Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada ; Office of Biotechnology and Population Health, Public Health Agency of Canada, Toronto, Ontario, Canada.
Diabetes Metab Syndr Obes. 2012;5:347-55. doi: 10.2147/DMSO.S35115. Epub 2012 Oct 4.
Obesity is associated with a state of chronic inflammation, and increased cardiometabolic disease risk. The present study examined the relationship between body mass index (BMI) and cardiometabolic and inflammatory biomarkers among normal weight, overweight, and obese Canadian adults.
Subjects (n = 1805, aged 18 to 79 years) from the Canadian Health Measures Survey (CHMS) were examined for associations between BMI, cardiometabolic markers (apolipoprotein [Apo] A1, ApoB, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total cholesterol, total cholesterol/HDL ratio [total:HDL-C ratio], triglycerides, and glycosylated hemoglobin [HbA(1c)]), inflammatory factors (C-reactive protein [CRP], fibrinogen, and homocysteine), and 25-hydroxyvitamin D [25(OH)D]. Bootstrap weights for variance and sampling weights for point estimates were applied to account for the complex survey design. Linear regression models adjusted for age, sex, physical activity, smoking status, and ethnicity (in addition to season of clinic visit, for vitamin D analyses only) were used to examine the association between cardiometabolic markers, inflammatory factors, and BMI in Canadian adults.
All biomarkers were significantly associated with BMI (P ≤ 0.001). ApoA1 (β = -0.31, P < 0.0001), HDL-C (β = -0.61, P < 0.0001), and 25(OH)D (β = -0.25, P < 0.0001) were inversely associated with BMI, while all other biomarkers showed positive linear associations. Distinct patterns of association were noted among normal weight, overweight, and obese groups, excluding CRP which showed a significant positive association with BMI in the overall population (β = 2.80, P < 0.0001) and in the normal weight (β = 3.20, P = 0.02), overweight (β = 3.53, P = 0.002), and obese (β = 2.22, P = 0.0002) groups.
There is an apparent profile of cardiometabolic and inflammatory biomarkers that emerges as BMI increases from normal weight to obesity. Understanding these profiles may permit developing an effective approach for early risk prediction for cardiometabolic disease.
肥胖与慢性炎症状态和增加的心血管代谢疾病风险相关。本研究旨在探讨加拿大正常体重、超重和肥胖成年人的体重指数(BMI)与心血管代谢和炎症生物标志物之间的关系。
本研究共纳入了来自加拿大健康测量调查(CHMS)的 1805 名受试者(年龄 18-79 岁),分析了 BMI 与心血管代谢标志物(载脂蛋白[Apo] A1、ApoB、低密度脂蛋白胆固醇[LDL-C]、高密度脂蛋白胆固醇[HDL-C]、总胆固醇、总胆固醇/高密度脂蛋白比值[总:HDL-C 比值]、甘油三酯和糖化血红蛋白[HbA1c])、炎症因子(C 反应蛋白[CRP]、纤维蛋白原和同型半胱氨酸)和 25-羟维生素 D[25(OH)D]之间的关系。为了考虑复杂的调查设计,应用了引导权重估计方差和点估计抽样权重。采用线性回归模型调整年龄、性别、体力活动、吸烟状况和种族(仅针对维生素 D 分析调整就诊季节),以检验加拿大成年人中心血管代谢标志物、炎症因子与 BMI 之间的关系。
所有生物标志物与 BMI 均显著相关(P≤0.001)。ApoA1(β=-0.31,P<0.0001)、HDL-C(β=-0.61,P<0.0001)和 25(OH)D(β=-0.25,P<0.0001)与 BMI 呈负相关,而其他所有生物标志物均呈正线性相关。在正常体重、超重和肥胖组中,观察到不同的关联模式,除 CRP 外,CRP 在总体人群(β=2.80,P<0.0001)和正常体重组(β=3.20,P=0.02)、超重组(β=3.53,P=0.002)和肥胖组(β=2.22,P=0.0002)中均与 BMI 呈显著正相关。
随着 BMI 从正常体重增加到肥胖,心血管代谢和炎症生物标志物呈现出明显的特征。了解这些特征可能有助于制定一种有效的早期心血管代谢疾病风险预测方法。