与代谢异常的肥胖表型相比，代谢健康但肥胖的表型与较低水平的持久性有机污染物血浆浓度相关。

The metabolically healthy but obese phenotype is associated with lower plasma levels of persistent organic pollutants as compared to the metabolically abnormal obese phenotype.

作者信息

Gauthier Marie-Soleil, Rabasa-Lhoret Rémi, Prud'homme Denis, Karelis Antony D, Geng Dawei, van Bavel Bert, Ruzzin Jérôme

机构信息

Institut de Recherches Cliniques de Montréal (M.-S.G., R.R.-L.), Montréal, Québec, H2W 1R7, Canada; Montreal Diabetes Research Centre at the Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) (M.-S.G., R.R.-L.) Montréal, Québec, H1W 4A4, Canada; The Nutrition Department (R.R.-L.), Université de Montréal; the Endocrinology Division (R.R.-L.), Montreal University Hospital, Montréal, Québec, Canada H2W 1T8; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada; Institut de Recherche de l'Hôpital Montfort (D.P.), Ottawa, Ontario, K1K 0T2, Canada; Department of Kinanthropology (A.K.), Université du Québec à Montréal, Montréal, Québec, Canada H3C 3P8; MTM Research Center (D.G., B.v.B.), School of Science and Technology, Örebro University, SE-701 82 Örebro, Sweden; and Department of Biology (J.R.), University of Bergen, N-5006 Bergen, Norway.

出版信息

J Clin Endocrinol Metab. 2014 Jun;99(6):E1061-6. doi: 10.1210/jc.2013-3935. Epub 2014 Feb 25.

DOI:10.1210/jc.2013-3935

PMID:24606089

Abstract

CONTEXT

Although obesity is strongly linked to insulin resistance and type 2 diabetes, a subset of obese individuals termed metabolically healthy but obese (MHO) appears relatively protected from the development of cardiometabolic complications. The origins of this metabolically healthy phenotype remain unclear. Recently, persistent organic pollutants (POPs) have emerged as potential endocrine disruptors.

OBJECTIVE

The aim of this study was to test the hypothesis that the MHO phenotype presents lower circulating levels of POPs as compared to the metabolically abnormal obese (MAO) phenotype.

DESIGN, SETTING, AND PATIENTS: We conducted a cross-sectional study of 76 nondiabetic obese (body mass index ≥30 kg/m(2)) postmenopausal women.

MAIN OUTCOME MEASURES

Plasma concentrations of 21 POPs as well as cardiometabolic risk factors were analyzed.

RESULTS

For similar age, body mass index, and fat mass index, MHO women (n = 40) showed higher insulin sensitivity levels and a more favorable cardiometabolic profile than MAO women (n = 36), as evidenced by a 2-fold increase in glucose disposal rates measured by the hyperinsulinemic-euglycemic clamp (P = .001). Among 18 detectable pollutants measured, MAO women had higher plasma concentrations of 12 POPs (fold increase, 1.4-2.9; P < .001-.036). Logistic regression analyses showed that the prevalence of the MAO phenotype was significantly associated with higher levels of total dioxin- and non-dioxin-like polychlorinated biphenyls (odds ratio, 4.7; 95% confidence interval, 1.8-12.5; P = .002), as well as trans-nonachlor (odds ratio, 6.1; 95% CI, 2.2-16.4; P < .001).

CONCLUSION

Our study demonstrates that the metabolically healthy and abnormal phenotypes have distinct plasma POP profiles.

摘要

背景

尽管肥胖与胰岛素抵抗和2型糖尿病密切相关，但一部分被称为代谢健康但肥胖（MHO）的肥胖个体似乎相对不易发生心血管代谢并发症。这种代谢健康表型的起源尚不清楚。最近，持久性有机污染物（POPs）已成为潜在的内分泌干扰物。

目的

本研究的目的是检验以下假设：与代谢异常肥胖（MAO）表型相比，MHO表型的循环中POPs水平较低。

设计、地点和患者：我们对76名非糖尿病肥胖（体重指数≥30 kg/m²）绝经后女性进行了一项横断面研究。

主要观察指标

分析了21种POPs的血浆浓度以及心血管代谢危险因素。

结果

在年龄、体重指数和脂肪量指数相似的情况下，MHO女性（n = 40）比MAO女性（n = 36）表现出更高的胰岛素敏感性水平和更有利的心血管代谢特征，通过高胰岛素-正常血糖钳夹法测量的葡萄糖处置率增加了2倍就证明了这一点（P = 0.001）。在检测的18种污染物中，MAO女性的12种POPs血浆浓度较高（增加倍数，1.4 - 2.9；P < 0.001 - 0.036）。逻辑回归分析表明，MAO表型的患病率与总二噁英类和非二噁英类多氯联苯的较高水平显著相关（优势比，4.7；95%置信区间，1.8 - 12.5；P = 0.002），以及反式九氯（优势比，6.1；95% CI，2.2 - 16.4；P < 0.001）。