Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Obesity (Silver Spring). 2011 Jul;19(7):1482-91. doi: 10.1038/oby.2010.332. Epub 2011 Jan 13.
Individuals with "metabolically benign" obesity (obesity unaccompanied by hypertension, dyslipidemia, and diabetes) are not at elevated 10-year risk of cardiovascular disease (CVD) compared to normal weight individuals. It remains unclear whether these obese individuals or normal weight individuals with clustering of cardiometabolic factors display heightened immune activity. Therefore, we characterized levels of acute-phase reactants (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), white blood cell (WBC) count), adhesion molecules (E-selectin, vascular cell adhesion molecule-1), and coagulation products (fibrinogen, plasminogen activator inhibitor-1 (PAI-1)) among four body size phenotypes (normal weight with 0/1 vs. ≥2 metabolic syndrome components/diabetes and overweight/obesity with 0/1 vs. ≥2 metabolic syndrome components/diabetes) in cross-sectional analyses of 1,889 postmenopausal women from the Women's Health Initiative Observational Study (WHI-OS) nested case-control stroke study. Higher levels of all three inflammatory marker categories were found among women with overweight/obesity or ≥2 metabolic syndrome components or diabetes. Compared to normal weight women with 0 or 1 metabolic syndrome components, normal weight women with ≥2 metabolic syndrome components or diabetes were more likely to have ≥3 inflammatory markers in the top quartile (multivariate odds ratio (OR) 2.0, 95% confidence interval (CI): 1.3-3.0), as were overweight/obese women with 0 or 1 metabolic syndrome components (OR 2.3; 95% CI: 1.5-3.5). Overweight/obese women with ≥2 metabolic syndrome components or diabetes had the highest OR (OR 4.2; 95% CI: 2.9-5.9). Despite findings that metabolically benign obese individuals are not at increased 10-year risk of CVD compared to normal weight individuals, the current results suggest that overweight/obese women without clustering of cardiometabolic risk factors still possess abnormal levels of inflammatory markers.
个体如果患有“代谢良好”型肥胖（不伴有高血压、血脂异常和糖尿病），那么其 10 年患心血管疾病（CVD）的风险与体重正常的个体相比并不高。目前尚不清楚这些肥胖个体或伴有心血管代谢危险因素聚集的体重正常个体是否表现出更高的免疫活性。因此，我们在 Women's Health Initiative Observational Study（WHI-OS）嵌套病例对照卒中研究中，对 1889 名绝经后妇女进行了横断面分析，根据四个体型表型（0/1 个代谢综合征成分/糖尿病和≥2 个代谢综合征成分/糖尿病的体重正常者，0/1 个代谢综合征成分/糖尿病和≥2 个代谢综合征成分/糖尿病的超重/肥胖者），描述了急性时相反应物（C 反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞计数）、黏附分子（E-选择素、血管细胞黏附分子-1）和凝血产物（纤维蛋白原、纤溶酶原激活物抑制剂-1（PAI-1））的水平。所有三种炎症标志物类别的水平在超重/肥胖或≥2 个代谢综合征成分或糖尿病的女性中更高。与 0 或 1 个代谢综合征成分的体重正常女性相比，0 或 1 个代谢综合征成分但患有糖尿病的正常体重女性更有可能具有≥3 个炎症标志物处于最高四分位（多变量比值比（OR）2.0，95%置信区间（CI）：1.3-3.0），0 或 1 个代谢综合征成分的超重/肥胖女性也是如此（OR 2.3；95% CI：1.5-3.5）。0 或 1 个代谢综合征成分但患有糖尿病的超重/肥胖女性具有最高的 OR（OR 4.2；95% CI：2.9-5.9）。尽管有研究表明，与体重正常的个体相比，“代谢良好”型肥胖个体患 CVD 的 10 年风险没有增加，但目前的结果表明，没有心血管代谢危险因素聚集的超重/肥胖女性仍然存在异常水平的炎症标志物。
