Adipocyte Size and Type 2 Diabetes in Obesity – A Study of Patients undergoing Bariatric Surgery

BACKGROUND

Type 2 Diabetes has long been associated with unhealthy overweight and obese adults. However, as the saying goes ‘one should not judge a book by its cover’. Interestingly, over the years it has arisen that a considerable percentage of obese individuals are not at risk of developing Type 2 diabetes. In 2007 a study led by Professor Donal O’Shea  researched extreme obesity and Type 2 diabetes by examining the fat cells form fifty patients attending St. Columcille’s Hospital, Dublin who were undergoing Bariatric (weight reducing) surgery. Each patient had a BMI (Body Mass Index) of over 50 which is medically considered as severely obese. Fat cells were taken from each patient with the aim of revealing differences and highlighting those at risk of ill health and those apparently ‘protected’ from ill health.

FINDINGS

The study discovered that Metabolically Healthy Obese (MHO) individuals i.e. those with “healthy” fat cells are at a lower risk of developing Type 2 Diabetes than Metabolically Unhealthy Obese (MUO) individuals i.e. those with “unhealthy” fat cells.

The study demonstrated that MHO patients have ‘healthier’ fat cells and healthier levels of blood pressure, cholesterol and sugar where as MHU patients have significantly unhealthier levels and fat cells. MHO individuals possess the ability to store excess energy intake as the  fat cells act as affective, protective sponges whereas MHU individuals cannot store similar excess energy and therefore  develop high cholesterol and a very high risk of  Type 2 diabetes. As a result of unhealthy fat cells MHU patients develop metabolic imbalances.

The study also showed that normal thyroid status, no history of cardiovascular, respiratory or metabolic diseases and also no use of any lipid lowering agents in very obese people may be indicative of having “healthier” fat cells.  On the contrary the examined MUO group failed to match any of the above indicators.

CONCLUSION

Professor Donal O’Shea said “This study has helped us to identify that there are a small percentage of people who are grossly overweight yet do not suffer the normal health problems associated with obesity”.  The key message established from this research for the general public is that it is possible to be extremely overweight yet healthy but caution and consideration must be taken when assessing risk factors. If underlying health history issues exist such as cardiovascular disease, high cholesterol or high blood pressure the overweight individual is at very high risk of developing Type 2 diabetes as well as further related conditions.