Up to 25% of those who are classified as obese are actually metabolically healthy and do not have a high risk of developing type 2 diabetes, says a study.
Although obesity is a major risk factor for diabetes, the two conditions aren’t always linked.
A study published in the journal Cell sheds light on a possible explanation, revealing that high levels of a molecule called heme oxygenase-1 (HO-1) are linked to poor metabolic health and an increased risk of type 2 diabetes in obese people.
The HO-1 inhibition improves metabolic health in obese mice, suggesting that HO-1 blockers could represent a promising new strategy for the treatment of metabolic disease.
And some obese people may be able to remain “metabolically healthy” despite their size because they have low levels of (HO-1).
“The results indicate that HO-1 is in fact necessary for the development of metabolic disease and call for a re-evaluation of numerous findings in the field,” says senior study author Harald Esterbauer of the Medical University of Vienna.
“The study also reveals HO-1 as a candidate biomarker for the stratification of metabolically healthy and unhealthy obesity and provides a framework for selective, personalized therapy.”
The factors that determine whether obesity leads to poor metabolic health have been unclear, but the evidence suggests that an immune response called metabolic inflammation plays an important role.
However, studies examining the relationship between a supposedly anti-inflammatory molecule called HO-1 and metabolic disease have produced conflicting results.
“Our findings show that HO-1 is among the strongest predictors of metabolically unhealthy obesity in humans, and it could have a high prognostic value for detecting disease onset,” Pospisilik says.
“This could allow clinicians to use targeted interventions to prevent disease progression specifically in obese individuals who show early signs of type 2 diabetes.”
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