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Table 1 MHO definition; cohort studies

From: Beyond BMI: The “Metabolically healthy obese” phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic review

Study Definition of metabolically healthy obese (MHO) Definition of metabolically healthy, normal weight (MHNW)
Katzmarzyk [19] • <3 MetS • ≤ 2 MetS criteria, normal weight (BMI 18.5-24.9 kg/m2)
• BMI ≥30 kg/m2
• Diabetics included
St-Pierre [17] • ≤2 insulin resistance syndromeA (IRS) criteria • ≤2 IRSA criteria, normal weight (BMI <25 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics excluded
Meigs [14] • < 3 MetS criteria and/or IS by HOMA-IR < 75th percentile • <3 MetS criteria, normal weight (BMI < 25 kg/m2) and/or IS, normal weight (BMI < 25 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics excluded
Daly [20] • <3 MetSB • <3 MetSB , normal weight (BMI <25 kg/m2)
• BMI > 30 kg/m2
• Diabetics included
Song [21] • < 3 MetSC criteria • <3 MetSC , normal weight (BMI <25 kg/m2)
• BMI ≥30 kg/m2
• Diabetics included
Kuk [13] • ≤1 MetS criteria and/or IS by HOMA < 2.5 • ≤1 MetS criteria, normal weight (BMI < 25 kg/m2) and/or IS, normal weight (BMI < 25 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics included
Arnlov [9] • <3 MetSD criteria and/or IS by HOMA-IR <75th percentile • <3 MetSD criteria, normal weight (BMI < 25 kg/m2) and/or IS, normal weight (BMI < 25 kg/m2)
• BMI > 30 kg/m2
• Diabetics excluded
Calori [10] •IS by HOMA-IR < 2.5 • IS, not obese (BMI < 30 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics included
Voulgari [18] • < 3 MetS criteria • <3 MetS criteria, normal weight (BMI <24.9 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics excluded
Hosseinpanah [12] • <3 MetSE criteria • <3 MetSE criteria, normal weight (BMI 18.5-24.9 kg/m2)
• BMI ≥30 kg/m2
• Diabetics included
Bobbioni-Harsch [23] • 0 MetS criteria • 0 MetS criteria, normal weight (BMI < 25 kg/m2)
• BMI ≥25 kg/m2
Ogorodnikova [15] • ≤ 2 MetSC criteria; ≤1 of any MetSC criteria, IR by HOMA-IR > 75th percentile of all participants, or systemic inflammation by WBC >75th percentile for all participants; or IS by HOMA-IR ≤25th percentile among non-diabetic obese, sex-specific • ≤ 2 MetSC criteria, normal weight (BMI 18.5-24.9 kg/m2) or ≤ 1 MetSC criteria, IR by HOMA-IR > 75th percentile of all participants, or systemic inflammation by WBC >75th percentile for all participants, normal weight (BMI 18.5-24.9 kg/m2) or IS, normal weight (BMI 18.5-24.9 kg/m2)
• BMI ≥ 30 kg/m2
• Diabetics included
Hamer [11] • <2 MetSF criteria (including CRP ≥3.0 mg/L) • <2 MetSF criteria, not obese (BMI 18–29.9 kg/m2) or <2 MetSF criteria, normal waist (≤102 cm in men, ≤88 cm in women)
• BMI ≥30 kg/m2 or waist circumference >102 cm men, >88 cm women
• Diabetics included
Bo [22] • < IS by HOMA < 2.5 AND <3 MetSG criteria • IS, normal weight (BMI <25 kg/m2)
• BMI > 30 kg/m2
• Diabetics included
Ortega [16] • ≤1 MetSC criteria • ≤1 MetSC criteria, normal weight (BMI 18.5-24.9 kg/m2) or • ≤1 MetSC criteria, normal body fat (<25% men/<30% women)
• Body Fat% ≥ 25/30 (M/F) ORBMI ≥ 30 kg/m2
• Diabetics included
  1. A TG ≥150 mg/dL, HDL <50 mg/dL, ≥54.5% of LDL particles with diameter <255A, Apo lipoprotein B level ≥1.36 g/L, fasting insulin level ≥ 85.2 pmol/L, blood pressure ≥ 135/85 mmHg, CRP ≥3.0 mg/L; B TG and waist circumference excluded, added BMI > 30 kg/m2 into criteria; C Waist circumference excluded; D Waist circumference excluded, added BMI ≥ 29.4 kg/m2 cut-point into criteria; E Waist circumference ≥89 cm for men and ≥91 cm for women, blood pressure ≥ 140/85 mmHg; F TG excluded, added CRP ≥ 3 mg/L into criteria; G Waist circumference ≥94 cm for men and ≥80 cm for women, fasting plasma glucose ≥ 100 mg/dl or use of hypoglycemic therapy.