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Sujets « métaboliquement sains », bien qu’obèses. Deuxième partie : pronostic et prise en charge

Metabolically healthy, but obese subjects. Second part: prognosis and management

  • Revue Générale / General Review
  • Published:
Obésité

Résumé

Environ 30 à 50 % des sujets sont « métaboliquement sains » bien qu’ils soient obèses (MHO pour metabolically healthy, but obese) alors qu’inversement, nombre de sujets non obèses sont « métaboliquement anormaux ». La topographie et la fonction des dépÔts graisseux semblent jouer un rôle déterminant pour expliquer cette apparente discordance. Nous avons décrit dans un premier article les caractéristiques cliniques, les mécanismes physiopathologiques et la prévalence du syndrome MHO dans la population adulte. Ce second article a pour objectif d’évaluer le pronostic, notamment en termes de diabète et de risque cardiovasculaire, et de discuter les avantages et inconvénients d’une prise en charge classique de l’obésité chez ces patients MHO.

Abstract

Approximately 30 to 50% of obese subjects are “Metabolically Healthy, but Obese“ (MHO) whereas numerous non-obese subjects are “metabolically abnormal“. The distribution and function of adipose depots seems to play a crucial role in explaining this apparent discrepancy. In a first paper, we described the clinical and biological characteristics of these MHO individuals, analyzing the underlying pathophysiological mechanisms, and reporting the prevalence of this syndrome in the adult population. This second paper aims at assessing the prognosis, especially with regard to the risk of diabetes and cardiovascular disease, and discussing the advantages and disadvantages of a classical therapeutic strategy for obesity among MHO individuals.

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Authors and Affiliations

  1. Service de diabétologie, nutrition et maladies métaboliques, département de médecine, CHU Sart-Tilman, B-4000, Liège, Belgique

    N. Esser, N. Paquot & A. -J. Scheen

  2. Université de Liège, 9, place du 20-Août, B-4000, Liège, Belgique

    N. Paquot & A. -J. Scheen

  3. Unité de pharmacologie clinique, département de médecine, CHU Sart-Tilman, B-4000, Liège, Belgique

    A. -J. Scheen

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  1. N. Esser
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  2. N. Paquot
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  3. A. -J. Scheen
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Correspondence to A. -J. Scheen.

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La première partie de cet article est parue dans Obésité 2009; 4: 56–65

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Esser, N., Paquot, N. & Scheen, A.J. Sujets « métaboliquement sains », bien qu’obèses. Deuxième partie : pronostic et prise en charge. Obes 4, 134–141 (2009). https://doi.org/10.1007/s11690-009-0188-y

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