Cui Z, Truesdale K P, Bradshaw P T, Cai J, Stevens J
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Int J Obes (Lond). 2015 Aug;39(8):1203-8. doi: 10.1038/ijo.2015.56. Epub 2015 Apr 14.
BACKGROUND/OBJECTIVES: Approximately 17% of obese Americans are free of the cardiometabolic risk factors, but few studies have compared responses to weight change in metabolically healthy obese (MHO) and metabolically healthy normal weight (MHNW) adults. We compared the impact of weight loss, weight maintenance and weight gain on cardiometabolic risk factors in the MHO and the MHNW.
SUBJECTS/METHODS: Data were from the Atherosclerosis Risk in Communities (ARIC) study. Multiple observations on 2710 participants were included, yielding 4541 observations of sequential 3-year intervals. Metabolically healthy was defined as absence of all components of metabolic syndrome excluding waist circumference. Mixed effects models were used to compare changes in each of five cardiometabolic risk factors within weight change categories (<-3% for weight loss, ±3% for weight maintenance and >3% for weight gain).
Weight loss was associated with comparable small changes or no changes in cardiometabolic risk factors in MHO and MHNW individuals. Weight gain was associated with larger increases in systolic (8.6 vs 6.2 mm Hg) and diastolic (3.9 vs 2.5 mm Hg) blood pressure, triglycerides (21.9 vs 15.8 mg/dl) and glucose (4.9 vs 1.9 mg/dl) in MHO individuals compared with MHNW individuals. Weight maintenance was associated with larger increases in triglycerides (10.0 vs 6.4 mg/dl) and glucose (1.7 vs 0.9 mg/dl) in MHO compared with MHNW individuals. MHO weight losers had more favorable changes in the five cardiometabolic risk factors compared to MHO weight maintainers (P<0.02) or gainers (P<0.0001).
This work showed differences between MHNW and MHO adults and supports recommendations for weight loss in the MHO in order to avoid increases in risk factors associated with weight maintenance and weight gain.
背景/目的：约17%的美国肥胖者没有心血管代谢危险因素，但很少有研究比较代谢健康的肥胖（MHO）和代谢健康的正常体重（MHNW）成年人对体重变化的反应。我们比较了体重减轻、体重维持和体重增加对MHO和MHNW人群心血管代谢危险因素的影响。
受试者/方法：数据来自社区动脉粥样硬化风险（ARIC）研究。纳入了对2710名参与者的多次观察，产生了4541次连续3年间隔的观察结果。代谢健康定义为除腰围外不存在代谢综合征的所有组分。使用混合效应模型比较体重变化类别（体重减轻<-3%、体重维持±3%和体重增加>3%）内五个心血管代谢危险因素的变化。
体重减轻与MHO和MHNW个体的心血管代谢危险因素的类似小变化或无变化相关。与MHNW个体相比，体重增加与MHO个体的收缩压（8.6对6.2mmHg）、舒张压（3.9对2.5mmHg）、甘油三酯（21.9对15.8mg/dl）和血糖（4.9对1.9mg/dl）的更大升高相关。与MHNW个体相比，体重维持与MHO个体的甘油三酯（10.0对6.4mg/dl）和血糖（1.7对0.9mg/dl）的更大升高相关。与MHO体重维持者（P<0.02）或体重增加者（P<0.0001）相比，MHO体重减轻者在五个心血管代谢危险因素方面有更有利的变化。
这项研究显示了MHNW和MHO成年人之间的差异，并支持对MHO进行体重减轻的建议，以避免与体重维持和体重增加相关的危险因素增加。
