Drug Safety Unit - Director's Office, Center for Evaluation of Radiopharmaceuticals and Biotherapeutics, Biologic and Genetic Therapies Directorate, Health Canada, Ottawa, Ontario, Canada; The School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Department of Kinanthropology, Université du Québec à Montréal, Montréal, Québec, Canada.
Nutr Metab Cardiovasc Dis. 2014 May;24(5):455-9. doi: 10.1016/j.numecd.2013.12.002. Epub 2014 Jan 12.
A unique subset of obese individuals who appear to be protected from the development of metabolic disturbances has been identified in the medical literature and is termed metabolically healthy but obese (MHO). Part of the issue is that there are no clear accepted criteria on the definition of MHO and the biological mechanisms to explain this phenotype are still unknown which render findings and/or conclusions difficult to interpret and making the application of this concept difficult in clinical practice. With the current definitions, the true prevalence of the MHO phenotype in the general population varies widely from approximately 3-57% of obese adults. In several prospective studies, the MHO individual has been associated with a similar risk of developing type 2 diabetes, cardiovascular disease and mortality when compared to healthy normal weight subjects; however, there is evidence to refute this concept. Furthermore, the current evidence cannot confirm that MHO subjects are permanently protected from the risk of developing metabolic disturbances associated with obesity. Currently, no standard practice guidelines for the treatment of MHO can be proposed, however, a regular surveillance of the waist circumference and cardio-metabolic risk factors such as elevated triglycerides, glycaemia, HOMA, C-reactive protein and low HDL, as well as the prevention of any further weight gain seem to represent the most prudent and sound attitude in the management of MHO subjects.
在医学文献中已经确定了一类独特的肥胖个体亚群，他们似乎免受代谢紊乱的影响，被称为代谢健康但肥胖（MHO）。部分问题在于，对于 MHO 的定义没有明确公认的标准，并且解释这种表型的生物学机制仍不清楚，这使得研究结果和/或结论难以解释，并且使得该概念在临床实践中的应用变得困难。根据目前的定义，MHO 表型在普通人群中的真实患病率差异很大，从肥胖成年人的约 3-57%不等。在几项前瞻性研究中，与健康的正常体重受试者相比，MHO 个体患 2 型糖尿病、心血管疾病和死亡率的风险相似；然而，有证据反驳了这一概念。此外，目前的证据不能证实 MHO 受试者可以永久免受与肥胖相关的代谢紊乱风险的影响。目前，不能提出针对 MHO 的标准治疗指南，但是，定期监测腰围和心血管代谢危险因素，如甘油三酯升高、血糖升高、HOMA、C 反应蛋白和低 HDL，以及预防体重进一步增加，似乎代表了 MHO 受试者管理中最谨慎和合理的态度。
