New obesity classification criteria as a tool for bariatric surgery indication.

Abstract

Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy (''sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described: (1) normal weight obese (NWO); (2) metabolically obese normal weight; (3) metabolically healthy obese; and (4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.

• Authors: Antonino De Lorenzo, Laura Soldati, Francesca Sarlo, Menotti Calvani, Nicola Di Lorenzo, Laura Di Renzo
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 22 Issue 2 Pg. 681-703 (Jan 14 2016) ISSN: 2219-2840 [Electronic] United States
• PMID: 26811617 (Publication Type: Journal Article, Review)

Chemical References

• Adipokines
• Inflammation Mediators

Topics

• Adipokines (metabolism)
• Adipose Tissue (metabolism, physiopathology)
• Adiposity (ethnology)
• Anthropometry
• Bariatric Surgery (adverse effects)
• Body Weight
• Decision Support Techniques
• Energy Metabolism
• Female
• Humans
• Inflammation Mediators (metabolism)
• Male
• Obesity (classification, diagnosis, physiopathology, surgery)
• Obesity, Metabolically Benign (diagnosis, physiopathology, surgery)
• Patient Selection
• Phenotype
• Predictive Value of Tests
• Risk Factors
• Sarcopenia (diagnosis, physiopathology)
• Sex Factors
• Terminology as Topic