H-NMR Metabolomics: A New Perspective for Classifying Obesity and Predicting Cardiometabolic Risks

Obesity, a complex and multifactorial disease, currently affects more than 13% of adults worldwide, according to the latest data from the World Health Organization (WHO). This alarming increase, which has reached epidemic proportions in recent decades, highlights the urgent need for innovative and effective approaches to better understand and manage this condition.

Traditionally, obesity has been classified using metrics such as body mass index (BMI) or waist-to-hip ratio (WHR). While these tools provide a general assessment of physical health, they fail to capture the underlying physiological complexity, overlooking key factors such as metabolism, inflammation, and lipid profiles. This limitation reduces their ability to accurately predict specific risks associated with obesity, such as type 2 diabetes, cardiovascular diseases, and other severe comorbidities. Consequently, there is a growing need to adopt more advanced approaches that account for the metabolic diversity of individuals, enabling more precise and personalized risk assessments.

A recent study published by Enrique Ozcariz, Montse Guardiola, Núria Amigó, Sergio Valdés, Wasima Oualla-Bachiri, Pere Rehues, Gemma Rojo-Martínez, and Josep Ribalta, from the CIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Hospital Regional Universitario de Málaga, Institut d’Investigació Sanitària Pere Virgili, and the company Biosfer Teslab, introduces a groundbreaking approach to redefining obesity through the analysis of metabolic profiles using proton nuclear magnetic resonance (H-NMR). This method has enabled the identification of three clearly distinct metabolic subtypes in individuals with obesity, providing valuable insights into their specific risks for cardiometabolic diseases and overcoming the limitations of traditional classifications.

Identifying Metabolic Subtypes

Metabolically Healthy Obesity (MHO):
This group includes individuals with obesity who exhibit a lower association with cardiovascular diseases. They are characterized by elevated HDL cholesterol levels, low systemic inflammation, and healthier lipid function. Although the risk of developing diseases is not zero, it is significantly lower compared to the other subtypes.

Atherogenic Dyslipidemia:
This subtype is associated with insulin resistance, elevated triglyceride levels, and the presence of dysfunctional lipoproteins. These metabolic characteristics indicate a higher risk of developing type 2 diabetes, exacerbated by systemic inflammation and alterations in lipid metabolism.

Predominant Hypercholesterolemia:
Individuals in this group show elevated LDL cholesterol and total cholesterol levels, significantly increasing the risk of cardiovascular events such as heart attacks or strokes. While systemic inflammation is less pronounced compared to atherogenic dyslipidemia, it remains a relevant factor.

H-NMR Metabolomics redefines obesity
Figure 1. Logistic regression analysis. Several logistic regressions were fitted to predict future development of obesity-associated cardiometabolic disease in the follow-up. The confusion matrix computed in the testing of each model is also displayed. The y-axis shows the true classes, with 0 corresponding to no development of cardiometabolic disease in the follow-up and 1 corresponding to the development of cardiometabolic disease in the follow-up. The x-axis displays the label predicted by the model.

Impact of Metabolomics on Risk Prediction

H-NMR metabolomic analysis represents a significant breakthrough in predicting cardiometabolic diseases. By combining this technique with traditional measures such as BMI and WHR, predictive models become more accurate and sensitive. This allows for earlier and more effective identification of at-risk patient subgroups, potentially leading to more personalized and effective clinical intervention strategies.

Furthermore, this approach provides a comprehensive view of underlying metabolic processes, such as systemic inflammation and lipid functionality, offering detailed insights into the mechanisms contributing to the progression of obesity-related diseases.

This study highlights the potential of H-NMR metabolomics as a complementary tool in the treatment of obesity. By offering a more detailed, data-driven classification, this technique enhances the understanding of associated risks and opens new opportunities for more targeted clinical interventions.

Integrating this technology into clinical practice could transform how obesity is assessed and managed, focusing not only on body weight but also on the metabolic complexity of each individual.

If you are a researcher and want to learn how NMR metabolomics can assist you in your studies, don’t hesitate to contact us! We would be delighted to explore new opportunities in biomarker analysis together and improve health through research.

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