Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 107, Issue 5, Pages 1337-1345Publisher
ENDOCRINE SOC
DOI: 10.1210/clinem/dgab922
Keywords
metabolomics; metabolic syndrome; insulin resistance; obesity; epidemiology
Categories
Funding
- Swedish Heart-Lung Foundation [2019-0526]
- Swedish Research Council [2019-01236]
- European Research Council [ERC-STG-2015-679242]
- Skane University Hospital
- Knut and Alice Wallenberg foundation
- Wallenberg Center for Molecular Medicine in Lund
- Swedish Research Council (Linnaeus grant) [349-2006237]
- Strategic Research Area Exodiab [2009-1039]
- Swedish Foundation for Strategic Research [IRC150067]
- Lund University Diabetes Center
- Swedish HeartLung Foundation [20200173]
- Swedish Heart-Lung Foundation [20200173] Funding Source: Swedish Heart-Lung Foundation
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This study compared the plasma metabolome in obese subjects with and without metabolic syndrome (MetS) to normal-weight subjects without MetS. The results showed significant differences in metabolite profiles between obese and normal-weight individuals without MetS, with a gradual deterioration in metabolite profile from lean to obese to MetS. The pathways highlighted in this study, such as amino acid synthesis/metabolism and sphingolipid metabolism, may play a role in this metabolic deterioration, with insulin resistance as a potential mediator.
Context There is a dispute whether obesity without major metabolic derangements may represent a benign condition or not. Objective We aimed to compare the plasma metabolome in obese subjects without metabolic syndrome (MetS) with normal-weight subjects without MetS and with obese subjects with MetS. Methods This was a cross-sectional study at 2 academic centers in Sweden. Individuals from 3 population-based samples (EpiHealth, n = 2342, SCAPIS-Uppsala, n = 4985, and SCAPIS-Malmo, n = 3978) were divided into groups according to their body mass index (BMI) and presence/absence of MetS (National Cholesterol Education Program [NCEP]/consensus criteria). In total, 791 annotated endogenous metabolites were measured by ultra-performance liquid chromatography-tandem mass spectrometry. Results We observed major differences in metabolite profiles (427 metabolites) between obese (BMI >= 30 kg/m(2)) and normal-weight (BMI < 25 kg/m(2)) subjects without MetS after adjustment for major lifestyle factors. Pathway enrichment analysis highlighted branch-chained and aromatic amino acid synthesis/metabolism, aminoacyl-tRNA biosynthesis, and sphingolipid metabolism. The same pathways, and similar metabolites, were also highlighted when obese subjects with and without MetS were compared despite adjustment for BMI and waist circumference, or when the metabolites were related to BMI and number of MetS components in a continuous fashion. Similar metabolites and pathways were also related to insulin sensitivity (Matsuda index) in a separate study (POEM, n = 501). Conclusion Our data suggest a graded derangement of the circulating metabolite profile from lean to obese to MetS, in particular for metabolites involved in amino acid synthesis/metabolism and sphingolipid metabolism. Insulin resistance is a plausible mediator of this gradual metabolic deterioration.
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