Table 6.
Summarization of the patient characteristics in the four obesity subtypes.
| MHO | HMO-U | HMO-I | LMO | |
|---|---|---|---|---|
| Percentage in obesity | 44% | 33% | 8% | 15% |
| Sex | Equal | Equal | More men | Equal |
| Age at onset and duration of obesity | Average | Average | Youngest age at onset | Longest duration at visit |
| Acanthosis nigricans | The lowest prevalence in obesity | Higher prevalence compared with MHO | The highest prevalence in obesity | Similar to MHO |
| Fat distribution | Relative lower BMI compared with the other 3 subgroups | Higher BMI compared with MHO | Higher BMI compared with MHO | Higher BMI compared with MHO, with the most severe central obesity |
| Glucometabolism | Normal glucose with slightly compensated insulin secretion | Slightly increased glucose with moderately compensated insulin secretion | Slightly increased glucose with overcompensated insulin secretion | The highest glucose with decompensated insulin secretion, and the highest prevalence of diabetes in obesity |
| Insulin resistance | Slightly insulin resistance | Moderate insulin resistance | The most severe liver and peripheral insulin resistance | Severe liver insulin resistance |
| Lipid profile | Worse compared with NW | Worse than MHO | Worse than MHO | The worst in obesity with the most severe carotid lipid deposition |
| Uric acid | Slightly increased compared with NW | The highest in obesity | Moderately increased compared with MHO | Similar to MHO |
| PCOS | Relative lower in obesity | Increased testosterone (women) and incidence of PCOS compared with MHO | Largely increased incidences of PCO and PCOS compared with MHO | Similar to MHO |
| Potential treatment suggestions | Weight loss | Weight loss | Weight loss | Weight loss |
| Symptom therapy if it’s necessary | Focus on uric acid management but avoid overtreatment | Focus on the relief of hyperinsulinemia Appropriate hormonotherapy if it’s necessary |
Focus on the management of glucolipid metabolism and restoration of pancreatic β-cell function |
BMI, body mass index; HMO-I, hypermetabolic obesity hyperinsulinemia subtype; HMO-U, hypermetabolic obesity hyperuricemia subtype; LMO, hypometabolic obesity; MHO, metabolic healthy obesity; NW, normal-weight control; PCO, polycystic ovary; PCOS, polycystic ovary syndrome.