Date of Award

Fall 1-5-2018

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Dora Il`yasova

Second Advisor

Dr. Emily Graybill





Tatiana Victoria Piccoli


Introduction: Obesity-related morbidity continues to increase worldwide. Obesity is one of the primary conditions for the development of metabolic syndrome which is characterized by a combination of different components, including metabolic, physiological, and biochemical factors that influence the development of cardiovascular disease, diabetes mellitus type two and contribute to all-cause mortality. The development of metabolic abnormalities is related to oxidative stress which increases among obese individuals. The obese population is not homogenous and represented by individuals with altered and with a normal metabolic profile, those with the normal metabolic profile are recognized as Metabolically Healthy Obese (MHO). The lipid peroxidation is the main hallmark of oxidative stress and this process can be evaluated via the measurement of the end products such as F2 -Isoprostanes.

Aim: The goal of this study was to investigate the relationship between metabolically healthy and unhealthy obesity with markers of oxidative stress (urinary F2 -Isoprostanes) and assess whether free radical-induced oxidative stress influences transition from metabolically healthy to the metabolically unhealthy group. Metabolic health was defined as blood pressure below 130/85 mmHg, fasting blood glucose level as below 126 mg/dl and HDL-cholesterol above 40 mg/dl for males and above 50 mg/dl for females.

Method: The cohort of 857 participants included Hispanic, non-Hispanic black, and non-Hispanic white from 40 to 69 years of age and had an obesity prevalence of 29% (n=244) at baseline. Among this group, 11.07% (n=27) were metabolically healthy and 88.93% (n=217) were metabolically unhealthy based on criteria for MHO. Among the MHO group, after 5-year follow-up, 37% remained metabolically stable and 63% developed metabolic abnormalities and among the MUO group, 5.6% became metabolically healthy and 94.4% remained metabolically unhealthy. The association between different types of metabolic health and F2 -Isoprostanes species was measured using Wilcoxon rank-sum test.

Result: The MUO status had a direct association with greater weight, Hispanic ethnicity, impaired glucose tolerance, decreased insulin sensitivity, and decreased fasting insulin level. No association was found between metabolic health status and levels of F2 -Isoprostanes at baseline and follow-up.

Conclusion: The result suggests that elevated levels of F2 -Isoprostanes do not promote the transformation of metabolically healthy obesity into metabolically unhealthy obesity.

Keywords: Obesity, metabolic health, metabolically healthy obesity, oxidative stress, F2 -Isoprostanes