Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
Int J Obes (Lond). 2018 Mar;42(3):295-301. doi: 10.1038/ijo.2017.249. Epub 2017 Oct 9.
Some obese adults are not afflicted by the metabolic abnormalities often associated with obesity (the 'metabolically healthy obese' (MHO)); however, they may be at increased risk of developing cardiometabolic abnormalities in the future. Little is known about the relative incidence of individual components of metabolic syndrome (MetSyn).
We used data from a multicenter, community-based cohort aged 45-64 years at recruitment (the Atherosclerosis Risk In Communities study) to examine the first appearance of any MetSyn component, excluding waist circumference. Body mass index (BMI, kg m) and cardiometabolic data were collected at four triennial visits. Our analysis included 3969 adults who were not underweight and free of the components of MetSyn at the initial visit. Participants were classified as metabolically healthy normal weight (MHNW), overweight (MHOW) and MHO at each visit. Adjusted hazard ratios (HR) and 95% confidence intervals were estimated with proportional hazards regression models.
The relative rate of developing each risk factor was higher among MHO than MHNW, with the strongest association noted for elevated fasting glucose (MHO vs MHNW, HR: 2.33 (1.77, 3.06)). MHO was also positively associated with elevated triglycerides (HR: 1.63 (1.27, 2.09)), low high-density lipoprotein-cholesterol (HR: 1.68 (1.32, 2.13)) and elevated blood pressure (HR: 1.54 (1.26, 1.88)). A similar, but less pronounced pattern was noted among the MHOW vs MHNW.
We conclude that even among apparently healthy individuals, obesity and overweight are related to more rapid development of at least one cardiometabolic risk factor, and that elevations in blood glucose develop most rapidly.
一些肥胖成年人没有受到肥胖相关的代谢异常的困扰（“代谢健康肥胖者”（MHO））；然而，他们未来可能面临发展出心血管代谢异常的风险增加。关于代谢综合征（MetSyn）的个体成分的相对发病率知之甚少。
我们使用了一项多中心、基于社区的队列研究的数据，该研究的招募年龄为 45-64 岁（动脉粥样硬化风险社区研究），以检查除腰围外，任何 MetSyn 成分的首次出现。体重指数（BMI，kg/m）和心血管代谢数据在四次每三年一次的访问中收集。我们的分析包括 3969 名在初始访问时没有体重不足和没有 MetSyn 成分的成年人。参与者在每次访问时被分类为代谢健康正常体重（MHNW）、超重（MHOW）和 MHO。使用比例风险回归模型估计调整后的风险比（HR）和 95%置信区间。
与 MHNW 相比，MHO 发展每个危险因素的相对比率更高，其中空腹血糖升高的相关性最强（MHO 与 MHNW，HR：2.33（1.77，3.06））。MHO 还与甘油三酯升高（HR：1.63（1.27，2.09））、高密度脂蛋白胆固醇降低（HR：1.68（1.32，2.13））和血压升高（HR：1.54（1.26，1.88））相关。在 MHOW 与 MHNW 之间也观察到类似但不太明显的模式。
我们的结论是，即使在看似健康的个体中，肥胖和超重也与至少一种心血管代谢危险因素的更快发展有关，而血糖升高的发展最快。
