Schröder Helmut, Ramos Rafel, Baena-Díez José M, Mendez Michelle A, Canal Dolors Juvinyà, Fíto Montserrat, Sala Joan, Elosua Roberto
Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Institut de Recerca Hospital del Mar), Barcelona, Spain,
Eur J Nutr. 2014 Sep;53(6):1345-53. doi: 10.1007/s00394-013-0635-2. Epub 2013 Dec 10.
There is limited prospective evidence at population scale of the impacts of lifestyle and surrogate measures of general and abdominal adiposity on the transition of a metabolically healthy (absence of a metabolic disorder) overweight/obese (MHOO) phenotype to a metabolically abnormal overweight/obese (MAOO) phenotype. Therefore, we determined the relationship between 10-year body mass index (BMI), waist circumferences (WC), waist to height ratio (WHtR), and lifestyle changes and the transition of the MHOO phenotype.
We conducted a prospective population-based study of 3,052 male and female Spaniards aged 25-74 years who were followed from 2000 through 2009. Diet and leisure-time physical activity were recorded on validated questionnaires. Weight, height, WC, blood lipids, glycemia, and blood pressure were measured. All variables were obtained at baseline (BL) and follow-up (FL). Participants with a BMI ≥ 25 kg/m(2) and free from hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, and low HDL and high LDL cholesterol levels were characterized as the MHOO phenotype. A composite healthy lifestyle index (HLI) was constructed by including temporary changes in 3 lifestyle variables (diet, leisure-time physical activity, and smoking).
Initially, 20.8% of subjects had the MHOO phenotype; 49.2% of these shifted to MAOO phenotype. In multivariate analysis, changes in BMI, WC, WHtR were positively associated (p = 0.004, p = 0.018, and p = 0.016, respectively) with this transition. One unit increase in the HLI was associated with a 33% lower risk (p = 0.025) to the MAOO phenotype transition after adjusting for age, sex, educational level, and baseline energy intake, BMI, WC, and WHtR.
The presence of metabolic disorders in the MHOO phenotype is predicted by an increase in anthropometric surrogate measures of general and abdominal adiposity. In contrast, a healthy lifestyle protects against a transition to the MAOO phenotype.
在人群规模上，关于生活方式以及一般和腹部肥胖的替代指标对代谢健康（无代谢紊乱）的超重/肥胖（MHOO）表型转变为代谢异常的超重/肥胖（MAOO）表型的影响，前瞻性证据有限。因此，我们确定了10年体重指数（BMI）、腰围（WC）、腰高比（WHtR）和生活方式变化与MHOO表型转变之间的关系。
我们对3052名年龄在25 - 74岁的西班牙男性和女性进行了一项基于人群的前瞻性研究，研究时间从2000年持续到2009年。通过经过验证的问卷记录饮食和休闲时间的身体活动情况。测量体重、身高、WC、血脂、血糖和血压。所有变量均在基线（BL）和随访（FL）时获取。BMI≥25 kg/m²且无高胆固醇血症、高甘油三酯血症、糖尿病、高血压以及低高密度脂蛋白和高低密度脂蛋白胆固醇水平的参与者被定义为MHOO表型。通过纳入3种生活方式变量（饮食、休闲时间身体活动和吸烟）的临时变化构建了一个综合健康生活方式指数（HLI）。
最初，20.8%的受试者具有MHOO表型；其中49.2%转变为MAOO表型。在多变量分析中，BMI、WC、WHtR的变化与这种转变呈正相关（分别为p = 0.004、p = 0.018和p = 0.016）。在调整年龄、性别、教育水平以及基线能量摄入、BMI、WC和WHtR后，HLI每增加一个单位与MAOO表型转变风险降低33%相关（p = 0.025）。
一般和腹部肥胖的人体测量替代指标增加可预测MHOO表型中代谢紊乱的存在。相比之下，健康的生活方式可防止向MAOO表型的转变。
