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Obesity classifications, Conclusion: take into account adiposopathy and…

- - - - Normal weight + High BFP
        
        Normal BMI (18.5-24.9 kg/m2) + High body fat percentage (men, >23.5% and women, >29.2%)
        
        Do not manifest Metabolic Syndrome
        
        Higher oxidative stress level, early inflammatory status, few metabolic abnormalities
    - - High BMI + Absence of metabolic abnormalities
        
        Healthier metabolic risk profile and higher disposition index (insulin sensitivity X insulin secretion)
        
        High insulin sensitivity, Favorable lipid profile, No sign of hypertension
        
        Obese phenotype
        
        Greater risk of greater CVD events compared to Metabolic Healthy Normal Weight patients
        
        Unstable condition, increases risk of developing metabolic abnormalities (MHO patients tend to progress to MUO within <8 years)
  - - - Normal BMI + Metabolic abnormalities
        
        “Thin-on-the-outside fat-on-the-inside"
        
        Low BMI, low lean body mass + High fat mass, high visceral fat
        
        Increase possibility of Metabolic Syndrome: Low insulin sensitivity, High triacylglycerol concentration, Liver fat
        
        High visceral obesity markers + Higher ratio of visceral:subcutaneous abdominal adipose tissue
        
        More likely in males, former smokers, hypertensive and less physically active
    - - High BMI + High BFP + Metabolic abnormalities
        
        BMI: >30 kg/m2 + BFP: >30%
        
        High visceral fat mass + Omental adipocyte size
        
        Linked to development of Metabolic Syndrome, Diabetes Mellitus Type II and atherosclerotic CVD
- - - - "Android obesity" acumulate adipose tissue in upar body (trunk, abdomen)
        
        Visceral fat depot is associated with metabolic alterations and insulin sensitivity
    - - "Gynoid obesity" Accumulate adipose tissue in lower body (hips and thighs)
  - - - Acumulation of fat is mainly in visceral area
    - - Less abdominal fat than Indian Asians
    - - Less VAT than caucasians
- - - - Hyperglycemia
        
        Deterioraron of beta cell function or exhaustion
        
        Oxidative stress induce by free radical oxygen species
        
        Endoplasmatic reticulum stress
        
        Inflammation caused by proinflammatory cytokines and chemokines
        
        Loss of neogenesis
        
        Proliferación of beta-cells
        
        Gradual loss of insulina gene expresion and other beta-cells specific genes
        
        Changes in mitochondrial number
        
        Disruption in calcium homeostasis
- - - - Skeletal muscle
        
        Contributing to intracellular lipid accumulation
        
        Insulin resistence in liver
      - Muscle
      - Pancreas
        
        Insufficient insulin secretion