Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Obesity (Silver Spring). 2014 Feb;22(2):557-64. doi: 10.1002/oby.20480. Epub 2013 Jul 5.
It appears that a certain proportion of obese individuals have a normal metabolic profile despite having excess weight. Whether these so-called "metabolically healthy" obese express lower disease and mortality risks than "metabolically unhealthy" obese is still unclear. The mortality risk of "metabolically healthy" abdominal obese (MHAO) individuals was investigated.
Prospective cohort study (EPIC-MORGEN) among 22,654 individuals aged 20-59 years followed for an average of 13.4 years (SD 2.3). MHAO was assessed at baseline (1993-1997) and defined as abdominal obesity (waist circumference ≥102 cm/≥88 cm (men/women)) with normal glucose, blood pressure, and plasma lipids. All-cause mortality risks adjusted for age and sex were estimated using Cox proportional hazards models.
Individuals who were "metabolically healthy" nonabdominal obese (MHNAO) comprised the reference group. As compared to MHNAO, mortality risk for MHAO was around 40% higher (Hazard ratio (HR) 1.43; 95% confidence interval (CI): 1.00-2.04) and of the same magnitude as that for "metabolically unhealthy" nonabdominal obese (MUNAO) (HR 1.31; 95% CI: 1.08-1.59). The HR for MUAO was 1.99 (95% CI: 1.62-2.43).
Mortality risk of MHAO individuals was significantly higher than that of MHNAO individuals and lower than, but not statistically significantly different from, that of MUAO individuals.
尽管体重超标，但似乎有一定比例的肥胖个体具有正常的代谢特征。这些所谓的“代谢健康”肥胖者是否比“代谢不健康”肥胖者的疾病和死亡风险更低尚不清楚。本研究旨在调查“代谢健康”腹型肥胖（MHAO）个体的死亡风险。
这是一项前瞻性队列研究（EPIC-MORGEN），纳入了 22654 名年龄在 20-59 岁的个体，平均随访时间为 13.4 年（SD 2.3）。MHAO 是在基线（1993-1997 年）评估的，定义为腹部肥胖（腰围≥102cm/≥88cm（男性/女性））伴正常血糖、血压和血浆脂质。使用 Cox 比例风险模型，根据年龄和性别调整全因死亡率风险。
将“代谢健康”非腹型肥胖（MHNAO）个体作为参考组。与 MHNAO 相比，MHAO 的死亡风险高出约 40%（危险比（HR）1.43；95%置信区间（CI）：1.00-2.04），与“代谢不健康”非腹型肥胖（MUNAO）的死亡风险相当（HR 1.31；95% CI：1.08-1.59）。MUAO 的 HR 为 1.99（95% CI：1.62-2.43）。
MHAO 个体的死亡风险明显高于 MHNAO 个体，低于但与 MUAO 个体无统计学差异。
