Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Int J Obes (Lond). 2012 Sep;36(9):1187-94. doi: 10.1038/ijo.2011.247. Epub 2011 Dec 13.
Although the existence of metabolically healthy obese (MHO) individuals has been recognized, little is known regarding metabolic health status in these subjects over time. Thus, we evaluated longitudinal changes in metabolic parameters among MHO subjects compared with metabolically healthy, normal-weight (MHNW) subjects.
A cohort study was performed on 2599 Korean men, 30-59 years of age, with no evidence of fatty liver disease on ultrasound and no traits of metabolic syndrome at baseline. BMI was categorized based on criteria for Asian population. Study participants were followed annually or biennially between 2002 and 2009. At each visit, the fatty liver on ultrasound was assessed and metabolic abnormalities were measured. Parametric Cox models and a pooled logistic regression models were used to evaluate the relationships of BMI with incident metabolic abnormalities.
During 9647.1 person-years of follow-up, 1673 participants developed metabolic abnormalities. After adjusting for age, smoking, alcohol intake and exercise, higher baseline BMI categories predicted increased incidences of metabolic abnormalities in a dose-response manner. The hazard ratios (95% confidence intervals) for hypertriglyceridemia, prediabetes, pre-hypertension, low high-density lipoprotein-cholesterol, fatty liver, elevated high sensitivity-C reactive protein, elevated homeostasis model assessment of insulin resistance, any metabolic abnormality and metabolic syndrome among the MHO subjects compared with the MHNW subjects were 1.51 (1.23-1.85), 1.43 (1.19-1.72), 1.79 (1.45-2.22), 1.80 (1.30-2.49), 2.69 (2.19-3.31), 1.39 (1.16-1.67), 2.90 (2.31-3.62), 1.68 (1.45-1.93) and 1.84(1.02-3.30), respectively.
In this study, MHO individuals showed higher incidences of metabolic abnormalities compared with MHNW individuals. This suggests that initially MHO individuals undergo adverse metabolic changes associated with obesity over time.
尽管代谢健康肥胖（MHO）个体的存在已得到公认，但对于这些个体随时间推移的代谢健康状况却知之甚少。因此，我们评估了 MHO 个体与代谢健康、正常体重（MHNW）个体相比，代谢参数的纵向变化。
对 2599 名年龄在 30-59 岁之间、超声检查未见脂肪肝且基线时无代谢综合征特征的韩国男性进行了一项队列研究。BMI 根据亚洲人群的标准进行分类。在 2002 年至 2009 年期间，研究参与者每年或每两年随访一次。每次就诊时，均通过超声评估肝脏脂肪变性情况，并测量代谢异常。采用参数 Cox 模型和汇总逻辑回归模型评估 BMI 与新发代谢异常的关系。
在 9647.1 人年的随访期间，1673 名参与者发生了代谢异常。在校正年龄、吸烟、饮酒和运动后，较高的基线 BMI 类别与代谢异常发生率呈剂量反应关系。与 MHNW 个体相比，MHO 个体发生高甘油三酯血症、糖尿病前期、高血压前期、低高密度脂蛋白胆固醇血症、脂肪肝、高敏 C 反应蛋白升高、胰岛素抵抗的稳态模型评估升高、任何代谢异常和代谢综合征的风险比（95%置信区间）分别为 1.51（1.23-1.85）、1.43（1.19-1.72）、1.79（1.45-2.22）、1.80（1.30-2.49）、2.69（2.19-3.31）、1.39（1.16-1.67）、2.90（2.31-3.62）、1.68（1.45-1.93）和 1.84（1.02-3.30）。
在这项研究中，与 MHNW 个体相比，MHO 个体发生代谢异常的发生率更高。这表明，最初 MHO 个体随时间推移会发生与肥胖相关的不良代谢变化。
