青少年肥胖或从青少年到成年期的肥胖变化能否预测成年期的代谢健康型肥胖？

Does youth adiposity, or change in adiposity from youth to adulthood, predict metabolically healthy obesity in adulthood?

作者信息

Smith K J, Bessell E, Magnussen C G, Dwyer T, Venn A J

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.

Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

出版信息

Pediatr Obes. 2016 Oct;11(5):349-53. doi: 10.1111/ijpo.12065. Epub 2015 Aug 28.

DOI:10.1111/ijpo.12065

PMID:26317846

Abstract

BACKGROUND

Individuals with metabolically healthy obesity (MHO) do not have the metabolic complications usually associated with obesity.

OBJECTIVE

To examine whether youth adiposity, or change in adiposity from youth to adulthood, predicts MHO 20 years later.

METHODS

A national sample of 2410 Australian participants had height, weight and waist circumference (WC) measured in 1985 (7-15 years old) and 2004-2006 (26-36 years old). A fasting blood sample was taken in 2004-2006. MHO was defined as body mass index (BMI) ≥30 kg m(-2) , normal fasting glucose (<5.6 mmol L(-1) ), triglycerides (<1.695 mmol L(-1) ), high-density lipoprotein-cholesterol (>1.036 mmol L(-1) men, > 1.295 mmol L(-1) women), blood pressure (<130/85 mmHg) and no medication for these conditions. Relative risks (RR) were calculated using log binomial regression and expressed per unit of youth BMI (or WC) z-score or change in BMI (or WC) z-score from youth to adulthood, adjusted for sex and youth age.

RESULTS

In total 323 individuals were obese at follow-up, 79 (24.5%) were MHO. Adult MHO was not associated with youth BMI (RR: 1.00, 95%CI: 0.85-1.19) or WC (RR: 0.93, 95%CI: 0.79-1.11). Individuals were less likely to be MHO if they had larger increases in BMI (BMI RR: 0.74, 95%CI: 0.57-0.97) or WC (RR: 0.70, 95%CI: 0.55-0.90) from youth to adulthood.

CONCLUSIONS

Change in adiposity from youth to adulthood predicted adult MHO better than youth adiposity alone.

摘要

背景

代谢健康型肥胖（MHO）个体没有通常与肥胖相关的代谢并发症。

目的

研究青少年肥胖或从青少年到成年期肥胖的变化是否能预测20年后的MHO。

方法

对2410名澳大利亚参与者的全国性样本在1985年（7 - 15岁）和2004 - 2006年（26 - 36岁）测量身高、体重和腰围（WC）。在2004 - 2006年采集空腹血样。MHO定义为体重指数（BMI）≥30 kg·m⁻²，空腹血糖正常（<5.6 mmol·L⁻¹），甘油三酯（<1.695 mmol·L⁻¹），高密度脂蛋白胆固醇（男性>1.036 mmol·L⁻¹，女性>1.295 mmol·L⁻¹），血压（<130/85 mmHg）且未针对这些情况用药。使用对数二项回归计算相对风险（RR），并按青少年BMI（或WC）z评分的单位或从青少年到成年期BMI（或WC）z评分的变化表示，对性别和青少年年龄进行调整。

结果

随访时共有323人肥胖，79人（24.5%）为MHO。成年MHO与青少年BMI（RR：1.00，95%CI：0.85 - 1.19）或WC（RR：0.93，95%CI：0.79 - 1.11）无关。从青少年到成年期BMI（BMI RR：0.74，95%CI：0.57 - 0.97）或WC（RR：0.70，95%CI：0.55 - 0.90）增加幅度较大的个体患MHO的可能性较小。