Keihani Sorena, Hosseinpanah Farhad, Barzin Maryam, Serahati Sara, Doustmohamadian Soraya, Azizi Fereidoun
Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
Atherosclerosis. 2015 Feb;238(2):256-63. doi: 10.1016/j.atherosclerosis.2014.12.008. Epub 2014 Dec 9.
Obesity is a heterogeneous condition and risk of related health outcomes in different obesity phenotypes is a controversial subject. In this study, we aimed to evaluate the risk of cardiovascular disease (CVD) in different abdominal obesity phenotypes during a decade-long follow-up.
In this large population-based cohort, 7122 participants (42.7% men), aged ≥30 years, from the Tehran Lipid and Glucose Study (TLGS) were enrolled. Abdominal obesity was defined using national waist circumference cut-off points of ≥89 cm for men and ≥91 cm for women. Metabolic health was defined as ≤1 components of metabolic syndrome (excluding waist circumference), using the Joint Interim Statement (JIS) definition.
At baseline, 3745 individuals (52.7%) were abdominal obese and 23.5% (n = 881) of these were categorized as "metabolically healthy abdominal obese" (MHAO). A total of 638 CVD events occurred during a median follow-up of 10 years (1999-2011). "Metabolically healthy non-abdominal obese" was considered as the reference group. After adjustment for various variables, MHAO individuals were at increased risk for CVD events compared with the reference group (HR: 1.64, CI: 1.09-2.47). Both the metabolically unhealthy phenotypes (with and without abdominal obesity) were also at increased risk. We also observed the same pattern using insulin resistance data for categorizing abdominal obesity phenotypes.
Abdominal obesity and presence of metabolic derangements are both important risk factors for future CVD. MHAO may not be a benign condition regarding future CVD events, which highlights the importance of prevention and treatment of abdominal obesity, even in the absence of metabolic derangements.
肥胖是一种异质性疾病，不同肥胖表型相关健康结局的风险是一个有争议的话题。在本研究中，我们旨在评估不同腹部肥胖表型在长达十年的随访期间发生心血管疾病（CVD）的风险。
在这项基于人群的大型队列研究中，纳入了来自德黑兰血脂与血糖研究（TLGS）的7122名年龄≥30岁的参与者（42.7%为男性）。腹部肥胖采用国家腰围切点定义，男性≥89 cm，女性≥91 cm。代谢健康采用联合临时声明（JIS）定义，即代谢综合征（不包括腰围）的组成成分≤1项。
在基线时，3745人（52.7%）为腹部肥胖，其中23.5%（n = 881）被归类为“代谢健康的腹部肥胖”（MHAO）。在1999年至2011年的中位随访10年期间，共发生638例CVD事件。“代谢健康的非腹部肥胖”被视为参照组。在对各种变量进行调整后，与参照组相比，MHAO个体发生CVD事件的风险增加（HR：1.64，CI：1.09 - 2.47）。代谢不健康的表型（无论有无腹部肥胖）发生CVD事件的风险也增加。我们使用胰岛素抵抗数据对腹部肥胖表型进行分类时也观察到了相同的模式。
腹部肥胖和代谢紊乱都是未来发生CVD的重要危险因素。就未来CVD事件而言，MHAO可能并非良性状态，这凸显了即使在没有代谢紊乱的情况下，预防和治疗腹部肥胖的重要性。
