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Why Many Obese People Don’t Get Diabetes

Chronic inflammation may be a significant risk factor for both heart disease and diabetes…. 

The findings by researchers in Ireland could help to explain why as many as 35 percent of obese people are not affected by metabolic disorders, a phenomenon known as metabolically healthy obesity.

Study author Catherine Phillips, of University College Cork, said, in a news release, "In our study, metabolically healthy people — both obese and nonobese — had lower levels of a range of inflammatory markers." "Regardless of their body-mass index, people with favorable inflammatory profiles also tended to have healthy metabolic profiles."

For the study, the research team evaluated information on 2,040 participants between 50 and 60 years of age who were involved in the Cork and Kerry Diabetes and Heart Disease Study.

Participants were asked in a survey about their lifestyle, were given physical exams, and underwent blood tests to assess their BMI (body-mass-index, a calculation based on height and weight), metabolic profile and level of inflammation.

After examining for certain signs of inflammation, the investigators noticed that participants who were not affected by metabolic disorders had a lower white blood cell count and acute-phase response proteins, which are typically increased in the presence of inflammation.

The researchers also saw that those without any metabolic disorders had higher levels of adiponectin, a hormone that possesses anti-inflammatory properties. This was seen in both lean and obese participants who were metabolically healthy.

"From a public health standpoint, we need better methods for identifying which obese people face the greatest risk of diabetes and heart disease," Phillips concluded. "Inflammatory markers offer a potential strategy for pinpointing people who could benefit most from medical interventions."

Clinical Endocrinology & Metabolism, July 2013