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是否有可能轻松识别出代谢健康的肥胖女性?

Is it Possible to Easily Identify Metabolically Healthy Obese Women?

作者信息

Scorsatto Mauara, Rosa Glorimar, Pimentel Aline de Castro, Luiz Ronir Raggio, Oliveira Gláucia Maria Moraes de

机构信息

Programa de Pós-Graduação em Cardiologia - Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brazil.

Instituto de Nutrição Josué de Castro - Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brazil.

出版信息

Arq Bras Cardiol. 2018 Nov;111(5):733-737. doi: 10.5935/abc.20180228.

Abstract

BACKGROUND

Obesity is recognized as a major risk factor for the development of several metabolic complications. However, some obese individuals have a favorable metabolic profile.

OBJECTIVE

The aim of this study was to identify an easy parameter for recognizing metabolically healthy obese (MHO) women.

METHODS

A total of 292 non-diabetic women with a body mass index (BMI) ≥ 30 kg/m2 were selected, and 239 composed the final cohort. We classified the participants according to their metabolic state determined by homeostasis model assessment (HOMA) into MHO or metabolically unhealthy obese (MUO). Both groups were compared regarding biochemical, anthropometric, and body composition characteristics.

RESULTS

The average age of the cohort was 43.9 ± 10.9 years and the average BMI was 37.2 ± 5.3 kg/m2. In total, 75.7% of the participants were classified as MHO by HOMA. A cutoff of 108.2 cm for waist circumference (WC) identified MHO participants with a sensitivity of 72.4% (95% confidence interval [CI]: 59.8-82.3%), specificity of 66.9% (95% CI: 59.71-73.3%), and negative likelihood ratio of 0.41 (95% CI: 0.36-0.47). Additionally, a visceral adiposity index cutoff value of 99.2 identified MHO women with a sensitivity of 89.7% (95% CI: 79.2-95.2%), specificity of 48.6% (95% CI: 41.4-55.9%), and negative likelihood ratio of 0.21 (95% CI: 0.15-0.30).

CONCLUSION

Women classified as MHO exhibited smaller WC measurements and lower body fat percentages, as well as lower blood glucose and insulin levels. WC emerged as an easy parameter for identifying MHO women.

摘要

背景

肥胖被认为是多种代谢并发症发生的主要危险因素。然而,一些肥胖个体具有良好的代谢特征。

目的

本研究的目的是确定一种用于识别代谢健康肥胖(MHO)女性的简便参数。

方法

共选取292名体重指数(BMI)≥30kg/m²的非糖尿病女性,最终队列有239名。根据稳态模型评估(HOMA)确定的代谢状态将参与者分为MHO或代谢不健康肥胖(MUO)。比较两组在生化、人体测量和身体成分特征方面的差异。

结果

队列的平均年龄为43.9±10.9岁,平均BMI为37.2±5.3kg/m²。总体而言,75.7%的参与者通过HOMA被分类为MHO。腰围(WC)截断值为108.2cm时,识别MHO参与者的灵敏度为72.4%(95%置信区间[CI]:59.8 - 82.3%),特异度为66.9%(95%CI:59.71 - 73.3%),阴性似然比为0.41(95%CI:0.36 - 0.47)。此外,内脏脂肪指数截断值为99.2时,识别MHO女性的灵敏度为89.7%(95%CI:79.2 - 95.2%),特异度为48.6%(95%CI:41.4 - 55.9%),阴性似然比为0.21(95%CI:0.15 - 0.30)。

结论

被分类为MHO的女性腰围测量值更小、体脂百分比更低,血糖和胰岛素水平也更低。腰围成为识别MHO女性的简便参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43a0/6248237/ec77d50dfcf5/abc-111-05-0733-g01.jpg

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