Molecular alterations in the metabolically obese individual with normal weight

According to their "metabolic behaviour" people with and without obesity can be classified into several metabolic phenotypes: the metabolically healthy obese individual (MHO), the metabolically unhealthy obese individual (MUO), the metabolically obese lean individual (MONW), the sarcopenic obese individual ( SO) and the metabolically healthy normal-weight individual (MHNW). MOWN refers to individuals whose body mass index (BMI) is in the normal range (normal weight) but who present with metabolic disturbances such as dysglycaemia, dyslipidaemia and hypertension. The determinant causes of this phenotype are still a matter of debate, but alterations in body fat distribution, early infiltration of immune cells with monocytes to M1 macrophages polarisation, reduced gluteal-femoral adipose tissue and decreased lean mass have been cited. In clinical practice, it is essential to assess BMI and lean and fat mass distribution by anthropometric and bio-impedance techniques to establish the real risk of developing cardio-metabolic disease in people with normal weight.