Department of Epidemiology and Public Health, 1-19 Torrington Place, University College London, London WC1E 6BT, United Kingdom.
J Clin Endocrinol Metab. 2012 Jul;97(7):2482-8. doi: 10.1210/jc.2011-3475. Epub 2012 Apr 16.
Previous studies have identified an obese phenotype without the burden of adiposity-associated cardiometabolic risk factors, although the health effects remain unclear.
We examined the association between metabolically healthy obesity and risk of cardiovascular disease (CVD) and all-cause mortality.
This was an observational study with prospective linkage to mortality records in community-dwelling adults from the general population in Scotland and England.
A total of 22,203 men and women [aged 54.1 (SD 12.7 yr), 45.2% men] without known history of CVD at baseline.
Based on blood pressure, high-density lipoprotein-cholesterol, diabetes diagnosis, waist circumference, and low-grade inflammation (C-reactive protein ≥ 3 mg/liter), participants were classified as metabolically healthy (0 or 1 metabolic abnormality) or unhealthy (two or more metabolic abnormalities). Obesity was defined as a body mass index of 30 kg/m(2) or greater.
Study members were followed up, on average, more than 7.0 ± 3.0 yr for cause-specific mortality. Cox proportional hazards models were used to examine the association of metabolic health/obesity categories with mortality.
There were 604 CVD and 1868 all-cause deaths, respectively. Compared with the metabolically healthy nonobese participants, their obese counterparts were not at elevated risk of CVD [hazard ratio (HR) 1.26, 95% confidence interval (CI) 0.74-2.13], although both nonobese (HR 1.59, 95% CI 1.30-1.94) and obese (HR 1.64, 95% CI 1.17-2.30) participants with two or more metabolic abnormalities were at elevated risk. Metabolically unhealthy obese participants were at elevated risk of all-cause mortality compared with their metabolically healthy obese counterparts (HR 1.72, 95% CI 1.23-2.41).
Metabolically healthy obese participants were not at increased risk of CVD and all-cause mortality over 7 yr.
尽管肥胖相关的代谢风险因素尚未得到证实，但之前的研究已经确定了肥胖表型。
我们检验了代谢健康型肥胖与心血管疾病（CVD）和全因死亡率之间的相关性。
这是一项观察性研究，对苏格兰和英格兰社区居住的成年人进行前瞻性随访，以记录死亡情况。
共有 22203 名男性和女性（年龄 54.1（12.7 岁），45.2%为男性），在基线时没有已知的 CVD 病史。
根据血压、高密度脂蛋白胆固醇、糖尿病诊断、腰围和低度炎症（C 反应蛋白≥3 毫克/升），参与者被分为代谢健康（0 或 1 项代谢异常）或不健康（2 项或更多代谢异常）。肥胖定义为体重指数≥30kg/m²。
研究对象平均随访 7.0±3.0 年以上，随访终点为特定原因的死亡率。使用 Cox 比例风险模型检验代谢健康/肥胖类别与死亡率的关系。
分别发生了 604 例 CVD 和 1868 例全因死亡。与代谢健康的非肥胖参与者相比，肥胖参与者患 CVD 的风险并没有增加（风险比[HR]1.26，95%置信区间[CI]0.74-2.13），尽管非肥胖（HR 1.59，95%CI 1.30-1.94）和肥胖（HR 1.64，95%CI 1.17-2.30）参与者有两种或更多代谢异常的风险均增加。与代谢健康的肥胖参与者相比，代谢不健康的肥胖参与者的全因死亡率风险增加（HR 1.72，95%CI 1.23-2.41）。
在 7 年的随访中，代谢健康的肥胖参与者患 CVD 和全因死亡率的风险没有增加。
