Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada.
Pediatrics. 2013 Jul;132(1):e85-92. doi: 10.1542/peds.2013-0296.
Controversy exists surrounding the contribution of fitness and adiposity as determinants of the Metabolically Healthy Overweight(MHO) phenotype in youth. This study investigated the independent contribution of cardiorespiratory fitness and adiposity to the MHO phenotype among overweight and obese youth.
This cross-sectional study included 108 overweight and obese youth classified as MHO (no cardiometabolic risk factors) or non-MHO (≥1 cardiometabolic risk factor), based on age- and gender specific cut-points for fasting glucose, triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and hepaticsteatosis.
Twenty-five percent of overweight and obese youth were classified as MHO. This phenotype was associated with lower BMIz-score (BMI z-score: 1.8 ± 0.3 vs 2.1 ± 0.4, P = .02) and waist circumference (99.7 ± 13.2 vs 106.1 ± 13.7 cm, P = .04) compared with non-MHO youth. When matched for fitness level and stratified by BMI z-score (1.6 ± 0.3 vs 2.4 ± 0.2), the prevalence of MHO was four fold higher in the low BMI z-score group (27% vs 7%; P = .03).Multiple logistic regression analyses revealed that the best predictor of MHO was the absence of hepatic steatosis even after adjusting for waist circumference (odds ratio 0.57, 95% confidence interval 0.40–0.80) or BMI z-score (odds ratio 0.59, 95% confidence interval 0.43–0.80).
The MHO phenotype was present in 25% of overweight and obese youth and is strongly associated with lower levels of adiposity,and the absence of hepatic steatosis, but not with cardiorespiratory fitness.
关于体适能和肥胖对青少年代谢健康超重（MHO）表型的决定作用，目前仍存在争议。本研究旨在调查心肺适能和肥胖对超重和肥胖青少年 MHO 表型的独立影响。
本横断面研究纳入了 108 名超重和肥胖青少年，他们根据空腹血糖、甘油三酯、高密度脂蛋白胆固醇、收缩压和舒张压以及肝脂肪变性的年龄和性别特异性切点，被分为 MHO（无心血管代谢危险因素）或非 MHO（≥1 项心血管代谢危险因素）。
25%的超重和肥胖青少年被归类为 MHO。与非 MHO 青少年相比，这种表型与较低的 BMIz 分数（BMI z 分数：1.8 ± 0.3 对 2.1 ± 0.4，P =.02）和腰围（99.7 ± 13.2 对 106.1 ± 13.7 cm，P =.04）相关。当按体适能水平匹配并按 BMIz 分数分层（1.6 ± 0.3 对 2.4 ± 0.2）时，低 BMIz 分数组的 MHO 患病率高出四倍（27%对 7%；P =.03）。多因素逻辑回归分析显示，即使在调整腰围（比值比 0.57，95%置信区间 0.40-0.80）或 BMIz 分数（比值比 0.59，95%置信区间 0.43-0.80）后，无肝脂肪变性也是 MHO 的最佳预测因素。
25%的超重和肥胖青少年存在 MHO 表型，与较低的肥胖水平和无肝脂肪变性密切相关，但与心肺适能无关。
