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在非糖尿病的韩国人群中识别代谢肥胖但体重正常(MONW)个体:忠州代谢性疾病队列(CMC)研究。

Identifying metabolically obese but normal-weight (MONW) individuals in a nondiabetic Korean population: the Chungju Metabolic disease Cohort (CMC) study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Clin Endocrinol (Oxf). 2011 Oct;75(4):475-81. doi: 10.1111/j.1365-2265.2011.04085.x.

Abstract

OBJECTIVE

To investigate the prevalence and identify the phenotype of individuals suspected to be metabolically obese but normal weight (MONW).

DESIGN AND SUBJECTS

Eight thousand nine hundred and eighty-seven nondiabetic subjects aged over 40 years were selected from the Chungju Metabolic disease Cohort study performed in 2003-2006 in Korea. Those within the highest quartile in the homeostasis model assessment of insulin resistance (HOMA-IR) with a normal body mass index (BMI) between 18·5 and 23 kg/m(2) were classified as MONW.

MEASUREMENTS

Data on anthropometry, lipid profiles and HOMA-IR values were analysed.

RESULTS

The prevalence of MONW was 14·2% for men and 12·9% for women amongst normal-weight subjects. Multiple logistic regression analysis showed that total cholesterol (TC) levels over 5·17 mm (odds ratio, OR = 1·481; 95% confidence intervals, CI 1·086-2·021), triglyceride (TG) levels over 1·69 mm (OR = 1·507; 95% CI 1·093-2·077) and high-density lipoprotein-cholesterol levels lower than 1·03 mm (OR = 1·580; 95% CI 1·053-2·371) independently had higher odds of diagnosing MONW amongst men. For women, a BMI over 21·5 kg/m(2) (OR = 1·405; 95% CI 1·034-1·909), TC levels over 5·17 mm (OR = 1·524; 95% CI 1·112-2·090) and TG levels over 1·69 mm (OR = 1·799; 95% CI 1·302-2·487) were independently associated with a diagnosis of MONW.

CONCLUSIONS

More than 10% of normal-weight subjects were classed as MONW in this cohort. Identification of these subjects based on lipid profiles could aid in the early detection of a high risk group of developing cardiometabolic diseases.

摘要

目的

研究代谢肥胖但体重正常(MONW)个体的流行情况并确定其表型。

设计和研究对象

本研究从韩国 2003-2006 年进行的忠州代谢疾病队列研究中选取了 8987 名年龄超过 40 岁的非糖尿病受试者。将胰岛素抵抗稳态模型评估(HOMA-IR)最高四分位数且体重指数(BMI)在 18.5 至 23kg/m²之间正常的个体归为 MONW。

测量方法

分析了人体测量学、血脂谱和 HOMA-IR 值的数据。

结果

在正常体重受试者中,MONW 的患病率为男性 14.2%,女性 12.9%。多因素 logistic 回归分析显示,总胆固醇(TC)水平>5.17mm(比值比,OR=1.481;95%置信区间,CI 1.086-2.021)、甘油三酯(TG)水平>1.69mm(OR=1.507;95%CI 1.093-2.077)和高密度脂蛋白胆固醇(HDL-C)水平<1.03mm(OR=1.580;95%CI 1.053-2.371)与男性 MONW 的诊断具有更高的相关性。对于女性,BMI >21.5kg/m²(OR=1.405;95%CI 1.034-1.909)、TC 水平>5.17mm(OR=1.524;95%CI 1.112-2.090)和 TG 水平>1.69mm(OR=1.799;95%CI 1.302-2.487)与 MONW 的诊断具有相关性。

结论

在本队列中,超过 10%的正常体重受试者被归类为 MONW。根据血脂谱对这些个体进行识别可能有助于早期发现发生心血管代谢疾病的高危人群。

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