Increased oxidative stress in normal-weight postmenopausal women with metabolic syndrome compared with metabolically healthy overweight/obese individuals

Objective: The purpose of this study was to assess whether the metabolically healthy overweight/obese phenotype is associated with decreased oxidative stress compared with normal-weight individuals with metabolic syndrome (MetS). Materials/Methods: Plasma oxidized LDL (ox-LDL) and urinary 8-epi-prostaglandin F_2α (8-epi-PGF_2α) were analyzed in a cross-sectional study of 1846 healthy postmenopausal women. Participants were classified by presence (n = 569) or absence (n = 1277) of MetS and by BMI (18.5-24.9 kg/m² = normal weight, n = 1254; ≥ 25 kg/m² = overweight/obese, n = 592). MetS was diagnosed with the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Compared to normal weight women with MetS (n = 296), metabolically healthy overweight/obese women (n = 319) showed lower blood pressure, triglyceride, and glucose and higher HDL cholesterol, adiponectin, and LDL particle size. Ox-LDL was higher in overweight/obese women without MetS than in normal weight women without MetS (n = 958) but was lower than in women with MetS. Urinary 8-epi-PGF_2α level was about 11% lower in women without MetS than in women with MetS. Normal weight women with MetS had greater odds of having ox-LDL (multivariate odds ratio [OR] 2.42, 95% CI: 1.65-3.55) and 8-epi-PGF_2α (OR 1.49; CI: 1.03-2.14) levels in the top quartile compared to normal weight women without MetS after adjusting for age, drinking, smoking, total- and LDL-cholesterol, and high sensitivity C-reactive protein. Additionally, there was no significant correlation between ox-LDL and 8-epi-PGF_2α. Conclusions: The metabolically healthy overweight/obese phenotype was associated with a better overall metabolic profile and less oxidative stress than that observed in normal weight individuals with MetS. Furthermore, there was a lack of association between ox-LDL and 8-epi-PGF_2α.