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代谢异常但体重正常(MANW)和代谢健康但肥胖(MHO)个体与动脉僵硬和颈动脉粥样硬化的关系。

Association of metabolically abnormal but normal weight (MANW) and metabolically healthy but obese (MHO) individuals with arterial stiffness and carotid atherosclerosis.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.

Department of Biostatistics, College of Medicine, Korea University, Seoul, Republic of Korea.

出版信息

Atherosclerosis. 2014 May;234(1):218-23. doi: 10.1016/j.atherosclerosis.2014.02.033. Epub 2014 Mar 16.

Abstract

OBJECTIVE

Despite recent interest in differential impact of body size phenotypes on cardiovascular outcomes and mortality, studies evaluating the association between body size phenotypes and indicators of atherosclerosis are limited. This study investigated the relationship of metabolically abnormal but normal weight (MANW) and metabolically healthy but obese (MHO) individuals with arterial stiffness and carotid atherosclerosis in Korean adults without cardiovascular disease.

METHODS

A total of 1012 participants (575 men and 437 women, mean age 50.8 years), who underwent a health examination between April 2012 and May 2013 were prospectively enrolled based on inclusion and exclusion criteria. Study subjects were classified according to body mass index (BMI) and the presence/absence of metabolic syndrome.

RESULTS

The prevalence of metabolically healthy normal weight (MHNW), MANW, MHO, and metabolically abnormal obese (MAO) were 54.84%, 6.42%, 22.83%, and 15.91%, respectively. Individuals with MANW had significantly higher brachial-ankle pulse wave velocity and maximal carotid intima-media thickness values than those with MHO, after adjusting for age and gender (P = 0.026 and P = 0.018, respectively). The odds ratio (OR) of arterial stiffness and carotid atherosclerosis in the MANW group were significantly higher than in the MHNW group in unadjusted models. Furthermore, multivariable models showed that increased OR of carotid atherosclerosis in the MANW group persisted even after adjusting for confounding factors (OR = 2.98, 95% CI = [1.54, 5.73], P = 0.011).

CONCLUSIONS

Compared to MHNW or MHO subjects, Korean men and women with the MANW phenotype exhibited increased arterial stiffness and carotid atherosclerosis.

CLINICAL TRIALS NO

NCT01594710.

摘要

目的

尽管最近人们对不同体型表型对心血管结局和死亡率的影响产生了兴趣,但评估体型表型与动脉粥样硬化指标之间关系的研究仍然有限。本研究旨在调查在无心血管疾病的韩国成年人中,代谢异常但体重正常(MANW)和代谢健康但肥胖(MHO)个体与动脉僵硬和颈动脉粥样硬化的关系。

方法

根据纳入和排除标准,共有 1012 名参与者(575 名男性和 437 名女性,平均年龄 50.8 岁)于 2012 年 4 月至 2013 年 5 月间接受健康检查并前瞻性入组。根据体重指数(BMI)和代谢综合征的存在与否对研究对象进行分类。

结果

代谢健康正常体重(MHNW)、MANW、MHO 和代谢异常肥胖(MAO)的患病率分别为 54.84%、6.42%、22.83%和 15.91%。在调整年龄和性别后,与 MHO 相比,MANW 个体的肱踝脉搏波速度和最大颈动脉内膜中层厚度值显著更高(P = 0.026 和 P = 0.018)。在未调整模型中,MANW 组的动脉僵硬和颈动脉粥样硬化的比值比(OR)明显高于 MHNW 组。此外,多变量模型显示,即使在调整混杂因素后,MANW 组颈动脉粥样硬化的 OR 增加仍然持续(OR = 2.98,95%CI [1.54, 5.73],P = 0.011)。

结论

与 MHNW 或 MHO 受试者相比,具有 MANW 表型的韩国男性和女性表现出动脉僵硬和颈动脉粥样硬化增加。

临床试验编号

NCT01594710。

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