Okamura Takuro, Hashimoto Yoshitaka, Hamaguchi Masahide, Ohbora Akihiro, Kojima Takao, Fukui Michiaki
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan.
Department of Diabetology, Kameoka Municipal Hospital, Kyoto 621-8585, Japan.
Endocr J. 2018 Jun 27;65(6):669-675. doi: 10.1507/endocrj.EJ18-0023. Epub 2018 Apr 10.
Metabolically healthy obese (MHO) individual is known to be defended from the metabolic complications of obesity. Leukoaraiosis, which is commonly detected on brain magnetic resonance imaging (MRI), is now recognized as a risk of stroke, dementia and death. However, the association between MHO and the prevalence of leukoaraiosis is unclear. In this cross-sectional study of 796 participants who received a medical examination program, we investigated the association between MHO and the prevalence of leukoaraiosis. We used common clinical markers for definition of metabolic healthy status: blood pressure, fasting plasma glucose, triglycerides and high-density lipoprotein cholesterol concentrations. Obesity was defined by body mass index ≥25.0 kg/m. We diagnosed leukoaraiosis by fluid-attenuated inversion recovery without hypointensity on T1-weighted images or the presence of a hyperintensity on T2-weighted images. The crude prevalence proportion of leukoaraiosis was 44.5% (case/n = 171/384) in metabolically healthy nonobese (MHNO) individual, 46.3% (44/95) in MHO individual, 62.3% (114/183) in metabolically unhealthy nonobese (MUNO) individual or 56.6% (77/136) in MUO individual. The odds ratios of prevalence of leukoaraiosis were 1.19 (95% CI 0.74-1.90, p = 0.471) for MHO, 1.79 (1.22-2.62, p = 0.003) for MUNO and 1.56 (1.03-2.37, p = 0.037) for MUO individuals after adjusting for sex, age, smoking statues, habit of exercise and alcohol, compared with MHNO individual. We revealed that MHO individuals were not related with the higher risk of leukoaraiosis, whereas MUNO and MUO individuals were.
代谢健康的肥胖（MHO）个体被认为可免受肥胖相关代谢并发症的影响。脑白质疏松症通常在脑部磁共振成像（MRI）检查中被检测到，目前被认为是中风、痴呆和死亡的风险因素。然而，MHO与脑白质疏松症患病率之间的关联尚不清楚。在这项对796名接受体检项目参与者的横断面研究中，我们调查了MHO与脑白质疏松症患病率之间的关联。我们使用常见的临床指标来定义代谢健康状况：血压、空腹血糖、甘油三酯和高密度脂蛋白胆固醇浓度。肥胖定义为体重指数≥25.0kg/m²。我们通过液体衰减反转恢复序列诊断脑白质疏松症，即T1加权图像上无低信号或T2加权图像上有高信号。代谢健康的非肥胖（MHNO）个体中脑白质疏松症的粗患病率为44.5%（病例数/总人数=171/384），MHO个体中为46.3%（44/95），代谢不健康的非肥胖（MUNO）个体中为62.3%（114/183），代谢不健康的肥胖（MUO）个体中为56.6%（77/136）。在调整性别、年龄、吸烟状况、运动习惯和饮酒情况后，与MHNO个体相比，MHO个体脑白质疏松症患病率的比值比为1.19（95%可信区间0.74 - 1.90，p = 0.471），MUNO个体为1.79（1.22 - 2.62，p = 0.003），MUO个体为1.56（1.03 - 2.37，p = 0.037）。我们发现，MHO个体与脑白质疏松症的较高风险无关，而MUNO和MUO个体则有关。
