Metabolically healthy obesity: Is it really healthy for type 2 diabetes mellitus?

Table 1 Definitions of metabolic health in previous publications

Ref.	BP, kPa (mmHg)	Plasma glucose, mmol/L	TG, mmol/L	HDL-C, mmol/L	LDL-C, mmol/L	TC, mmol/L	WC, cm	Insulin sensitivity	CRP, mg/L		Intrahepatic lipid content	Others	Metabolic health
NECP ATP III[9]	SBP ≥ 17.3 (130) and/or DBP ≥ 11.3 (85) and/or treatment	FPG ≥ 5.60	≥ 1.70	< 1.29 in women, < 1.03 in men	-	-	> 88 in women, >102 in men	-	-		-	-	< 3 of above
Karelis et al[17]	-	-	≤ 1.70	≥ 1.30 and no treatment	≤ 2.60 and no treatment	≤ 5.20	-	HOMA-IR ≤ 1.95	-		-	-	> 3 of above
Meigs et al[4]	SBP ≥ 17.3 (130) or DBP ≥ 11.3(85) or treatment	5.6 < FPG ≤ 6.9	≥ 1.70	< 1.30 in women, < 1.00 in men	-	-	> 88 in women, > 102 in men	-	-		-	-	< 2 of above
Meigs et al[4]	-	-	-	-	-	-	-	HOMA-IR ≥ 75th percentile	-		-	-	None of above
Aguilar-Salinas et al[89]	SBP > 18.6 (140) and/or DBP > 12.0 (90) and/or treatment	FPG ≥ 7.0, or 2-h OGTT ≥ 11.1, or RBG ≥ 11.11 or treatment	-	< 1.04	-	-	-	-	-		-	-	None of above
Wildman et al[18]	SBP ≥ 17.3 (130) or DBP ≥ 11.3 (85) or treatment	FPG ≥ 5.56 or treatment	≥ 1.70	< 1.30 in women, < 1.04 in men or treatment	-	-	-	HOMA-IR > 90th percentile	> 90th percentile		-	-	< 2 of above
van Vliet-Ostaptchouk et al[90]	SBP ≥ 17.3 (130) or DBP ≥ 11.3 (85) or treatment	FPG ≥ 6.10 or treatment or history/diagnosis of type 2 diabetes	≥ 1.70 or treatment	< 1.03 in men or < 1.30 in women or treatment	-	-	-	-	-		-	-	<2 of above
Jana V van Vliet-Ostaptchouk et al[90]	SBP ≥ 18.6 (140) or DBP ≥ 12.0(90) or treatment	FPG ≥ 7.0 or treatment or history/diagnosis of type 2 diabetes	≥ 1.70 or treatment	< 1.03 in men or < 1.30 in women or treatment	-	-	-	-	-		-	-	< 2 of above
Smith et al[20]	SBP < 17.3 (130) and/or DBP < 11.3 (85)	FPG < 5.60, or 2-h OGTT glucose < 7.80	< 1.07	≥ 1.29 in women, ≥ 1.04 in men	-	-	-	GIR > 8 mg/kg FFM/min during an HECP (insulin infusion rate: 40 mU/m2/min)		-	< 5% of liver volume by imaging or < 5% of hepatocytes with intracellular TG by histology	Basic criteria: Absence of diagnosis or therapy of cardiometabolic diseases	all of above

BP: Blood pressure; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; OGTT: Oral glucose tolerance test; RBG: Random blood glucose; HbA1c: Glycosylated hemoglobin A1c; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; TC: Total cholesterol; WC: Waist circumference; HOMA-IR: Homeostasis model assessment of insulin resistance; GIR: Glucose infusion rate; HECP: Hyperinsulinemic-euglycemic clamp procedure; hs-CRP: High-sensitivity C-reactive protein.