doi: 10.1249/01.mss.0000185674.09066.8a – volume: 61 start-page: 697 year: 2008 ident: BFijo2010264_CR22 publication-title: J Clin Pathol doi: 10.1136/jcp.2007.048363 – volume: 34 start-page: 416 year: 1991 ident: BFijo2010264_CR10 publication-title: Diabetologia doi: 10.1007/BF00403180 – volume: 30 start-page: 337 year: 2007 ident: BFijo2010264_CR19 publication-title: Diabetes Care doi: 10.2337/dc06-1883 – volume: 29 start-page: 404 year: 2006 ident: BFijo2010264_CR25 publication-title: Diabetes Care doi: 10.2337/diacare.29.02.06.dc05-1636 – volume: 237 start-page: E214 year: 1979 ident: BFijo2010264_CR9 publication-title: Am J Physiol – volume: 108 start-page: 82 year: 2008 ident: BFijo2010264_CR6 publication-title: J Am Diet Assoc doi: 10.1016/j.jada.2007.10.013 – volume: 168 start-page: 1617 year: 2008 ident: BFijo2010264_CR3 publication-title: Arch Intern Med doi: 10.1001/archinte.168.15.1617 – volume: 18 start-page: 624 year: 2008 ident: BFijo2010264_CR11 publication-title: Nutr Metab Cardiovasc Dis doi: 10.1016/j.numecd.2007.05.002 – volume: 28 start-page: 412 year: 1985 ident: BFijo2010264_CR8 publication-title: Diabetologia doi: 10.1007/BF00280883 – volume: 92 start-page: 2885 year: 2007 ident: BFijo2010264_CR16 publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2007-0334 – volume: 30 start-page: 777 year: 1998 ident: BFijo2010264_CR20 publication-title: Med Sci Sports Exerc doi: 10.1097/00005768-199805000-00021 |
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| Title | Metabolic normality in overweight and obese subjects. Which parameters? Which risks |
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