Benziger Catherine P, Bernabé-Ortiz Antonio, Gilman Robert H, Checkley William, Smeeth Liam, Málaga Germán, Miranda J Jaime
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Division of Cardiology, University of Washington, Seattle, WA, United States of America.
PLoS One. 2015 Nov 23;10(11):e0138968. doi: 10.1371/journal.pone.0138968. eCollection 2015.
We aimed to characterize metabolic status by body mass index (BMI) status.
The CRONICAS longitudinal study was performed in an age-and-sex stratified random sample of participants aged 35 years or older in four Peruvian settings: Lima (Peru's capital, costal urban, highly urbanized), urban and rural Puno (both high-altitude), and Tumbes (costal semirural). Data from the baseline study, conducted in 2010, was used. Individuals were classified by BMI as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2), and as metabolically healthy (0-1 metabolic abnormality) or metabolically unhealthy (≥2 abnormalities). Abnormalities included individual components of the metabolic syndrome, high-sensitivity C-reactive protein, and insulin resistance.
A total of 3088 (age 55.6±12.6 years, 51.3% females) had all measurements. Of these, 890 (28.8%), 1361 (44.1%) and 837 (27.1%) were normal weight, overweight and obese, respectively. Overall, 19.0% of normal weight in contrast to 54.9% of overweight and 77.7% of obese individuals had ≥3 risk factors (p<0.001). Among normal weight individuals, 43.1% were metabolically unhealthy, and age ≥65 years, female, and highest socioeconomic groups were more likely to have this pattern. In contrast, only 16.4% of overweight and 3.9% of obese individuals were metabolically healthy and, compared to Lima, the rural and urban sites in Puno were more likely to have a metabolically healthier profile.
Most Peruvians with overweight and obesity have additional risk factors for cardiovascular disease, as well as a majority of those with a healthy weight. Prevention programs aimed at individuals with a normal BMI, and those who are overweight and obese, are urgently needed, such as screening for elevated fasting cholesterol and glucose.
我们旨在通过体重指数（BMI）状态来描述代谢状况。
CRONICAS纵向研究在秘鲁四个地区对年龄35岁及以上的参与者进行了年龄和性别分层随机抽样：利马（秘鲁首都，沿海城市，高度城市化）、普诺的城市和农村地区（均为高海拔地区）以及通贝斯（沿海半农村地区）。使用了2010年进行的基线研究数据。个体根据BMI分为正常体重（18.5 - 24.9千克/平方米）、超重（25.0 - 29.9千克/平方米）和肥胖（≥30千克/平方米），并分为代谢健康（0 - 1种代谢异常）或代谢不健康（≥2种异常）。异常包括代谢综合征的各个组成部分、高敏C反应蛋白和胰岛素抵抗。
共有3088人（年龄55.6±12.6岁，51.3%为女性）进行了所有测量。其中，正常体重、超重和肥胖者分别为890人（28.8%）、1361人（44.1%）和837人（27.1%）。总体而言，正常体重者中有19.0%与超重者的54.9%和肥胖者的77.7%相比有≥3个风险因素（p<0.001）。在正常体重个体中，43.1%代谢不健康，年龄≥65岁、女性和社会经济地位最高的群体更有可能呈现这种模式。相比之下，只有16.4%的超重者和3.9%的肥胖者代谢健康，并且与利马相比，普诺的农村和城市地区更有可能具有代谢更健康的特征。
大多数超重和肥胖的秘鲁人以及大多数体重正常的人都有心血管疾病的其他风险因素。迫切需要针对BMI正常、超重和肥胖个体的预防计划，例如筛查空腹胆固醇和血糖升高情况。
