Department of Medical Sciences, Uppsala University, Sweden.
Arterioscler Thromb Vasc Biol. 2011 Aug;31(8):e27-34. doi: 10.1161/ATVBAHA.110.221572. Epub 2011 May 5.
Although obesity without metabolic disturbances has been regarded as harmless, we have recently shown that obese subjects without the metabolic syndrome (MetS) has an increased risk of cardiovascular (CV) disorders and mortality during long-term follow-up. To investigate the basis for that increased risk, we studied the impact of obesity without MetS on multiple markers of subclinical CV disease.
At age 70, 1016 subjects were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors study. According to body mass index (BMI)/MetS status, they were categorized as normal weight (BMI <25 kg/m(2)) without MetS (National Cholesterol Education Program criteria, n=319), normal weight with MetS (n=19), overweight (BMI 25 to 29.9 kg/m(2)) without MetS (n=333), overweight with MetS (n=94), obese (BMI ≥30 kg/m(2)) without MetS (n=102), and obese with MetS (n=118). Several different measurements of endothelial reactivity, arterial compliance (plethysmography and ultrasound), carotid artery atherosclerosis, and echocardiography were performed, and 7 markers of coagulation/fibrinolysis were measured. Subjects with obesity without MetS showed impaired vasoreactivity, a more echolucent carotid artery wall, increased left ventricular mass and function together with impaired coagulation/fibrinolysis compared with normal-weight subjects without the MetS (P<0.05 to 0.001). The majority of these disturbances were also seen in overweight subjects without the MetS.
In contrast to some previous studies, our data do not support that obesity without MetS is a benign condition, because obesity without MetS was associated with impairments in multiple markers of subclinical CV disease. This was also the case for overweight subjects without the MetS.
虽然没有代谢紊乱的肥胖被认为是无害的，但我们最近发现，没有代谢综合征（MetS）的肥胖患者在长期随访中发生心血管（CV）疾病和死亡的风险增加。为了研究这种风险增加的基础，我们研究了没有 MetS 的肥胖对多种亚临床 CV 疾病标志物的影响。
在 Prospective Investigation of the Vasculature in Uppsala Seniors 研究中，1016 名受试者在 70 岁时接受了调查。根据体重指数（BMI）/MetS 状态，他们被分为正常体重（BMI<25kg/m²）且无 MetS（国家胆固醇教育计划标准，n=319）、正常体重且有 MetS（n=19）、超重（BMI 为 25 至 29.9kg/m²）且无 MetS（n=333）、超重且有 MetS（n=94）、肥胖（BMI≥30kg/m²）且无 MetS（n=102）和肥胖且有 MetS（n=118）。进行了内皮反应性、动脉顺应性（体积描记法和超声）、颈动脉粥样硬化和超声心动图的多项不同测量，并测量了 7 项凝血/纤溶标志物。与无 MetS 的正常体重受试者相比，无 MetS 的肥胖受试者表现出血管反应受损、颈动脉壁更亮、左心室质量和功能增加以及凝血/纤溶受损（P<0.05 至 0.001）。大多数这些异常在无 MetS 的超重受试者中也存在。
与一些先前的研究不同，我们的数据不支持无 MetS 的肥胖是良性的，因为无 MetS 的肥胖与多种亚临床 CV 疾病标志物受损有关。无 MetS 的超重受试者也是如此。
