In vivo imaging methodologies have identified sub-phenotypes such as metabolically healthy obese and thin-on-the-outside fat-on-the-inside individuals, highlighting that visceral and ectopic fat are key risk factors independent of BMI.
Direct assessment of body fat distribution using in vivo imaging is crucial for identifying metabolic risk sub-phenotypes that are not accurately reflected by BMI alone.
Excess body adiposity, especially abdominal obesity and ectopic fat accumulation, are key risk factors in the development of a number of chronic diseases. The advent of in vivo imaging methodologies that allow direct assessment of total body fat and its distribution have been pivotal in this process. They have helped to identify a number of sub-phenotypes in the general population whose metabolic risk factors are not commensurate with their BMI. At least two such sub-phenotypes have been identified: subjects with normal BMI, but excess intra-abdominal (visceral) fat (with or without increased ectopic fat) and subjects with elevated BMI (> 25 kg/m(2)) but low visceral and ectopic fat. The former sub-phenotype is associated with adverse metabolic profiles, while the latter is associated with a metabolically normal phenotype, despite a high BMI. Here, examples of these phenotypes are presented and the value of carrying out enhanced phenotypical characterisation of subjects in interventional studies discussed.
Thomas et al. (Fri,) conducted a review in Obesity and metabolic phenotypes. Visceral and ectopic fat accumulation was evaluated. In vivo imaging methodologies have identified sub-phenotypes such as metabolically healthy obese and thin-on-the-outside fat-on-the-inside individuals, highlighting that visceral and ectopic fat are key risk factors independent of BMI.
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