Zheng Ruizhi, Liu Chengguo, Wang Chunmei, Zhou Biao, Liu Yi, Pan Feixia, Zhang Ronghua, Zhu Yimin
Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou 310058, Zhejiang, China.
Department of Endocrinology and Institute of Cardiovascular Diseases, Zhejiang Putuo Hospital, Zhoushan 316100, Zhejiang, China.
Nutrients. 2016 Jul 15;8(7):430. doi: 10.3390/nu8070430.
Few studies have described the characteristics of metabolically healthy individuals with excess fat in the Chinese population. This study aimed to prospectively investigate the natural course of metabolically healthy overweight/obese (MH-OW/OB) adults, and to assess the impact of weight change on developing metabolic abnormalities. During 2009-2010, 525 subjects without any metabolic abnormalities or other obesity-related diseases were evaluated and reevaluated after 5 years. The subjects were categorized into two groups of overweight/obese and normal weight based on the criteria of BMI by 24.0 at baseline. At follow-up, the MH-OW/OB subjects had a significantly increased risk of developing metabolically abnormalities compared with metabolically healthy normal-weight (MH-NW) individuals (risk ratio: 1.35, 95% confidence interval: 1.17-1.49, p value < 0.001). In the groups of weight gain and weight maintenance, the MH-OW/OB subjects was associated with a larger increase in fasting glucose, triglycerides, systolic blood pressure, diastolic blood pressure and decrease in high-density lipoprotein cholesterol comparing with MH-NW subjects. In the weight loss group, no significant difference of changes of metabolic parameters was observed between MH-OW/OB and MH-NW adults. This study verifies that MH-OW/OB are different from MH-NW subjects. Weight management is needed for all individuals since weight change has a significant effect on metabolic health without considering the impact of weight change according to weight status.
很少有研究描述中国人群中脂肪过多的代谢健康个体的特征。本研究旨在前瞻性地调查代谢健康的超重/肥胖（MH-OW/OB）成年人的自然病程，并评估体重变化对代谢异常发生的影响。在2009年至2010年期间，对525名无任何代谢异常或其他肥胖相关疾病的受试者进行了评估，并在5年后进行了重新评估。根据基线时BMI为24.0的标准，将受试者分为超重/肥胖组和正常体重组。在随访中，与代谢健康的正常体重（MH-NW）个体相比，MH-OW/OB受试者发生代谢异常的风险显著增加（风险比：1.35，95%置信区间：1.17-1.49，p值<0.001）。在体重增加和体重维持组中，与MH-NW受试者相比，MH-OW/OB受试者的空腹血糖、甘油三酯、收缩压、舒张压升高幅度更大，高密度脂蛋白胆固醇降低幅度更大。在体重减轻组中，MH-OW/OB和MH-NW成年人之间代谢参数变化无显著差异。本研究证实MH-OW/OB与MH-NW受试者不同。所有个体都需要进行体重管理，因为体重变化对代谢健康有显著影响，而不考虑根据体重状况进行的体重变化影响。
