{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T03:54:13Z","timestamp":1772596453342,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T00:00:00Z","timestamp":1522800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes can be present in any subject independently of their body mass index (BMI). However, factors related to the presence of these phenotypes are poorly understood. Therefore, the aim of this cross-sectional study is to describe the prevalence and characteristics associated with the MH and MUH phenotypes in Mexican subjects with different BMI categories. Anthropometric and biochemical parameters were evaluated after 12 h of fasting. HMW (High Molecular Weight) adiponectin and insulin levels were measured by ELISA (enzyme-linked immunosorbent assay). A total of 345 subjects were included, of which, 73.9% were women. The prevalence of the MH phenotype was 69.9%, 46.7%, and 19% in normal weight, overweight, and obesity, respectively. ROC (receiver operating characteristic) curve analysis showed that the waist circumference demonstrated a statistical significance (p &lt; 0.01) in detecting the MUH phenotype in each BMI group only in women. Furthermore, subjects with lower HMW adiponectin levels showed a 2.1 increased risk of presenting the MUH phenotype. In conclusion, in this Mexican population, waist circumference was an anthropometric parameter that identified women with the MUH phenotype in all BMI categories and hypoadiponectinemia was a risk factor for the presence of this phenotype.<\/jats:p>","DOI":"10.3390\/nu10040447","type":"journal-article","created":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T12:42:57Z","timestamp":1522845777000},"page":"447","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Waist Circumference Is an Anthropometric Parameter That Identifies Women with Metabolically Unhealthy Phenotypes"],"prefix":"10.3390","volume":"10","author":[{"given":"Nathaly","family":"Torres-Castillo","sequence":"first","affiliation":[{"name":"Service of Molecular Biology in Medicine, Civil Hospital Fray Antonio Alcalde, 44280 Guadalajara, Mexico"},{"name":"Department of Molecular Biology and Genomic, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Campos-Perez","sequence":"additional","affiliation":[{"name":"Service of Molecular Biology in Medicine, Civil Hospital Fray Antonio Alcalde, 44280 Guadalajara, Mexico"},{"name":"Department of Molecular Biology and Genomic, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina","family":"Gonzalez-Becerra","sequence":"additional","affiliation":[{"name":"Service of Molecular Biology in Medicine, Civil Hospital Fray Antonio Alcalde, 44280 Guadalajara, Mexico"},{"name":"Department of Molecular Biology and Genomic, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iv\u00e1n","family":"Hernandez-Ca\u00f1averal","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Parasitology, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0680-0802","authenticated-orcid":false,"given":"Barbara","family":"Vizmanos","sequence":"additional","affiliation":[{"name":"Department of Human Reproduction, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Mu\u00f1oz-Valle","sequence":"additional","affiliation":[{"name":"Institute of Research in Biomedical Sciences, University of Guadalajara. 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2005-9512","authenticated-orcid":false,"given":"Erika","family":"Martinez-Lopez","sequence":"additional","affiliation":[{"name":"Service of Molecular Biology in Medicine, Civil Hospital Fray Antonio Alcalde, 44280 Guadalajara, Mexico"},{"name":"Department of Molecular Biology and Genomic, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,4]]},"reference":[{"key":"ref_1","unstructured":"(2015, December 19). Obesity and Overweight. Available online: http:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/."},{"key":"ref_2","unstructured":"(2017, December 27). Encuesta Nacional de Salud y Nutrici\u00f3n 2016. (In Spanish)."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/mnfr.201400521","article-title":"Can metabolically healthy obesity be explained by diet, genetics, and inflammation?","volume":"59","author":"Navarro","year":"2015","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_4","doi-asserted-by":"crossref","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","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/obr.12157","article-title":"Metabolically healthy obesity and risk of incident type 2 diabetes: A meta-analysis of prospective cohort studies","volume":"15","author":"Bell","year":"2014","journal-title":"Obes. Rev."},{"key":"ref_6","unstructured":"Samouda, H., Ruiz-Castell, M., Karimi, M., Bocquet, V., Kuemmerle, A., Chioti, A., Dadoun, F., and Stranges, S. (2017). Metabolically healthy and unhealthy weight statuses, health issues and related costs: Findings from the 2013-2015 European Health Examination Survey in Luxembourg. Diabetes Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1038\/ijo.2010.216","article-title":"Characterizing the profile of obese patients who are metabolically healthy","volume":"35","author":"Primeau","year":"2011","journal-title":"Int. J. Obes."},{"key":"ref_8","doi-asserted-by":"crossref","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","journal-title":"Obesity"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4075","DOI":"10.1210\/jc.2007-2724","article-title":"High adiponectin concentrations are associated with the metabolically healthy obese phenotype","volume":"93","author":"Robles","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S1262-3636(07)70156-8","article-title":"Can we identify metabolically healthy but obese individuals (MHO)?","volume":"30","author":"Karelis","year":"2004","journal-title":"Diabetes Metab."},{"key":"ref_11","first-page":"794","article-title":"Anthropometric parameters-predictive factors for cardio-metabolic diseases","volume":"116","author":"Mihalache","year":"2012","journal-title":"Rev. Med. Chir. Soc. Med. Nat. Iasi"},{"key":"ref_12","first-page":"727","article-title":"Waist circumference correlates with metabolic syndrome indicators better than percentage","volume":"14","author":"Shen","year":"2006","journal-title":"Fat. Obes."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4172","DOI":"10.1210\/jc.2015-2765","article-title":"Adiponectin levels differentiate metabolically healthy vs. unhealthy among obese and nonobese white individuals","volume":"100","author":"Ahl","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_14","unstructured":"(2016, January 27). What\u2019s At-Risk or Heavy Drinking?, Available online: https:\/\/www.rethinkingdrinking.niaaa.nih.gov\/How-much-is-too-much\/Is-your-drinking-pattern-risky\/Whats-At-Risk-Or-Heavy-Drinking.aspx."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Boonchaya-anant, P., and Apovian, C.M. (2014). Metabolically healthy obesity--does it exist?. Curr. Atheroscler Rep., 16.","DOI":"10.1007\/s11883-014-0441-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/0002-9149(88)90248-2","article-title":"The Friedewald-Levy-Fredrickson formula for calculating low-density lipoprotein cholesterol, the basis for lipid-lowering therapy","volume":"62","author":"Roberts","year":"1988","journal-title":"Am. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5097","DOI":"10.1210\/jc.2010-0716","article-title":"High-molecular-weight adiponectin and the risk of type 2 diabetes in the ARIC study","volume":"95","author":"Zhu","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1001\/archinte.168.15.1617","article-title":"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\u20132004)","volume":"168","author":"Wildman","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jpeds.2016.05.037","article-title":"Sex differences in cardiometabolic risk factors among Hispanic\/Latino youth","volume":"176","author":"Isasi","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Goday, A., Calvo, E., V\u00e1zquez, L.A., Caveda, E., Margallo, T., Catalina-Romero, C., and Reviriego, J. (2016). Prevalence and clinical characteristics of metabolically healthy obese individuals and other obese\/non-obese metabolic phenotypes in a working population: Results from the Icaria study. BMC Public Health.","DOI":"10.1186\/s12889-016-2921-4"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1002\/oby.20227","article-title":"Body composition determinants of metabolic phenotypes of obesity in nonobese and obese postmenopausal women","volume":"21","author":"Peppa","year":"2013","journal-title":"Obesity"},{"key":"ref_25","unstructured":"Chang, C.-S., Lu, Y.-J., Chang, H.-H., Hsu, S.-H., Kuo, P.-H., Shieh, C.-C., Yao, W.J., Hsu, M.C., Young, K.C., and Lin, W.Y. (2016). Role of adiponectin gene variants, adipokines and hydrometry-based percent body fat in metabolically healthy and abnormal obesity. Obes. Res. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1038\/ijo.2013.208","article-title":"Differences in body composition between metabolically healthy obese and metabolically abnormal obese adults","volume":"38","author":"Camhi","year":"2014","journal-title":"Int. J. Obes."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1002\/oby.20326","article-title":"A metabolically healthy obese phenotype in hispanic participants in the IRAS family study","volume":"21","author":"Samaropoulos","year":"2013","journal-title":"Obesity"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.bbalip.2009.12.006","article-title":"Adipose tissue expandability, lipotoxicity and the Metabolic Syndrome\u2014An allostatic perspective","volume":"1801","author":"Virtue","year":"2010","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1038\/ijo.2017.4","article-title":"What have human experimental overfeeding studies taught us about adipose tissue expansion and susceptibility to obesity and metabolic complications?","volume":"41","author":"Cuthbertson","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/ajcn\/75.4.683","article-title":"Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat","volume":"75","author":"Janssen","year":"2002","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1136\/adc.2005.085522","article-title":"Measuring body composition","volume":"91","author":"Wells","year":"2006","journal-title":"Arch. Dis. Child."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/j.1749-6632.2000.tb06501.x","article-title":"Waist circumference and sagittal diameter reflect total body fat better than visceral fat in older men and women: The Health, Aging and Body Composition Study","volume":"904","author":"Harris","year":"2000","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/13548506.2016.1220596","article-title":"The prevalence and predictors of metabolically healthy obesity in obese rural population of China: A cross-sectional study","volume":"22","author":"Zhang","year":"2017","journal-title":"Psychol. Health Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Phillips, C.M., Dillon, C., Harrington, J.M., McCarthy, V.J.C., Kearney, P.M., Fitzgerald, A.P., and Perry, I.J. (2013). Defining metabolically healthy obesity: Role of dietary and lifestyle factors. PLoS ONE.","DOI":"10.1371\/journal.pone.0076188"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4082\/kjfm.2013.34.1.19","article-title":"Comparison of metabolic characteristics of metabolically healthy but obese (MHO) middle-aged men according to different criteria","volume":"34","author":"Yoo","year":"2013","journal-title":"Korean J. Fam. Med."},{"key":"ref_36","first-page":"51","article-title":"Paradoxical hyperadiponectinemia is associated with the metabolically healthy obese (MHO) phenotype in African Americans","volume":"2","author":"Doumatey","year":"2012","journal-title":"J. Endocrinol. Metab."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Berezina, A., Belyaeva, O., Berkovich, O., Baranova, E., Karonova, T., Bazhenova, E., Brovin, D., Grineva, E., and Shlyakhto, E. (2015). Prevalence, risk factors, and genetic traits in metabolically healthy and unhealthy obese individuals. Biomed. Res. Int.","DOI":"10.1155\/2015\/548734"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Aprahamian, T.R., and Sam, F. (2011). Adiponectin in cardiovascular inflammation and obesity. Int. J. Inflam.","DOI":"10.4061\/2011\/376909"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.atherosclerosis.2009.11.035","article-title":"Clear detection of ADIPOQ locus as the major gene for plasma adiponectin: Results of genome-wide association analyses including 4659 European individuals","volume":"208","author":"Heid","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1093\/hmg\/11.21.2607","article-title":"Single-nucleotide polymorphism haplotypes in the both proximal promoter and exon 3 of the APM1 gene modulate adipocyte-secreted adiponectin hormone levels and contribute to the genetic risk for type 2 diabetes in French Caucasians","volume":"11","author":"Vasseur","year":"2002","journal-title":"Hum. Mol. Genet."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1111\/j.1365-2265.2010.03841.x","article-title":"The association between the ratio of visceral fat to thigh muscle area and metabolic syndrome: The Korean Sarcopenic Obesity Study (KSOS)","volume":"73","author":"Lim","year":"2010","journal-title":"Clin. Endocrinol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1210\/jc.2012-3292","article-title":"Body size phenotypes and low muscle mass: The Korean sarcopenic obesity study (KSOS)","volume":"98","author":"Kim","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1055\/s-0042-121605","article-title":"Systematic Review and meta-analysis of randomized, controlled trials on the effect of exercise on serum leptin and adiponectin in overweight and obese individuals","volume":"49","author":"Yu","year":"2017","journal-title":"Horm. Metab. Res."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/4\/447\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:59:37Z","timestamp":1760194777000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/4\/447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,4]]},"references-count":43,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4]]}},"alternative-id":["nu10040447"],"URL":"https:\/\/doi.org\/10.3390\/nu10040447","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,4]]}}}