Search

Background & aims Severe acute COVID-19 has taken on pandemic proportions with growing interest in identification of prognostic factors for mortality. Standardized bioelectrical impedance (BI) phase angle (SPhA), which is PhA adjusted by age and sex, has been related to mortality in patients with several diseases but never investigated in COVID-19. Inflammation, a consequence of COVID-19 infection, affects fluid status (hydration) and can be identified with PhA. The aim of this study was to determine the predictive role of PhA on 90 days survival of adults with COVID-19. Methods We studied 127 consecutive patients diagnosed with COVID-19. BI measurements determined with a 50 kHz phase-sensitive BI device, body composition parameters and laboratory markers were evaluated as predictors of mortality. Results Non-surviving COVID-19 patients had significantly lower PhA and SPhA values (p

Objetivo: Fue realizar una caracterización sociodemográfica de los para atletas chilenos. Métodos: Consistió en la aplicación del cuestionario diseñado para la especificidad de las informaciones intencionadas, y las variables relacionadas pesquisadas fueron con relación a la edad, sexo, región donde vive, tipo de discapacidad, deporte que practica, nivel educacional de las y los para atletas. Resultados: Participaron 176 deportistas, 39 mujeres (22.15%) y 137 hombres (77.84%). El deporte con mayor cantidad de participantes para las mujeres es el Goalball (30,76%) , y para los hombres fue el Fútbol 7 (24.81%). Respecto a la distribución por deficiencia la mayoría de los deportistas corresponden a la discapacidad física (80,68%). De los diagnósticos médicos la mayoría es lesión cerebral (32,38%), y en el caso de las mujeres la lesión medular y deficiencia visual (29,73%). De los niveles de formación educacional podemos observar que la mayoría escolar media/técnica de modo completo 72(40,90%). Al observar la distribución por región, la mayoría se encuentran en la región Metropolitana de Santiago con un 53,98%. Conclusión: La información recabada es de alta importancia para generar políticas que permitan distribuir los recursos y los programas a nivel nacional

In the last decades, the global prevalence of non-alcoholic fatty liver disease (NAFLD) has reached pandemic proportions with derived major health and socioeconomic consequences; this tendency is expected to be further aggravated in the coming years. Obesity, insulin resistance/type 2 diabetes mellitus, sedentary lifestyle, increased caloric intake and genetic predisposition constitute the main risk factors associated with the development and progression of the disease. Importantly, the interaction between the inherited genetic background and some unhealthy dietary patterns has been postulated to have an essential role in the pathogenesis of NAFLD. Weight loss through lifestyle modifications is considered the cornerstone of the treatment for NAFLD and the inter-individual variability in the response to some dietary approaches may be conditioned by the presence of different single nucleotide polymorphisms. In this review, we summarize the current evidence on the influence of the association between genetic susceptibility and dietary habits in NAFLD pathophysiology, as well as the role of gene polymorphism in the response to lifestyle interventions and the potential interaction between nutritional genomics and other emerging therapies for NAFLD, such as bariatric surgery and several pharmacologic agents.

Background: Antibiotic therapy used to eradicate Helicobacter pylori has been associated with changes in plasma ghrelin and alterations in the gut microbiota. On the other hand, changes in ghrelin levels have been related to changes in gut microbiota composition. Our aim was to evaluate the relationship between changes in the gut microbiota and ghrelin levels in H. pylori infected patients who received antibiotic treatment for its eradication.Methods: A prospective case-control study that included forty H. pylori-positive patients who received eradication therapy (omeprazole, clarithromycin, and amoxicillin) and twenty healthy H. pylori antigen-negative participants. Patients were evaluated, including clinical, anthropometric and dietary variables, before and 2 months after treatment. Gut microbiota composition was analyzed through 16S rRNA amplicon sequencing (IlluminaMiSeq).Results: Changes in gut microbiota profiles and decrease in ghrelin levels were identified after H. pylori eradication treatment. Gut bacteria such as Bifidobacterium longum, Bacteroides, Prevotella, Parabacteroides distasonis, and RS045 have been linked to ghrelin levels fasting and/or post meals. Changes in the abundance of Lachnospiraceae, its genus Blautia, as well as Prevotella stercorea, and Megasphaera have been inversely associated with changes in ghrelin after eradication treatment.Conclusions: Eradication treatment for H. pylori produces changes in the composition of the intestinal microbiota and ghrelin levels. The imbalance between lactate producers such as Blautia, and lactate consumers such as Megasphaera, Lachnospiraceae, or Prevotella, could trigger changes related to ghrelin levels under the alteration of the eradication therapy used for H. pylori. In addition, acetate producing bacteria such as B. longum, Bacteroides, and P. distasonis could also play an important role in ghrelin regulation.

Helicobacter pylori (H. pylori) is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide. Although the majority of infected individuals remain asymptomatic, this bacterium colonizes the gastric mucosa causing the development of various clinical conditions as peptic ulcers, chronic gastritis and gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas, but complications are not limited to gastric ones. Extradigestive pathologies, including metabolic disturbances such as diabetes, obesity and nonalcoholic fatty liver disease, have also been associated with H. pylori infection. However, the underlying mechanisms connecting H. pylori with extragastric metabolic diseases needs to be clarified. Notably, the latest studies on the topic have confirmed that H. pylori infection modulates gut microbiota in humans. Damage in the gut bacterial community (dysbiosis) has been widely related to metabolic dysregulation by affecting adiposity, host energy balance, carbohydrate metabolism, and hormonal modulation, among others. Taking into account that Type 2 diabetic patients are more prone to be H. pylori positive, gut microbiota emerges as putative key factor responsible for this interaction. In this regard, the therapy of choice for H. pylori eradication, based on proton pump inhibitor combined with two or more antibiotics, also alters gut microbiota composition, but consequences on metabolic health of the patients has been scarcely explored. Recent studies from our group showed that, despite decreasing gut bacterial diversity, conventional H. pylori eradication therapy is related to positive changes in glucose and lipid profiles. The mechanistic insights explaining these effects should also be addressed in future research. This review will deal with the role of gut microbiota as the linking factor between H. pylori infection and metabolic diseases, and discussed the impact that gut bacterial modulation by H. pylori eradication treatment can also have in host’s metabolism. For this purpose, new evidence from the latest human studies published in more recent years will be analyzed.

Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.

Background: The gut microbiome plays an important role in the development of diseases associated with altered lipid metabolis. Antibiotic treatment causes changes in the intestinal microbiota. Our aim was to evaluate the relationship between changes in the intestinal microbiota and the level of plasma HDL cholesterol and LDL cholesterol. Methods: Prospective case-control study with H. pylori-positive patients undergoing eradication therapy (omeprazole, clarithromycin, and amoxicillin). Stool and blood samples were obtained from 20 controls (H. pylori negative) and 40 patients before and two months after antibiotic treatment. Gut microbiota composition was analyzed through 16S rRNA amplicon sequencing (IlluminaMiSeq). Results: Eradication treatment for H. pylori increased the HDL- colesterol levels, and caused changes in gut microbiota profiles. An unfavorable lipid profiles (high LDL-cholesterol and low HDL-cholesterol level) was associated with a low microbial richness and an increased of the Bacteroidetes phylum. P. Copri, Lachonobacterium and Delsufovibrio were positively associated with HDL-c while Rikenellaceae was negatively associated with HDL-c after completing antibiotic treatment. Conclusions: Treatment to eradicate H. pylori could improve lipid metabolism in relation with an increase in the HDL-cholesterol. Changes in the abundance of specific bacteria, such as P. Copri, Lachonobacterium, Delsufovibrio and Rikenellaceae could be associated with change in the plasma HDL-cholesterol levels.

The COVID-19 pandemic is posing a great challenge worldwide. Its rapid progression has caused thousands of deaths worldwide. Although multiple aspects remain to be clarified, some risk factors associated with a worse prognosis have been identified. These include obesity and some of its main complications, such as diabetes and high blood pressure. Furthermore, although the possible long-term complications and psychological effects that may appear in survivors of COVID-19 are not well known yet, there is a concern that those complications may be greater in obese patients. In this manuscript, we review some of the data published so far and the main points that remain to be elucidated are emphasized.

Objective: To compare the effects of an inspiratory versus and expiratory muscle-training program on voluntary and reflex peak cough flow in patients with Parkinson disease. Design: A randomized controlled study. Setting: Home-based training program. Participants: In all, 40 participants with diagnosis of Parkinson’s disease were initially recruited in the study and randomly allocated to three study groups. Of them, 31 participants completed the study protocol (control group, n = 10; inspiratory training group, n = 11; and expiratory training group, n = 10) Intervention: The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle-training program, respectively (five sets of five repetitions). Both groups trained six times a week for two months using a progressively increased resistance. The control group performed expiratory muscle training using the same protocol and a fixed resistance. Main measures: Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, and peak cough flow during voluntary and reflex cough were assessed before and at two months after training. Results: The magnitude of increase in maximum expiratory pressure ( d = 1.40) and voluntary peak cough flow ( d = 0.89) was greater for the expiratory muscle-training group in comparison to the control group. Reflex peak cough flow had a moderate effect ( d = 0.27) in the expiratory group in comparison to the control group. Slow vital capacity ( d = 0.13) and forced vital capacity ( d = 0.02) had trivial effects in the expiratory versus the control group. Conclusions: Two months of expiratory muscle-training program was more beneficial than inspiratory muscle-training program for improving maximum expiratory pressure and voluntary peak cough flow in patients with Parkinson’s disease.

Heart failure (HF) has been a hot topic in diabetology in the last few years, mainly due to the central role of sodium-glucose cotransporter 2 inhibitors (iSGLT2) in the prevention and treatment of cardiovascular disease and heart failure. It is well known that HF is a common complication in diabetes. However, most of the knowledge about it and the evidence of cardiovascular safety trials with antidiabetic drugs refer to type 2 diabetes (T2D). The epidemiology, etiology, and pathophysiology of HF in type 1 diabetes (T1D) is still not well studied, though there are emerging data about it since life expectancy for T1D has increased in the last decades and there are more elderly patients with T1D. The association of T1D and HF confers a worse prognosis than in T2D, thus it is important to investigate the characteristics, risk factors, and pathophysiology of this disease in order to effectively design prevention strategies and therapeutic tools.

Obesity is one of the most serious worldwide epidemics of the twenty-first century according to the World Health Organization. Frequently associated with a number of comorbidities, obesity threatens and compromises individual health and quality of life. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss. The beneficial effects of BS on metabolic traits are so widely recognized that some authors have proposed BS as metabolic surgery that could be prescribed even for moderate obesity. However, most of the BS procedures imply malabsorption and/or gastric acid reduction which lead to nutrient deficiency and, consequently, further complications could be developed in the long term. In fact, BS not only affects metabolic homeostasis but also has pronounced effects on endocrine systems other than those exclusively involved in metabolic function. The somatotropic, corticotropic, and gonadal axes as well as bone health have also been shown to be affected by the various BS procedures. Accordingly, further consequences and complications of BS in the long term in systems other than metabolic system need to be addressed in large cohorts, taking into account each bariatric procedure before making generalized recommendations for BS. In this review, current data regarding these issues are summarized, paying special attention to the somatotropic, corticotropic, gonadal axes, and bone post-operative health.

Introduction: Antibiotic treatments modify gut microbiota. Microbiota alterations (in composition and biodiversity) are fundamental pieces in the development of metabolic disorders (T2DM and obesity). Objective: To evaluate the relationship between microbiota changes due to antibiotic treatment in patients colonized by H. pylori and GLP-1 secretion. Methods: A prospective case control study was assessed. We evaluated a H. pylori positive patient model before and two months after a short-term eradication therapy and a control group. Anthropometric measurements, carbohydrate and lipid metabolisms, GLP-1 levels and fecal microbiota composition (determined by 16S rRNA gene (V3-V4) sequencing with an Illumina Miseq) were analyzed. Results: We studied 40 cases and 20 controls (60% women, respectively). Average age was 47.0±2 vs. 43.6±2.7 years. 42.5% vs. 40% had clinical history of gastrointestinal disease. After eradication treatment, we found significant changes in microbiota profile at phylum, family, genus and species levels. The Chao1 and Shannon indices showed a decreased in bacterial richness and diversity in patients (pre and post H. pylori eradication) compared to controls. GLP-1 secretion and carbohydrate metabolism were improved after antibiotic treatment. GLP-1 changes were related to microbial community disturbances through correlation analysis, specifically with Bifidobacterium adolescentis (r=0.354, p=0.034), Lachnobacterium (r=-0.332, p=0.048) and Coriobacteriaceae (r=0.372, p=0.026). Conclusions: Antibiotic treatment to eradicate H. pylori increased the secretion of GLP-1 and improved the carbohydrate metabolism. This GLP-1 secretion improvement was related to changes in microbial community because of the antibiotic treatment, particularly in Bifidobacterium adolescentis, Lachnobacterium and Coriobacteriaceae. These taxa could play their roles through the production of short chain fatty acids (SCFA) and/or bile acid metabolism. Disclosure I. Cornejo-Pareja: None. G. Martin-Nuñez: None. I. Moreno-Indias: None. F.F. Cardona-Díaz: None. M. Roca-Rodriguez: None. L. Coin-Arangüez: None. I. Mancha-Doblas: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.

Objective MircroRNAs (miR) are small, noncoding RNA molecules of 18-25 nucleotides. Their dysregulation has been widely studied in many human tumours including differentiated thyroid cancer (DTC). miRs more frequently associated with these kinds of tumours are miR-146, miR-221 and miR-222. Our objective was to assess the relationship among circulating miR levels and the evolution and outcomes of disease. Design We analysed a sample of 60 patients with DTC assigning them to one of three groups according to the dynamic scale of risk (excellent response, incomplete biochemical response and incomplete structural response). Patients and measurements At study inclusion, we determined thyroid-stimulating hormone, thyroxine, thyroglobulin, antithyroglobulin antibodies and plasma levels of miR-146, miR-221 and miR-222. Results Male sex and advanced age at diagnosis were associated with the worst disease progression. miR-222 was twofold to threefold higher in tall cell papillary carcinomas (P = 0.038). miR-146 (P = 0.016) and miR-221 (P = 0.050) had a positive correlation with thyroglobulin at the time of sampling. In regression analysis, miR-146 (P = 0.006), miR-221 (P = 0.004) and miR-222 (P = 0.007) predicted more than 70% of the variation in thyroglobulin levels at the time of sampling. Conclusions Elevated miR-222 and miR-146 levels are associated with poorer outcomes of the disease and may have a prognostic value in the management and follow-up of DTC.

Changes in the intestinal microbial community and some metabolic disturbances, including obesity and type2 diabetes, are related. Glucagon-like peptide-1 (GLP-1) regulates glucose homeostasis. Microbiota have been linked to incretin secretion. Antibiotic use causes changes in microbial diversity and composition. Our aim was to evaluate the relationship between microbiota changes and GLP-1 secretion. A prospective case-control study with a Helicobacter pylori-positive patient model involving subjects under eradication therapy (omeprazole, clarithromycin, and amoxicillin). Forty patients with H. pylori infection and 20 matched participants, but negative for H. pylori antigen. Patients were evaluated before and two months after treatment. We analyzed anthropometric measurements, carbohydrate metabolism, lipid profile, and C-reactive protein. Gut microbiota composition was analyzed through 16S rRNA amplicon sequencing (IlluminaMiSeq). Eradication treatment for H. pylori decreased bacterial richness (Chao1, p = 0.041). Changes in gut microbiota profiles were observed at phylum, family, genus and species levels. GLP-1 secretion and variables of carbohydrate metabolism were improved. Correlations were seen between GLP-1 changes and variations within microbial community abundances, specifically Bifidobacterium adolescentis, the Lachnobacterium genus, and Coriobacteriaceae family. A conventional treatment to eradicate H. pylori could improve carbohydrate metabolism possibly in relation with an increase in GLP-1 secretion. GLP-1 secretion may be related to alterations in intestinal microbiota, specifically Lachnobacterium, B. adolescentis and Coriobacteriaceae.

BackgroundH. pylori infection and eradication cause perturbations of the gut microbiome. The gut microbiota has been identified as a potential contributor to metabolic diseases. We evaluate whether these alterations in intestinal microbiota composition produced by H. pylori infection and its posterior eradication with antibiotic treatment could be associated with glucose homeostasis in metabolically healthy subjects.MethodsForty adult patients infected with H. pylori and 20 control subjects were recruited. The infected subjects were evaluated before and two months after eradication treatment (omeprazole, clarithromycin, amoxicillin). The microbiota composition in fecal samples was determined by 16S rRNA gene (V3-V4) sequencing using Illumina Miseq.ResultsPatients (pre- and post-H. pylori eradication) showed a decreased bacterial richness and diversity with respect to controls. There was an improvement in glucose homeostasis in subjects two months after H. pylori eradication treatment. Changes in the amount of Rikenellaceae, Butyricimonas, E. biforme, B. fragilis, and Megamonas were inversely associated with changes in the glucose level or related parameters (Hb1ac) in H. pylori eradication subjects.ConclusionsH. pylori infection and eradication with antibiotic treatment causes alteration of the human gut microbiome. The increase in SCFA-producing bacteria and glucose-removing bacteria, specifically members of Megamonas, Rikenellaceae and Butyricimonas, has been related with an improvement in glucose homeostasis after H. pylori eradication with antibiotic treatment.

Summary Introduction In individuals with Parkinson's disease (PD), respiratory muscle weakness and rigidity, bradykinesia of abdominal muscles and stiffness of the chest wall, affect the respiratory component of voice intensity due to reduced pulmonary capacity and airflow needed to vibrate the vocal folds. It may be possible to improve voice production by strengthening respiratory muscles. The purpose of this study was to evaluate the effects of inspiratory and expiratory muscle training on voice production outcomes in individuals with PD. Method Thirty-one participants with PD were randomly allocated to three study groups (control group n = 10, inspiratory training group, n = 11, and expiratory training group, n = 11). The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle training program, respectively (five sets of five repetitions). Both groups trained six times a week for 2 months using a progressively increased resistance. The control group performed expiratory muscle training using the same protocol and a fixed resistance. Phonatory measures, maximum inspiratory/expiratory pressure, and spirometric indexes were assessed before and at 2 months after training. Results Differences in peak subglottic pressure were moderate (d = 0.59) between expiratory and inspiratory groups, large between inspiratory and control groups (d = 1.32), and large between expiratory and control groups (d = 1.96). Differences in maximum phonation time were large (d = 1.26) between inspiratory and control groups, moderate (negative) between expiratory and inspiratory groups (d = –0.60), and moderate between expiratory and control groups (d = 0.72). Differences in peak sound pressure level were large (d = 1.27) between inspiratory and control groups, trivial between expiratory and inspiratory groups (d = –0.18), and large between expiratory and control groups (d = 1.10). Conclusions Inspiratory muscle training is effective in improving maximum phonation time, and expiratory muscle training is more effective for improving peak subglottic pressure, and peak sound pressure level in individuals with PD.

Scope: To examine the association between milk and dairy products intake and the prevalence of cognitive decline among Spanish individuals at high cardiovascular risk. Methods and results: Cross-sectional analyses are performed on baseline data from 6744 adults (aged 55-75 years old). Intake of milk and dairy products is estimated using a food frequency questionnaire grouped into quartiles. The risk of developing cognitive impairment is based on the Mini-Mental State Examination (MMSE). A higher prevalence of cognitive decline was found in subjects who consumed more grams. Patients with worse MMSE score (10-24) consumed a mean of 395.14 ± 12.21 g, while patients with better MMSE score (27-30) consumed a mean of 341.23 ± 2.73 g (p < 0.05). Those subjects with the lower milk consumption (

Introduction: Antibiotic treatments cause changes in gut microbiota. Dysbiosis of gut microbiota has been linked to metabolic diseases such as type 2 diabetes mellitus (T2DM). Objective: To evaluate whether changes in gut microbiota due to antibiotic treatment in patients colonized by H. pylori, could be related to improvements in carbohydrate metabolism. Material and Method: A prospective case-control study were performed. Clinical data, carbohydrate metabolism, and microbiota composition in feces (determined by 16S rRNA gene (V3-V4) sequencing using the Illumina Miseq) before and 2 months after eradication treatment were analyzed. Results: We studied 40 cases and 20 controls (60% women, respectively). Average age was 47.0 ± 2 vs. 43.6 ± 2.7 years old. 70% vs. 60% had family history of digestive disorders and 42.5% vs. 40% clinical history of gastrointestinal disease. After antibiotics, we found significant changes in gut microbiota profile at phylum, family, genus and species levels. The Chao and Shannon indices showed a decreased in bacterial richness and diversity in patients (pre and post H. pylori eradication) compared to controls. We observed an improvement in glucose homeostasis in cases 2 month after H. pylori eradication treatment, with decrease in HbA1c (p=0.014), 60’ (p=0.018) and 120’ (p=0.019) glucose post OGTT. Changes in Rikenellaceae, Butyricimonas, E. biforme, B. fragilis, and Megamonas were inversely associated with changes in glucose level and Hb1Ac in patients which got H. pylori eradication. Conclusion: H. pylori eradication treatment causes alteration in human gut microbiota. The glucose homeostasis improvement found after antibiotic treatment was related to changes in microbial community, particularly in Megamonas and Butyricimonas genus, Rikenellaceae family and E. biforme and B. fragilis species. SCFA-producing and glucose remover bacterias could play an important role in these associations. Disclosure I. Cornejo-Pareja: None. G. Martin-Nuñez: None. M. Roca-Rodriguez: None. I. Moreno-Indias: None. L. Vinuela: None. L. Coin-Arangüez: None. I. Mancha-Doblas: None. F. Tinahones: None.

The application of genetic modification offers considerable opportunities for more efficient and more effective fish aquaculture. Susceptibility to infectious diseases and limitations in growth rates could be successfully tackled by the application of transgenic technology. Acceptance of transgenic technology applied to commercial fish has to surmount technical difficulties, regulatory barriers and public acceptance concerns. It seems desirable to implement transgenesis strategies that cause the least qualitative and quantitative alterations in the genetic composition of the resulting enhanced fish. With Atlantic salmon being the most important farmed fish worldwide, it seemed of interest to obtain genomic sequences from this species capable of directing autogenic expression of selected transgenes. We now report the isolation of the β-actin promoter from genomic DNA of Atlantic salmon locally produced in Chile. The activity of the promoter was demonstrated ex vivo in cultured salmon cells, as well as in vivo in transgenic fish. Transiently transfected CHSE-214 cells exhibited constitutive expression of reporter constructs driven by the cloned salmon β-actin genomic region. The suitability of the Atlantic salmon β-actin promoter to drive expression of the fluorescent protein EGFP in transgenic zebrafish was demonstrated. Germline transmission of the transgenes suggests that this promoter could be safely applied into fish transgenesis without health concerns. The isolation of functionally competent β-actin promoter from Atlantic salmon opens the way for its use in autogenic transgenesis in this commercially important salmonid species.

The relationship between obesity and other metabolic diseases have been deeply studied. However, there are clinical inconsistencies, exceptions to the paradigm of "more fat means more metabolic disease", and the subjects in this condition are referred to as metabolically healthy obese (MHO).They have long-standing obesity and morbid obesity but can be considered healthy despite their high degree of obesity. We describe the variable definitions of MHO, the underlying mechanisms that can explain the existence of this phenotype caused by greater adipose tissue inflammation or the different capacity for adipose tissue expansion and functionality apart from other unknown mechanisms. We analyze whether these subjects improve after an intervention (traditional lifestyle recommendations or bariatric surgery) or if they stay healthy as the years pass. MHO is common among the obese population and constitutes a unique subset of characteristics that reduce metabolic and cardiovascular risk factors despite the presence of excessive fat mass. The protective factors that grant a healthier profile to individuals with MHO are being elucidated.