A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

Figures & data

Table 1 Baseline and postprogram characteristics of the MAO and MA-NO phenotype groups who transitioned to metabolically healthy (values are mean ± standard deviation)

Outcome variable	MAO to MHO (n=27)		MA-NO to MH-NO (n=15)
	Baseline	Postprogram	Baseline	Postprogram
Absolute EE (kcal · wk^−1)	371±512	1,770±552*	643±549	1,425±315*
Relative EE (kcal · kg^−1 · wk^−1)	3.7±5.0	17.9±5.5*	8.6±7.6	19.4±5.2*
Waist circumference (cm)	112.0±13.0	109.3±12.5*	89.2±6.9	88.0±7.1
Body mass index (kg/m^2)	34.1±3.8	34.0±3.7	25.4±3.1	25.3±3.2
Body mass (kg)	101.9±17.9	101.4±17.5	75.3±8.0	74.8±8.0
Systolic BP (mmHg)	126±11	120±9*	122±11	119±8
Diastolic BP (mmHg)	78±7	76±7*	75±9	75±7
Total cholesterol (mmol · L^−1)	4.8±1.2	4.8±1.1	4.7±1.3	4.6±1.1
HDL cholesterol (mmol · L^−1)	1.0±0.3	1.1±0.3*	1.0±0.2	1.1±0.3*
LDL cholesterol (mmol · L^−1)	2.8±1.0	2.7±0.9	3.1±1.1	3.0±0.9
Triglycerides (mmol · L^−1)	2.0±0.9	1.7±0.8*	1.5±0.7	1.4±0.4
Glucose (mmol · L^−1)	5.9±0.9	5.4±0.6*	6.3±0.8	5.5±0.5*
CR fitness (mL · kg^−1 · min^−1)	28.4±7.8	32.0±8.6*	32.2±5.5	36.6±6.8*
10-year risk score (%)	5.5±5.5	5.1±5.2	5.1±7.0	4.7±6.9*

Notes:

* P<0.05 for within-group change versus baseline by paired t-test.

Abbreviations: BP, blood pressure; CR, cardiorespiratory; EE, energy expenditure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MA-NO, metabolically abnormal nonobese; MAO, metabolically abnormal obese; MH-NO, metabolically healthy nonobese; MHO, metabolically healthy obese.

Table 2 Baseline and postprogram characteristics of the obese and nonobese phenotypes who did not transition (values are mean ± standard deviation)

Outcome variable	Obese (no transition)				Nonobese (no transition)
	MHO n=37		MAO n=41		MH-NO n=200		MA-NO n=9
	Baseline	Postprogram	Baseline	Postprogram	Baseline	Postprogram	Baseline	Postprogram
Absolute EE (kcal · wk^−1)	438±512	1,422±381*	438±519	1,927±615*	492±488	1,371±483*	661±475	1,045±164
Relative EE (kcal · kg^−1 · wk^−1)	4.8±5.4	15.8±3.8*	4.2±5.2	17.7±5.2*	6.2±6.3	17.1±6.2*	8.5±5.9	13.4±1.7
Waist circumference (cm)	102.3±12.2	100.1±12.5*	118.2±13.7	116.6±13.6*	92.6±19.0	91.6±18.2*	90.4±7.4	89.2±8.0*
Body mass index (kg/m^2)	34.5±3.4	34.2±3.4*	35.1±4.0	34.9±4.0	26.7±1.9	26.6±1.9*	26.1±3.4	25.8±3.2
Body mass (kg)	91.7±16.4	90.7±15.8*	110.7±17.5	110.1±17.7	82.8±19.9	82.3±19.8*	79.1±8.6	78.3±8.5
Systolic BP (mmHg)	120±10	118±7*	131±13	125±11*	118±10	116±10*	128±17	120±19*
Diastolic BP (mmHg)	76±7	73±7	80±9	76±0.9*	74±8	73±7	81±14	76±14*
Total cholesterol (mmol · L^−1)	5.0±1.1	4.9±0.9	4.8±1.2	4.6±0.2*	4.8±1.0	4.8±1.0	4.7±1.7	4.6±1.5
HDL cholesterol (mmol · L^−1)	1.3±0.4	1.4±0.3*	0.8±0.3	0.9±0.8*	1.4±0.4	1.5±14*	0.9±0.4	1.0±0.3
LDL cholesterol (mmol · L^−1)	3.0±1.0	2.9±0.8*	2.9±0.9	2.9±0.8	2.9±0.9	2.8±0.9*	3.5±1.4	3.3±1.3
Triglycerides (mmol · L^−1)	1.4±0.7	1.3±0.6	2.4±1.1	2.0±0.8*	1.1±0.5	1.1±0.4	2.3±0.7	2.2±0.6
Glucose (mmol · L^−1)	5.8±0.9	5.6±0.8*	6.7±1.4	6.3±1.2*	5.4±1.1	5.3±0.9*	6.3±0.9	5.8±0.6
CR fitness (mL · kg^−1 · min^−1)	25.1±7.0	27.6±7.6*	29.0±8.7	32.2±9.0*	33.1±8.4	36.1±8.8*	29.5±8.0	31.8±7.0
10-year risk score (%)	1.5±2.6	1.5±2.3	6.7±6.4	6.1±5.4	5.4±6.3	4.7±5.5*	5.4±4.3	4.6±3.7*

Note:

* P<0.05 for within-group change versus baseline by paired t-test.

Abbreviations: BP, blood pressure; CR, cardiorespiratory; EE, energy expenditure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MA-NO, metabolically abnormal nonobese; MAO, metabolically abnormal obese; MH-NO, metabolically healthy nonobese; MHO, metabolically healthy obese.

Figure 1 Changes in point prevalence of metabolic syndrome risk factors before and after community exercise in the metabolically abnormal obese participants who transitioned to a metabolically healthy obese phenotype (A), and metabolically abnormal nonobese participants who transitioned to a metabolically healthy nonobese phenotype (B).

Notes: *P<0.05 versus before community exercise. Data analyzed using Crosstabs Procedure, Chi-square difference testing.
Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Figure 2 The odds of transition from the metabolically abnormal obese (MAO) phenotype to the metabolically healthy obese (MHO) phenotype across quartiles of increased relative energy expenditure (top panel) and increased cardiorespiratory fitness (bottom panel) adjusted for age and sex.

Note: Values represent odds ratios ±95% confidence interval.
Abbreviation: VO₂ max, maximal oxygen uptake.

Figure 3 Changes in point prevalence of metabolic syndrome risk factors before and after community exercise in the metabolically abnormal obese (A), metabolically healthy obese (B), metabolically abnormal nonobese (C), and metabolically healthy nonobese (D) subgroups who did not transition.

Notes: *P<0.05 versus before community exercise. Data analyzed using Crosstabs Procedure, Chi-square difference testing.
Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein.