Romero-Corral Abel, Somers Virend K, Sierra-Johnson Justo, Korenfeld Yoel, Boarin Simona, Korinek Josef, Jensen Michael D, Parati Gianfranco, Lopez-Jimenez Francisco
Mayo Clinic College of Medicine, Rochester, MN, USA.
Eur Heart J. 2010 Mar;31(6):737-46. doi: 10.1093/eurheartj/ehp487. Epub 2009 Nov 20.
We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality.
We analysed 6171 subjects >20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5-24.9 kg/m(2)), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors. Survival information was available for >99% of the subjects after a median follow-up of 8.8 years. We divided our sample using sex-specific tertiles of BF%. The highest tertile of BF (>23.1% in men and >33.3% in women) was labelled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher (16.6 vs. 4.8%, P < 0.0001). Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality (HR = 2.2; 95% CI, 1.03-4.67) in comparison to the low BF group.
Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality.
我们推测，体重指数（BMI）正常但体脂（BF）含量高[正常体重肥胖（NWO）]的受试者，心血管代谢失调的患病率更高，心血管（CV）死亡风险更高。
我们分析了来自第三次全国健康与营养检查调查（NHANES III）及NHANES III死亡率研究的6171名年龄大于20岁的受试者，他们的BMI在正常范围内（18.5 - 24.9 kg/m²），并接受了包括身体成分评估、血液检测及CV危险因素评估在内的全面评估。在中位随访8.8年后，超过99%的受试者可获得生存信息。我们根据BF%的性别特异性三分位数对样本进行划分。BF最高三分位数（男性>23.1%，女性>33.3%）被标记为NWO。与低BF组相比，NWO受试者中代谢综合征的患病率高出四倍（16.6%对4.8%，P < 0.0001）。NWO受试者的血脂异常、高血压（男性）和CV疾病（女性）患病率也更高。调整后，与低BF组相比，NWO女性的CV死亡风险显著增加2.2倍（HR = 2.2；95% CI，1.03 - 4.67）。
正常体重肥胖定义为正常BMI与高BF含量的结合，与心血管代谢失调、代谢综合征及CV危险因素的高患病率相关。在女性中，NWO与CV死亡风险增加独立相关。
