New obesity classification criteria as a tool for bariatric surgery indication

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 ob...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-01, Vol.22 (2), p.681-703
Main Authors: De Lorenzo, Antonino, Soldati, Laura, Sarlo, Francesca, Calvani, Menotti, Di Lorenzo, Nicola, Di Renzo, Laura
Format: Article
Language:English
Subjects:
Adipokines - metabolism
Adipose Tissue - metabolism
Adipose Tissue - physiopathology
Adiposity - ethnology
Anthropometry
Bariatric Surgery - adverse effects
Body Weight
Decision Support Techniques
Energy Metabolism
Female
Humans
Inflammation Mediators - metabolism
Male
Obesity - classification
Obesity - diagnosis
Obesity - physiopathology
Obesity - surgery
Obesity, Metabolically Benign - diagnosis
Obesity, Metabolically Benign - physiopathology
Obesity, Metabolically Benign - surgery
Patient Selection
Phenotype
Predictive Value of Tests
Risk Factors
Sarcopenia - diagnosis
Sarcopenia - physiopathology
Sex Factors
Terminology as Topic
Topic Highlight
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Summary: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.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i2.681