Background: Qatar is facing an epidemic of metabolic diseases such as obesity, and insulin resistant due to the rapid lifestyle and nutrition transition in the last few decades. Previous epidemiological studies have identified high prevalence of the metabolic syndrome (MetS) and obesity among Qataris. However, these studies are limited. Although obesity is an established risk factor for the MetS, studies have identified a subtype of obese individuals with healthy metabolic profile. To our knowledge, there were no identified studies that looked into the different subgroups of obesity among Qataris. Aims: This study aims to estimate the prevalence of the MetS. Moreover, to identify the various obesity subtypes and assess the difference between them regarding selected determinants. Methods: This research was conducted among 499 Qatari men and women aged ≥18 years old of the Qatar Biobank pilot phase cohort. The MetS prevalence was identified using the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATPIII) and the International Diabetes Federation (IDF) criteria. Four different subgroups of obesity were identified; these were Metabolic Healthy Normal Weight (MHN), Metabolic Abnormal Normal Weight (MAN), Metabolic Healthy Obese (MHO), and Metabolic Abnormal Obese (MAO). The classification was based on the body mass index (BMI) and the absence or presence of at least one metabolic risk factor of the MetS-NCEP ATPIII definition. Comparisons between the groups were conducted in relation to demographic, anthropometrics, lifestyle and biochemical characteristics using General linear models with post hoc Bonferroni correction. All models were adjusted for age and sex. Results: The MetS prevalence was 24.6% based on the NCEP-ATPIII definition and 27.1% based on the IDF definition. Among the studied cohort, 23.1% were classified as MHN, 13.2% were MAN, 13.6% were MHO and 50.1% were MAO. Compared to MHN, MHO subjects were characterized with significantly lower concentration of high-density lipoprotein (HDL), and two-fold higher insulin and c-peptide. On the other hand, MAO subjects were characterized with significantly lower physical activity and HDL levels compared to MHN, moreover, higher alkaline phosphatase, triglyceride, diabetes and blood pressure variables were found. When comparison between MHO and MAO was made, the latter had significantly lower HDL, and significantly higher triglycerides, waist circumference, waist-hip ratio, blood pressure and diabetes variables. Conclusions: The estimated MetS prevalence was 24.6% (NCEP-ATPIII) and 27.1% (IDF). About half of the studied individuals were classified as MAO. Although MHO and MAO were both characterized with a BMI ≥30 kg/m2, MHO subjects had significant smaller waist circumferences and waist-hip ratio. Additionally, MHO subjects had significantly healthier triglycerides, HDL, blood pressure and diabetes variables profiles. Due to the different characteristics, diverse therapeutics and interventions should be made for each subgroup of obesity. Keywords: Metabolic Syndrome, Obesity, healthy obese, Qatar Biobank.


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