A group of researchers from Leipzig University and the University of Gothenburg have developed a new way to more accurately assess a person’s risk of developing metabolic diseases such as type 2 diabetes or fatty liver disease.
Rather than relying on the traditional body mass index (BMI), which is based on weight and height, they created an AI-powered model that uses blood data to predict what they call a “metabolic BMI” or metBMI.
The standard BMI is widely used to classify people as underweight, normal weight, overweight, or obese. But it doesn’t tell us how healthy a person’s body fat really is.
Some people who are in the normal weight range may already have unhealthy metabolic signs, while others who are overweight might have a healthy metabolism. This can make it difficult to identify people who are at risk until it’s too late.
To solve this problem, the researchers analyzed data from nearly 2,000 people who took part in two large Swedish health studies. They collected blood samples, health and lifestyle information, and data about the gut microbiome—the bacteria that live in our intestines. Using this information, they built a computer model that predicts a person’s metabolic BMI.
This new model revealed something important: two people with the same traditional BMI can have very different risks of disease, depending on how their metabolism and fat tissue function.
According to the research, people with a high metabolic BMI were up to five times more likely to develop health problems like fatty liver disease, insulin resistance, and type 2 diabetes—even if they had a normal body weight.
The study also looked at people who had undergone weight-loss surgery at the University of Leipzig Medical Center. Those with a high metabolic BMI lost 30% less weight after surgery, showing that their metabolism may resist change even with strong interventions.
Another key finding was the link between metabolic BMI and gut bacteria. People with higher metabolic BMI had less diversity in their gut microbiome and fewer healthy bacteria that help turn fiber into good fatty acids like butyrate. This suggests that lifestyle and environment may have a bigger impact on metabolic health than genetics.
To make the tool more useful, the researchers narrowed down their analysis to 66 key substances in the blood. These molecules showed strong connections to both metabolic processes and gut bacteria, giving doctors a better picture of a person’s true health risks.
Dr. Rima Chakaroun, one of the lead researchers, says that this metabolic BMI tool can help doctors find people at risk earlier. It could also help doctors decide who might benefit most from treatments like weight-loss surgery or medication.
Over time, the model may be improved further by adding more information about insulin and testing the role of gut bacteria in greater detail.
Dr. Chakaroun did her research as a visiting scholar in Sweden and is now bringing her expertise back to Leipzig, where she will contribute to a new research center focused on metabolism.
In short, this new tool offers a better way to understand health risks beyond just body weight. It may help improve early detection and lead to more personalized treatments for people at risk of serious metabolic diseases.
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The study is published in Nature Medicine.
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