Kuk J L, Rotondi M, Sui X, Blair S N, Ardern C I
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Clin Obes. 2018 Oct;8(5):305-312. doi: 10.1111/cob.12263. Epub 2018 Jul 12.
Studies have examined mortality risk for metabolically healthy obesity, defined as zero or one metabolic risk factors but not as zero risk factors. Thus, we sought to determine the independent mortality risk associated with obesity or elevated glucose, blood pressure or lipids in isolation or clustered together. The sample included 54 089 men and women from five cohort studies (follow-up = 12.8 ± 7.2 years and 4864 [9.0%] deaths). Individuals were categorized as having obesity or elevated glucose, blood pressure or lipids alone or clustered with obesity or another metabolic factor. In our study sample, 6% of individuals presented with obesity but no other metabolic abnormalities. General obesity (hazard ratios [HR], 95% CI = 1.10, 0.8-1.6) and abdominal obesity (HR = 1.24, 0.9-1.7) in the absence of metabolic risk factors were not associated with mortality risk compared to lean individuals. Conversely, diabetes, hypertension and dyslipidaemia in isolation were significantly associated with mortality risk (HR range = 1.17-1.94, P < 0.05). However, when using traditional approaches, obesity (HR = 1.12, 1.02-1.23) is independently associated with mortality risk after statistical adjustment for the other metabolic risk factors. Similarly, metabolically healthy obesity, when defined as zero or one risk factor, is also associated with increased mortality risk (HR = 1.15, 1.01-1.32) as compared to lean healthy individuals. Obesity in the absence of metabolic abnormalities may not be associated with higher risk for all-cause mortality compared to lean healthy individuals. Conversely, elevation of even a single metabolic risk factor is associated with increased mortality risk.
已有研究探讨了代谢健康型肥胖的死亡风险，其定义为存在零个或一个代谢风险因素，而非零风险因素。因此，我们试图确定肥胖或血糖、血压或血脂升高单独出现或聚集在一起时的独立死亡风险。样本包括来自五项队列研究的54089名男性和女性（随访时间=12.8±7.2年，4864人[9.0%]死亡）。个体被分类为单独患有肥胖或血糖、血压或血脂升高，或与肥胖或其他代谢因素聚集在一起。在我们的研究样本中，6%的个体存在肥胖但无其他代谢异常。与瘦人相比，无代谢风险因素时的一般肥胖（风险比[HR]，95%置信区间=1.10，0.8 - 1.6）和腹型肥胖（HR = 1.24，0.9 - 1.7）与死亡风险无关。相反，单独的糖尿病、高血压和血脂异常与死亡风险显著相关（HR范围=1.17 - 1.94，P<0.05）。然而，使用传统方法时，在对其他代谢风险因素进行统计调整后，肥胖（HR = 1.12，1.02 - 1.23）与死亡风险独立相关。同样，当定义为零个或一个风险因素时，代谢健康型肥胖与瘦的健康个体相比也与死亡风险增加相关（HR = 1.15，1.01 - 1.32）。与瘦的健康个体相比，无代谢异常的肥胖可能与全因死亡风险升高无关。相反，即使单一代谢风险因素升高也与死亡风险增加相关。
