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Submitted on March 4, 2005
Accepted on April 19, 2005
Department of Nutrition, University of Montreal, Montreal, Quebec, Canada; Faculty of Physical activity and Sports, University of Sherbrooke, Sherbrooke, Quebec, Canada, INSERM U680; Faculté de Médecine Saint-Antoine et Service de Biochimie et Hormonologie, AP-HP; Hôpital Tenon, Université Pierre et Marie Curie, Paris, France; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
* To whom correspondence should be addressed. E-mail: antony.karelis{at}umontreal.ca.
Objective: The purpose of this study was to investigate the inflammatory state in obese women displaying the "Metabolically Healthy Obese" (MHO) phenotype.
Design: We examined the metabolic characteristics of 88 obese, sedentary postmenopausal women. Subjects were classified as MHO or as "at risk" based on the upper and lower quartiles of insulin sensitivity as measured by the hyperinsulinemic/euglycemic clamp technique. Thereafter, we determined 1) body composition, 2) body fat distribution, 3) plasma lipid and lipoprotein levels, 4) glucose homeostasis, 5) resting blood pressure, 6) peak oxygen consumption and 7) inflammation markers as potential modulators of differences in the coronary risk profile.
Results: Twenty-two MHO women displayed high insulin sensitivity (15.35 ± 2.3 mg/min/kg FFM) and 22 "at risk" subjects with low insulin sensitivity (7.98 ± 1.4 mg/min/kg FFM) were identified. Despite comparable total body fatness between groups (47.7 ± 4.8 vs. 45.5 ± 4.4%; NS), MHO individuals had significantly lower levels of visceral fat, fasting insulin, plasma triglycerides, high-sensitivity C-reactive protein (hsCRP) and 
-1 anti-trypsin levels and higher levels of HDL-cholesterol than "at risk" individuals (P < 0.05). Stepwise regression analysis showed that CRP, fasting triglycerides and the lean body mass index explained 19.5%, 8.5% and 4.0%, respectively, of the variance observed in glucose disposal (total r2 = 0.320; P: < 0.001)
Conclusion: Results of the present study indicate that postmenopausal women displaying the MHO phenotype also have a favorable inflammation profile as shown by lower CRP and -1 anti-trypsin levels compared with insulin resistant women. This suggests that a lower inflammation state, as attested by low CRP levels, could play a role in the protective profile of the MHO individual and this may be associated metabolically to a lower risk for cardiovascular disease.
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