Achilike I, Hazuda H P, Fowler S P, Aung K, Lorenzo C
Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
Int J Obes (Lond). 2015 Feb;39(2):228-34. doi: 10.1038/ijo.2014.113. Epub 2014 Jul 2.
The metabolically healthy (MHO) and unhealthy obese (MUHO) differ in terms of cardiovascular risk. However, little is known about predicting the development of these phenotypes and the future stability of the MHO phenotype. Therefore, we examined these two issues in the San Antonio Heart Study.
Longitudinal, population-based study of cardiometabolic risk factors among Mexican Americans and non-Hispanic whites in San Antonio.
The study sample included 2368 participants with neither MUHO nor diabetes at baseline. Median follow-up was 7.8 years. MHO was defined as obesity with ⩽1 metabolic abnormality; MUHO, as obesity with ⩾2 abnormalities.
At baseline, 1595 and 498 individuals were non-obese with ⩽1 and ⩾2 metabolic abnormalities, respectively, and 275 were MHO. Among non-obese individuals, independent predictors of incident MHO (odds ratio (OR) for 1 s.d. change (95% confidence interval)) included body mass index (8.12 (5.66-11.7)), triglycerides (0.52 (0.39-0.68)) and high-density lipoprotein cholesterol (HDL-C) (1.41 (1.11-1.81)), whereas independent predictors of incident MUHO included body mass index (5.97 (4.58-7.77)) and triglycerides (1.26 (1.05-1.51)). Among participants with ⩽1 metabolic abnormality, obesity was associated with greater odds of developing multiple metabolic abnormalities (OR 2.26 (1.74-2.95)).
Triglycerides and HDL-C may be useful for predicting progression to MHO. MHO may not be a stable condition, because it confers an increased risk of developing multiple metabolic abnormalities.
代谢健康的肥胖者（MHO）和代谢不健康的肥胖者（MUHO）在心血管风险方面存在差异。然而，对于预测这些表型的发展以及MHO表型未来的稳定性知之甚少。因此，我们在圣安东尼奥心脏研究中对这两个问题进行了研究。
对圣安东尼奥的墨西哥裔美国人及非西班牙裔白人的心血管代谢危险因素进行基于人群的纵向研究。
研究样本包括2368名在基线时既无MUHO也无糖尿病的参与者。中位随访时间为7.8年。MHO定义为伴有≤1项代谢异常的肥胖；MUHO定义为伴有≥2项异常的肥胖。
在基线时，分别有1595名和498名个体非肥胖，伴有≤1项和≥2项代谢异常，275名个体为MHO。在非肥胖个体中，MHO发病的独立预测因素（每标准差变化的比值比（OR）（95%置信区间））包括体重指数（8.12（5.66 - 11.7））、甘油三酯（0.52（0.39 - 0.68））和高密度脂蛋白胆固醇（HDL-C）（1.41（1.11 - 1.81）），而MUHO发病的独立预测因素包括体重指数（5.97（4.58 - 7.77））和甘油三酯（1.26（1.05 - 1.51））。在伴有≤1项代谢异常的参与者中，肥胖与发生多种代谢异常的较高几率相关（OR 2.26（1.74 - 2.95））。
甘油三酯和HDL-C可能有助于预测向MHO的进展。MHO可能不是一种稳定状态，因为它会增加发生多种代谢异常的风险。
