Metabolic syndrome (MetS) represents a cluster of interrelated conditions—including central obesity, hypertension, dyslipidemia, and hyperglycemia—that significantly increase the risk of cardiovascular disease, type 2 diabetes, and specific cancers. Although traditionally associated with behavioral and dietary factors, new avenues of research point to less conventional physiological variables, such as individual thermal sensitivity, as potential clinical markers of risk and targets for personalized interventions.
The study by Mun, Park, and Lee (2022) provides robust evidence that self-perceived thermal sensitivity may be associated with a predisposition to MetS, independent of obesity. The authors demonstrated that women with greater heat intolerance, greater body heat sensation, and lower cold intolerance had a higher prevalence of MetS and specific components such as elevated triglycerides, elevated fasting glucose, and elevated blood pressure—even with body mass index (BMI) levels similar to those of the control group.
A notable methodological aspect of the study is the use of generalized additive models (GAMs) to predict the expected pattern of thermal sensitivity based on obesity indicators (BMI and waist-to-hip ratio). From this, participants were classified into groups with higher, lower, or expected thermal sensitivity. This strategy allowed us to dissociate the direct effects of obesity from the effects of thermal sensitivity, demonstrating that subjective thermoregulation plays an independent role in the pathophysiology of MetS.
The clinical implications are significant. Early identification of at-risk individuals—particularly those with the “metabolically healthy obese” or “metabolically dysfunctional eutrophic” phenotype—remains a challenge. Because thermal sensitivity is simple and noninvasive to assess through questionnaires, it can be incorporated into the individual profile within the Predictive, Preventive, and Personalized Medicine (PPPM) approach, aiding both risk stratification and the indication of targeted interventions, such as cold-induced thermogenesis (CIT).
Furthermore, the authors suggest that individuals with greater heat intolerance and lower cold sensitivity may require more intense thermal stimuli (e.g., more prolonged or intense cold exposure) to trigger the beneficial metabolic effects of CIT, such as increased substrate oxidation and improved insulin sensitivity. This paves the way for personalized therapeutic protocols adjusted to the individual thermoneutral threshold, which is influenced by physiological and environmental characteristics but is rarely considered in clinical practice.
It’s important to highlight that, despite the promising findings, the study has limitations, such as its cross-sectional design (which prevents causal inferences) and the exclusive sample of Korean women aged 30 to 55. Nevertheless, the results provide a solid conceptual foundation for future experimental research exploring the role of thermoregulation in metabolic homeostasis and for the development of innovative therapeutic strategies to combat metabolic diseases.
In summary, thermal sensitivity emerges as a relevant functional marker in the management of metabolic diseases, not only as a reflection of obesity, but also as an autonomous risk factor and a variable modifiable by environmental interventions. By integrating this physiological dimension into clinical assessments and therapeutic protocols, we move toward truly personalized medicine.
Reference :
MUN, Sujeong; PARK, Kihyun; LEE, Siwoo. Evaluation of thermal sensitivity is of potential clinical utility for the predictive, preventive, and personalized approach advancing metabolic syndrome management. EPMA Journal, vol. 13, p. 125–135, 2022. DOI: https://doi.org/10.1007/s13167-022-00273-6.
