de Rooij Belle H, van der Berg Julianne D, van der Kallen Carla J H, Schram Miranda T, Savelberg Hans H C M, Schaper Nicolaas C, Dagnelie Pieter C, Henry Ronald M A, Kroon Abraham A, Stehouwer Coen D A, Koster Annemarie
Department of Social medicine, Maastricht University, Maastricht, the Netherlands.
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
PLoS One. 2016 May 3;11(5):e0154358. doi: 10.1371/journal.pone.0154358. eCollection 2016.
Both obesity and the metabolic syndrome are associated with increased risk of cardiovascular diseases and type 2 diabetes. Although both frequently occur together in the same individual, obesity and the metabolic syndrome can also develop independently from each other. The (patho)physiology of "metabolically healthy obese" (i.e. obese without metabolic syndrome) and "metabolically unhealthy non-obese" phenotypes (i.e. non-obese with metabolic syndrome) is not fully understood, but physical activity and sedentary behavior may play a role.
To examine objectively measured physical activity and sedentary behavior across four groups: I) "metabolically healthy obese" (MHO); II) "metabolically unhealthy obese" (MUO); III)"metabolically healthy non-obese" (MHNO); and IV) "metabolically unhealthy non-obese" (MUNO).
Data were available from 2,449 men and women aged 40-75 years who participated in The Maastricht Study from 2010 to 2013. Participants were classified into the four groups according to obesity (BMI≥30kg/m2) and metabolic syndrome (ATPIII definition). Daily activity was measured for 7 days with the activPAL physical activity monitor and classified as time spent sitting, standing, and stepping.
In our study population, 562 individuals were obese. 19.4% of the obese individuals and 72.7% of the non-obese individuals was metabolically healthy. After adjustments for age, sex, educational level, smoking, alcohol use, waking time, T2DM, history of CVD and mobility limitation, MHO (n = 107) spent, per day, more time stepping (118.2 versus 105.2 min; p<0.01) and less time sedentary (563.5 versus 593.0 min., p = 0.02) than MUO (n = 440). In parallel, MHNO (n = 1384) spent more time stepping (125.0 versus 115.4 min; p<0.01) and less time sedentary (553.3 versus 576.6 min., p<0.01) than MUNO (n = 518).
Overall, the metabolically healthy groups were less sedentary and more physically active than the metabolically unhealthy groups. Therefore, physical activity and sedentary time may partly explain the presence of the metabolic syndrome in obese as well as non-obese individuals.
肥胖和代谢综合征均与心血管疾病及2型糖尿病风险增加相关。尽管肥胖和代谢综合征常常在同一个体中同时出现，但它们也可能彼此独立发展。“代谢健康的肥胖者”（即无代谢综合征的肥胖者）和“代谢不健康的非肥胖者”（即有代谢综合征的非肥胖者）的（病理）生理学尚未完全明确，但身体活动和久坐行为可能起到一定作用。
客观检测四组人群的身体活动和久坐行为：I）“代谢健康的肥胖者”（MHO）；II）“代谢不健康的肥胖者”（MUO）；III）“代谢健康的非肥胖者”（MHNO）；IV）“代谢不健康的非肥胖者”（MUNO）。
数据来自2449名年龄在40 - 75岁之间、于2010年至2013年参与马斯特里赫特研究的男性和女性。参与者根据肥胖情况（BMI≥30kg/m2）和代谢综合征（ATPIII定义）被分为四组。使用activPAL身体活动监测仪对日常活动进行7天测量，并分类为久坐、站立和行走时间。
在我们的研究人群中，562人肥胖。19.4%的肥胖个体和72.7%的非肥胖个体代谢健康。在对年龄、性别、教育水平、吸烟、饮酒、醒着时间、2型糖尿病、心血管疾病史和行动受限情况进行调整后，MHO组（n = 107）每天行走时间比MUO组（n = 440）更长（118.2分钟对105.2分钟；p<0.01），久坐时间更短（563.5分钟对593.0分钟，p = 0.02）。同时，MHNO组（n = 1384）比MUNO组（n = 518）行走时间更长（125.0分钟对115.4分钟；p<0.01），久坐时间更短（553.3分钟对576.6分钟，p<0.01）。
总体而言，代谢健康组比代谢不健康组久坐时间更少，身体活动更多。因此，身体活动和久坐时间可能部分解释了肥胖及非肥胖个体中代谢综合征的存在情况。
