Clinical Characteristics and Classification of Obese Cameroonians with a Metabolically Normal Phenotype in the Western Region of Cameroon

The objective of this study was to classify and suggest an adequate definition of the metabolically normal phenotype in obese people living in the western region of Cameroon. A cross-sectional study was conducted in the West Cameroon region from August 2016 to August 2017. A total of 324 obese subjects (BMI > 27kg/m2) aged at least 20 years and not treated for cardiometabolic diseases were included in the study. Sociodemographic and clinical parameters of the subjects were collected. Four definitions of metabolic status were tested tosuggest the definition that best identified the obese subjects with metabolically normal phenotype (MNO) in the study.The prevalence of the MNO phenotype varied from 2.5% to 29.6% according to thedefinitions used. According to the individual definitions, the prevalence of the MNO phenotypewas 29.6% according to Hinnouho, 16% according to Mbanya, 7.4% according to Meigs and 2.5%according to Widman. Markers of inflammatory profile (hsCRP and TNFα), carbohydrate homeostasis (fasting glucose and HOMA), markers of lipid profile (total cholesterol and triglyceride), Systolic blood pressure (SBP), nitric oxide (NO) and adiposity indices (Waist circumference and waist to hip ratio) were significantly lower in MNO subjects for the majority of definitions (p<0.05). The modified Hinnouho definition showed better specificity (60.9%) and sensitivity (12.1%) for an area under the ROC curve of 0.98. The degree ofagreement was low between the different pairs of definition of the MNO phenotype (Kappa< 0.61). There is poor agreement between the different definitions of the MNO phenotype inobese Cameroonians. Therefore, the adoption of a universal definition of MNO phenotype shouldbe proposed to facilitate the management of metabolic health in the obese.