Martin-Piedra, LauraAlcala-Diaz, Juan F.Gutierrez-Mariscal, Francisco M.Arenas de Larriva, Antonio P.Romero-Cabrera, Juan L.Torres-Peña, Jose D.Caballero-Villarraso, JavierLuque, Raul M.Perez-Martinez, PabloLopez-Miranda, JoseDelgado-Lista, Javier2022-12-052022-12-052021-11-12Martin-Piedra L, Alcala-Diaz JF, Gutierrez-Mariscal FM, Arenas de Larriva AP, Romero-Cabrera JL, Torres-Peña JD, et al. Evolution of Metabolic Phenotypes of Obesity in Coronary Patients after 5 Years of Dietary Intervention: From the CORDIOPREV Study. Nutrients. 2021 Nov 12;13(11):4046http://hdl.handle.net/10668/4459Background: Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. Methods: The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Results: Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p < 0.05). Most of the MUO (92%) patients maintained unhealthy phenotypes (MUO-Non-Responders), but 8% became metabolically healthy (MUO-Responders) after a significant decrease in their BMI and FLI-score, with improvement in all metabolic criteria. No differences were found among dietary groups. Conclusions: A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Obesity metabolic phenotypesMetabolically healthy obeseMetabolically unhealthy obeseFatty liver indexDiet interventionMediterranean dietLow-fat dietCoronary patientsPhenotypeObesidadObesidad metabólica benignaHígado grasoDietaDieta mediterráneaDieta con restricción de grasasEnfermedad coronariaFenotipoMedical Subject Headings::Persons::Persons::Age Groups::AdultMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass IndexMedical Subject Headings::Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::DietMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, Fat-RestrictedMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, MediterraneanMedical Subject Headings::Diseases::Digestive System Diseases::Liver Diseases::Fatty LiverMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Demography::Health StatusMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::ObesityMedical Subject Headings::Persons::Persons::Age Groups::Adult::Young AdultMedical Subject Headings::Phenomena and Processes::Genetic Phenomena::PhenotypeMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up StudiesMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Secondary Preventionresearch article34836298open access10.3390/nu131140462072-6643PMC8624211