The Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan.
Endocr J. 2013;60(5):617-28. doi: 10.1507/endocrj.ej12-0351. Epub 2013 Jan 22.
In several countries including Japan, people without obesity but with a clustering of metabolic risk factors (MetRFs) were not considered to have the metabolic syndrome (MetS). Here, we examined whether lifestyle characteristics differed between non-obese and obese subjects with or without a clustering of MetRFs. From a population-based cross-sectional study of Japanese subjects aged ≥ 40 years, 1,601 subjects (age: 61.9 ± 10.3 years; 710/891 men/women) were recruited. Physical activity status and daily nutritional intake were estimated using questionnaires. A clustering of MetRFs was defined based on the presence of at least two non-essential risk factors for the diagnosis of the MetS in Japan. Energy intake was not higher in subjects with a clustering of MetRFs compared with those without. Among men, energy expenditure at work was significantly lower in non-obese (9.0 ± 8.2 vs. 11.3 ± 9.3 metabolic equivalents (METs), P = 0.025) and obese (9.0 ± 7.9 vs. 11.6 ± 9.4 METs, P = 0.017) subjects with a clustering of MetRFs than in those without. Multiple logistic regression analysis showed that energy expenditure at work was significantly associated with a clustering of MetRFs after adjusting for possible confounding factors including total energy intake. The ORs (per 1 METs) were 0.970 (95% CI, 0.944-0.997; P = 0.032) in non-obese men and 0.962 (0.926- 0.999; P = 0.043) in obese men. Similar associations were not observed in women. In Japanese males, lower physical activity, but not excessive energy intake, is a risk factor for a clustering of MetRFs independent of their obesity status.
在包括日本在内的一些国家，没有肥胖但存在代谢危险因素聚集（MetRFs）的人不被认为患有代谢综合征（MetS）。在这里，我们研究了非肥胖和肥胖个体中是否存在代谢危险因素聚集的情况下，生活方式特征是否存在差异。本研究基于日本≥40 岁人群的一项横断面研究，共招募了 1601 名受试者（年龄：61.9±10.3 岁；710/891 名男性/女性）。通过问卷调查评估体力活动状况和日常营养摄入。根据日本代谢综合征诊断中至少存在两个非必需危险因素的存在，定义代谢危险因素聚集。与无代谢危险因素聚集的受试者相比，有代谢危险因素聚集的受试者的能量摄入并没有更高。在男性中，非肥胖（9.0±8.2 与 11.3±9.3 代谢当量（METs），P=0.025）和肥胖（9.0±7.9 与 11.6±9.4 METs，P=0.017）受试者中，有代谢危险因素聚集的个体的工作时能量消耗明显较低。多元逻辑回归分析显示，在校正包括总能量摄入在内的可能混杂因素后，工作时能量消耗与代谢危险因素聚集显著相关。非肥胖男性的 OR（每 1 METs）为 0.970（95%CI，0.944-0.997；P=0.032），肥胖男性为 0.962（0.926-0.999；P=0.043）。在女性中未观察到类似的关联。在日本男性中，较低的体力活动而不是过度的能量摄入，是代谢危险因素聚集的独立风险因素，与肥胖状态无关。
