{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:59:30Z","timestamp":1791068370876,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,5,21]],"date-time":"2013-05-21T00:00:00Z","timestamp":1369094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p><jats:bold>Objective<\/jats:bold>: Although obesity is typically associated with increased cardiovascular risk, a subset of obese individuals display a normal metabolic profile (\u201cmetabolically healthy obese,\u201d MHO) and conversely, a subset of nonobese subjects present with obesity\u2010associated cardiometabolic abnormalities (\u201cmetabolically obese nonobese,\u201d MONO). The aim of this cross\u2010sectional study was to identify the most important body composition determinants of metabolic phenotypes of obesity in nonobese and obese healthy postmenopausal women.<\/jats:p><jats:p><jats:bold>Design and Methods<\/jats:bold>: We studied a total of 150 postmenopausal women (age 54 \u00b1 7 years, mean \u00b1 1 SD). Based on a cardiometabolic risk score, nonobese (body mass index [BMI] \u2264 27) and obese women (BMI &gt; 27) were classified into \u201cmetabolically healthy\u201d and \u201cunhealthy\u201d phenotypes. Total and regional body composition was assessed with dual\u2010energy X\u2010ray absorptiometry (DXA).<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: In both obese and nonobese groups, the \u201cunhealthy\u201d phenotypes were characterized by frequent bodyweight fluctuations, higher biochemical markers of insulin resistance, hepatic steatosis and inflammation, and higher anthropometric and DXA\u2010derived indices of central adiposity, compared with \u201chealthy\u201d phenotypes. Indices of total adiposity, peripheral fat distribution and lean body mass were not significantly different between \u201chealthy\u201d and \u201cunhealthy\u201d phenotypes. Despite having increased fat mass, MHO women exhibited comparable cardiometabolic parameters with healthy nonobese, and better glucose and lipid levels than MONO. Two DXA\u2010derived indices, trunk\u2010to\u2010legs and abdominal\u2010to\u2010gluteofemoral fat ratio were the major independent determinants of the \u201cunhealthy\u201d phenotypes in our cohort.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>: The \u201cmetabolically obese phenotype\u201d is associated with bodyweight variability, multiple cardiometabolic abnormalities and an excess of central relative to peripheral fat in postmenopausal women. DXA\u2010derived centrality ratios can discriminate effectively between metabolic subtypes of obesity in menopause.<\/jats:p>","DOI":"10.1002\/oby.20227","type":"journal-article","created":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T22:59:35Z","timestamp":1357167575000},"page":"1807-1814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Body composition determinants of metabolic phenotypes of obesity in nonobese and obese postmenopausal women"],"prefix":"10.1002","volume":"21","author":[{"given":"Melpomeni","family":"Peppa","sequence":"first","affiliation":[{"name":"Endocrine Unit Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrysi","family":"Koliaki","sequence":"additional","affiliation":[{"name":"Endocrine Unit Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Papaefstathiou","sequence":"additional","affiliation":[{"name":"Endocrine Unit Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Garoflos","sequence":"additional","affiliation":[{"name":"Endocrine Unit Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Katsilambros","sequence":"additional","affiliation":[{"name":"Experimental Research Laboratory \u201cN.S Christeas\u201d Athens University Medical School Athens 11527 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios A.","family":"Raptis","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"},{"name":"Hellenic National Diabetes Center for the Prevention Research and Treatment of Diabetes Mellitus and its Complications (H.N.D.C) Athens 10675 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios I.","family":"Hadjidakis","sequence":"additional","affiliation":[{"name":"Endocrine Unit Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George D.","family":"Dimitriadis","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine\u2010Propaedeutic Research Institute and Diabetes Center Athens University Medical School Attikon University Hospital Athens 12462 Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.1.76"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0165"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573399810602040367"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.47.5.699"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1139\/h06-092"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.48.11.2210"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.15.1609"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOL.0b013e3283346ccc"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e32832c6db7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030242"},{"key":"e_1_2_6_12_1","author":"Peppa M","year":"2012","journal-title":"Endocrinol Metab Syndrome"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.3.1020"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.364"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2009.06.020"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01234.2003"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2006.12.009"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000078924.61453.FB"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0482"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2008.23"},{"key":"e_1_2_6_21_1","article-title":"Body composition determinants of metabolic phenotypes of obesity in non\u2010obese and obese postmenopausal women","author":"Peppa M","year":"2012","journal-title":"Obesity"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"e_1_2_6_23_1","article-title":"The prevalence of metabolically healthy obese subjects defined by BMI and Dual\u2010energy X\u2010ray absorptiometry","author":"Shea JL","year":"2010","journal-title":"Obesity (Silver Spring)"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2007.11.004"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.15.1617"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-723"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000111245.75752.C6"},{"key":"e_1_2_6_28_1","author":"Robillard ME","year":"2011","journal-title":"Scand Cardiovasc J"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00467.2001"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801982"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.7.872"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0804"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.802226"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420120035004"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.8.2341"},{"issue":"1","key":"e_1_2_6_36_1","first-page":"666","article-title":"Discriminant features of \u201cMetabolically Healthy Obese\u201d and \u201cMetabolically Obese Normal Weight\u201d phenotypes in healthy postmenopausal women","volume":"54","author":"Peppa M","year":"2011","journal-title":"Diabetologia"},{"key":"e_1_2_6_37_1","article-title":"Association of lean body mass with cardiometabolic risk factors in healthy postmenopausal women","author":"Peppa M","year":"2012","journal-title":"Obesity"}],"container-title":["Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Foby.20227","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Foby.20227","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oby.20227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T05:08:01Z","timestamp":1696482481000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/oby.20227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,21]]},"references-count":36,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1002\/oby.20227"],"URL":"https:\/\/doi.org\/10.1002\/oby.20227","archive":["Portico"],"relation":{},"ISSN":["1930-7381","1930-739X"],"issn-type":[{"value":"1930-7381","type":"print"},{"value":"1930-739X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,21]]},"assertion":[{"value":"2012-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-11-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-05-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}