Howe Laura D, Zimmermann Esther, Weiss Ram, Sørensen Thorkild I A
MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, UK.
BMJ Open. 2014 Apr 15;4(4):e004827. doi: 10.1136/bmjopen-2014-004827.
Some obese individuals have no cardiometabolic abnormalities; they are 'metabolically healthy, but obese' (MHO). Similarly, some non-obese individuals have cardiometabolic abnormalities, that is, 'metabolically at risk, normal weight' (MANW). Previous studies have suggested that early-onset obesity may be associated with MHO. We aimed to assess whether body mass index (BMI) in childhood and early-onset obesity are associated with MHO.
General population longitudinal cohort study, Denmark.
From 362 200 young men (mean age 20) examined for Danish national service between 1943 and 1977, all obese men (BMI ≥31 kg/m(2), N=1930) were identified along with a random 1% sample of the others (N=3601). Our analysis includes 2392 of these men attending a research clinic in mid-life (mean age 42). For 613 of these men, data on childhood BMI are available. We summarised childhood BMI growth (7-13 years) using a multilevel model. Early-onset obesity was defined as obesity at examination for national service.
We defined metabolic health at the mid-life clinic as non-fasting serum cholesterol <6.6 mmol/L, non-fasting glucose <8.39 mmol/L and pulse pressure <48 mm Hg. Participants were categorised into four groups according to their obesity (BMI ≥30 kg/m(2)) and metabolic health in mid-life.
297 of 1097 (27.1%) of obese men were metabolically healthy; 826 of 1295 (63.8%) non-obese men had at least one metabolic abnormality. There was no evidence that rapid BMI growth in childhood or early-onset obesity was associated with either MHO or the MANW phenotype, for example, among obese men in mid-life, the OR for MHO comparing early-onset obesity with non-early-onset obesity was 0.97 (95% CI 0.85 to 1.10).
We found no robust evidence that early-onset obesity or rapid BMI growth in childhood is protective for cardiometabolic health.
一些肥胖个体没有心血管代谢异常，他们属于“代谢健康但肥胖”（MHO）。同样，一些非肥胖个体存在心血管代谢异常，即“代谢有风险，体重正常”（MANW）。既往研究提示早发性肥胖可能与MHO有关。我们旨在评估儿童期体重指数（BMI）和早发性肥胖是否与MHO有关。
丹麦普通人群纵向队列研究。
在1943年至1977年接受丹麦国民服役检查的362200名年轻男性（平均年龄20岁）中，识别出所有肥胖男性（BMI≥31kg/m²，N = 1930）以及其余人群的1%随机样本（N = 3601）。我们的分析纳入了这些男性中在中年时（平均年龄42岁）到研究诊所就诊的2392人。其中613人有儿童期BMI数据。我们使用多水平模型总结了儿童期BMI增长情况（7至13岁）。早发性肥胖定义为国民服役检查时肥胖。
我们将中年诊所时的代谢健康定义为非空腹血清胆固醇<6.6mmol/L、非空腹血糖<8.39mmol/L和脉压<48mmHg。根据参与者中年时的肥胖情况（BMI≥30kg/m²）和代谢健康状况将其分为四组。
1097名肥胖男性中有297名（27.1%）代谢健康；1295名非肥胖男性中有826名（63.8%）至少有一种代谢异常。没有证据表明儿童期BMI快速增长或早发性肥胖与MHO或MANW表型有关，例如，在中年肥胖男性中，将早发性肥胖与非早发性肥胖相比，MHO的比值比为0.97（95%CI 0.85至1.10）。
我们没有发现有力证据表明早发性肥胖或儿童期BMI快速增长对心血管代谢健康具有保护作用。
