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New obesity classification criteria as a tool for bariatricsurgery indication

World Journal of Gastroenterology 2016年第2期22卷 681-703页

作者： Antonino De Lorenzo Laura Soldati Francesca Sarlo Menotti Calvani Nicola Di Lorenzo Laura Di Renzo Division of Clinical Nutrition and Nutrigenomic Department of Biomedicine and PreventionUniversity of Tor Vergata00133 RomeItaly Department of Internal Medicine UOSD Service of Clinical Nutritionparenteral therapy and anorexia nervosaPoliclinico Tor Vergata00133 RomeItaly Department of Health Sciences University of Milan20122 MilanItaly Department of Agriculture University of Naples“Federico II” 80055 Portici(NA)Italy Department of Surgical Sciences University of Tor VergataPoliclinico Tor Vergata00133 RomeItaly

Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.

关键词： Obesity Adiposopathy Normal weightlean Normal weight obese Metabolically obese normalweight Metabolically healthy obese Metabolicallyhealthy normal weight Metabolically unhealthy obese Laparoscopic gastric banding Fat mass

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