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World Health Organization. Obesity and overweight. Fact sheet No. 311. Available at: http:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/. Accessed February 5, 2018."},{"key":"ref1","unstructured":"2. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. Available at: https:\/\/www.idf.org\/e-library\/consensus-statements\/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome. Accessed February 5, 2018."},{"issue":"4","key":"ref2","doi-asserted-by":"publisher","first-page":"1044S","DOI":"10.1093\/ajcn\/66.4.1044S","article-title":"Obesity and mortality: a review of the epidemiologic data.","volume":"66","author":"Solomon","year":"1997","unstructured":"3. Solomon CG, Manson JE. Obesity and mortality: a review of the epidemiologic data. Am J Clin Nutr 1997; 66(4 Suppl):1044S-1050S.","journal-title":"Am J Clin Nutr","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9165","issn-type":"print"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/ejcn.2011.145","article-title":"Relationship between body mass index and mortality among Europeans","volume":"66","author":"Song","year":"2012","unstructured":"4. Song X, Pitk\u00e4niemi J, Gao W, et al; DECODE Study Group. Relationship between body mass index and mortality among Europeans. Eur J Clin Nutr 2012; 66:156-65.","journal-title":"Eur J Clin Nutr"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/1471-2288-11-175","article-title":"Examining the BMI-mortality relationship using fractional polynomials","volume":"11","author":"Wong","year":"2011","unstructured":"5. Wong ES, Wang BC, Garrison LP, et al. Examining the BMI-mortality relationship using fractional polynomials. 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The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med 2008; 168:1617-24.","journal-title":"Arch Intern Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1001\/archinte.168.15.1609","article-title":"Identification and characterization of metabolically benign obesity in humans","volume":"168","author":"Stefan","year":"2008","unstructured":"8. Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med 2008; 168:1609-16.","journal-title":"Arch Intern Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1038\/nature05485","article-title":"Inflammation and metabolic disorders","volume":"444","author":"Hotamisligil","year":"2006","unstructured":"9. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006; 444:860-7.","journal-title":"Nature"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"E1610","DOI":"10.1210\/jc.2013-2038","article-title":"Does inflammation determine metabolic health status in obese and nonobese adults?","volume":"98","author":"Phillips","year":"2013","unstructured":"10. Phillips CM, Perry IJ. Does inflammation determine metabolic health status in obese and nonobese adults? J Clin Endocrinol Metab 2013; 98:E1610-9.","journal-title":"J Clin Endocrinol Metab","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4619","DOI":"10.1210\/jc.2009-0925","article-title":"Human adipose tissue macrophages: m1 and m2 cell surface markers in subcutaneous and omental depots and after weight loss","volume":"94","author":"Aron-Wisnewsky","year":"2009","unstructured":"11. Aron-Wisnewsky J, Tordjman J, Poitou C, et al. Human adipose tissue macrophages: m1 and m2 cell surface markers in subcutaneous and omental depots and after weight loss. J Clin Endocrinol Metab 2009; 94:4619-23.","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","unstructured":"5. Ahead Research Inc. American College of Cardiology-American Heart Association Omnibus risk calculator [online]. Available at: http:\/\/static.heart.org\/ahamah\/risk\/Omnibus_Risk_Estimator.xls. Accessed February 5, 2018."},{"key":"ref12","first-page":"219","article-title":"Characterization of the syndromes of obesity.","volume-title":"Diabetes Mellitus and Obesity","author":"Sims","year":"1982","unstructured":"13. Sims EA. Characterization of the syndromes of obesity. In: Brodoff DN, Bleicher SJ, eds. Diabetes Mellitus and Obesity. Brooklyn, NY: Williams & Wilkins, 1982: 219-26."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1053\/meta.2001.27213","article-title":"Are there persons who are obese, but metabolically healthy?","volume":"50","author":"Sims","year":"2001","unstructured":"14. Sims EA. Are there persons who are obese, but metabolically healthy? Metabolism 2001; 50:1499-504.","journal-title":"Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0026-0495","issn-type":"print"},{"key":"ref14","first-page":"1020","article-title":"What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women?","volume":"86","author":"Brochu","year":"2001","unstructured":"15. Brochu M, Tchernof A, Dionne IJ, et al. What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab 2001; 86:1020-5.","journal-title":"J Clin Endocrinol Metab","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.2337\/dc06-0581","article-title":"Are obesity-related metabolic risk factors modulated by the degree of insulin resistance in adolescents?","volume":"29","author":"Bacha","year":"2006","unstructured":"16. Bacha F, Saad R, Gungor N, Arslanian SA. Are obesity-related metabolic risk factors modulated by the degree of insulin resistance in adolescents? Diabetes Care 2006; 29:1599-604.","journal-title":"Diabetes Care","ISSN":"https:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"222","DOI":"10.4235\/jkgs.2011.15.4.222","article-title":"Obesity defined by body mass index and metabolic status in the elderly","volume":"15","author":"Choi","year":"2011","unstructured":"17. Choi J. Obesity defined by body mass index and metabolic status in the elderly. J Korean Geriatr Soc 2011; 15:222-9.","journal-title":"J Korean Geriatr Soc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.2337\/dc07-0419","article-title":"Metabolically healthy but obese women have an intermediate cardiovascular risk profile between healthy nonobese women and obese insulin-resistant women","volume":"30","author":"Marini","year":"2007","unstructured":"18. Marini MA, Succurro E, Frontoni S, et al. Metabolically healthy but obese women have an intermediate cardiovascular risk profile between healthy nonobese women and obese insulin-resistant women. 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J Clin Hypertens (Greenwich) 2012; 14:92-6.","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1038\/oby.2008.233","article-title":"Determinants of insulin-resistant phenotypes in normal-weight and obese Black African women","volume":"16","author":"Jennings","year":"2008","unstructured":"21. Jennings CL, Lambert EV, Collins M, et al. Determinants of insulin-resistant phenotypes in normal-weight and obese Black African women. Obesity (Silver Spring) 2008; 16:1602-9.","journal-title":"Obesity (Silver Spring)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"258","DOI":"10.3122\/jabfm.2007.03.060064","article-title":"Different waist circumferences, different metabolic risks in Koreans","volume":"20","author":"Joo","year":"2007","unstructured":"22. Joo NS, Kim BT, Park SB, et al. Different waist circumferences, different metabolic risks in Koreans. 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Trends Endocrinol Metab 2012; 23:116-24.","journal-title":"Trends Endocrinol Metab","ISSN":"https:\/\/id.crossref.org\/issn\/1043-2760","issn-type":"print"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1210\/jc.2004-0165","article-title":"Metabolic and body composition factors in subgroups of obesity: what do we know?","volume":"89","author":"Karelis","year":"2004","unstructured":"27. Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 2004; 89:2569-75.","journal-title":"J Clin Endocrinol Metab","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1194\/jlr.M700199-JLR200","article-title":"Influence of obesity and insulin sensitivity on insulin signaling genes in human omental and subcutaneous adipose tissue","volume":"49","author":"MacLaren","year":"2008","unstructured":"28. MacLaren R, Cui W, Simard S, Cianflone K. Influence of obesity and insulin sensitivity on insulin signaling genes in human omental and subcutaneous adipose tissue. J Lipid Res 2008; 49:308-23.","journal-title":"J Lipid Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.2337\/dc09-0574","article-title":"Are metabolically normal but obese individuals at lower risk for all-cause mortality?","volume":"32","author":"Kuk","year":"2009","unstructured":"29. Kuk JL, Ardern CI. Are metabolically normal but obese individuals at lower risk for all-cause mortality? Diabetes Care 2009; 32:2297-9.","journal-title":"Diabetes Care","ISSN":"https:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s00592-013-0511-9","article-title":"Differences in insulin clearance between metabolically healthy and unhealthy obese subjects.","author":"Marini","year":"2014","unstructured":"30. Marini MA, Frontoni S, Succurro E, et al. Differences in insulin clearance between metabolically healthy and unhealthy obese subjects. Acta Diabetol 2014; 257-61.","journal-title":"Acta Diabetol","ISSN":"https:\/\/id.crossref.org\/issn\/0940-5429","issn-type":"print"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1089\/met.2008.0047","article-title":"Prevalence and interrelationships between cardio-metabolic risk factors in abdominally obese individuals","volume":"7","author":"Pettman","year":"2009","unstructured":"31. Pettman TL, Buckley JD, Coates AM, et al. Prevalence and interrelationships between cardio-metabolic risk factors in abdominally obese individuals. Metab Syndr Relat Disord 2009; 7:31-6.","journal-title":"Metab Syndr Relat Disord"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.2337\/dc12-1654","article-title":"Metabolically healthy obesity and risk of mortality: does the definition of metabolic health matter?","volume":"36","author":"Hinnouho","year":"2013","unstructured":"32. Hinnouho GM, Czernichow S, Dugravot A, et al. Metabolically healthy obesity and risk of mortality: does the definition of metabolic health matter? Diabetes Care 2013; 36:2294-300.","journal-title":"Diabetes Care","ISSN":"https:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2388","DOI":"10.2337\/dc12-1971","article-title":"Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study","volume":"36","author":"SL","year":"2013","unstructured":"33. Appleton SL, Seaborn CJ, Visvanathan R, et al; North West Adelaide Health Study Team. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes Care 2013; 36:2388-94.","journal-title":"Diabetes Care"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1002\/oby.20480","article-title":"All-cause mortality risk of metabolically healthy abdominal obese individuals: the EPIC-MORGEN study","volume":"22","author":"van der A","year":"2014","unstructured":"34. van der A DL, Nooyens AC, van Duijnhoven FJ, Verschuren WM, Boer JM. All-cause mortality risk of metabolically healthy abdominal obese individuals: the EPIC-MORGEN study. Obesity (Silver Spring) 2014; 22:557-64.","journal-title":"Obesity (Silver Spring)"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2318","DOI":"10.1210\/jc.2012-4253","article-title":"Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study","volume":"98","author":"Soriguer","year":"2013","unstructured":"35. Soriguer F, Guti\u00e9rrez-Repiso C, Rubio-Mart\u00edn E, et al. Metabolically healthy but obese, a matter of time? 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BMC Public Health 2010; 10:723.","journal-title":"BMC Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.diabet.2010.03.004","article-title":"Effects of acute hyperinsulinaemia on total and high-molecular-weight adiponectin concentration in metabolically healthy but obese postmenopausal women: a Montreal-Ottawa New Emerging Team (MONET) study","volume":"36","author":"Elisha","year":"2010","unstructured":"37. Elisha B, Karelis AD, Imbeault P, Rabasa-Lhoret R. Effects of acute hyperinsulinaemia on total and high-molecular-weight adiponectin concentration in metabolically healthy but obese postmenopausal women: a Montreal-Ottawa New Emerging Team (MONET) study. Diabetes Metab 2010; 36:319-21.","journal-title":"Diabetes Metab"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4145","DOI":"10.1210\/jc.2005-0482","article-title":"The metabolically healthy but obese individual presents a favorable inflammation profile","volume":"90","author":"Karelis","year":"2005","unstructured":"38. Karelis AD, Faraj M, Bastard JP, et al. The metabolically healthy but obese individual presents a favorable inflammation profile. J Clin Endocrinol Metab 2005; 90:4145-50.","journal-title":"J Clin Endocrinol Metab"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/oby.2008.565","article-title":"Are natural killer cells protecting the metabolically healthy obese patient?","volume":"17","author":"Lynch","year":"2009","unstructured":"39. Lynch LA, O'Connell JM, Kwasnik AK, et al. Are natural killer cells protecting the metabolically healthy obese patient? 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