Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China.
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Obes Facts. 2019;12(1):78-90. doi: 10.1159/000495852. Epub 2019 Feb 27.
Obesity-related disease risks may vary depending on whether the subject has metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). At least 5 definitions/criteria of obesity and metabolic disorders have been documented in the literature, yielding uncertainties in a reliable international comparison of obesity phenotype prevalence. This report aims to compare differences in MHO and MUO prevalence according to the 5 most frequently used definitions.
A random sample of 4,757 adults aged 35 years and older (male 51.1%) was enrolled. Obesity was defined either according to body mass index or waist circumference, and the definitions of metabolic abnormalities were derived from 5 different criteria.
In MHO, the highest prevalence was obtained when using the homeostasis model assessment (HOMA) criteria (13.6%), followed by the Chinese Diabetes Society (11.4%), Adult Treatment Panel III (10.3%), Wildman (5.2%), and Karelis (4.2%) criteria; however, the MUO prevalence had an opposite trend to MHO prevalence. The magnitude of differences in the age-specific prevalence of MHO and MUO varied greatly and ranked in different orders. The proportion of insulin resistance for MHO and MUO individuals differed significantly regardless of which metabolic criterion was used.
The prevalence of MHO and MUO in the Chinese population varies according to different definitions of obesity and metabolic disorders.
肥胖相关疾病的风险可能因受试者是否患有代谢健康型肥胖（MHO）或代谢不健康型肥胖（MUO）而有所不同。至少有 5 种肥胖和代谢紊乱的定义/标准在文献中被记录下来，这使得肥胖表型患病率的可靠国际比较存在不确定性。本报告旨在根据最常用的 5 种定义比较 MHO 和 MUO 患病率的差异。
随机抽取了 4757 名年龄在 35 岁及以上的成年人（男性占 51.1%）进行研究。肥胖的定义要么根据体重指数，要么根据腰围，而代谢异常的定义则来自 5 种不同的标准。
在 MHO 中，采用稳态模型评估（HOMA）标准获得的患病率最高（13.6%），其次是中国糖尿病学会（11.4%）、成人治疗专家组 III（10.3%）、Wildman（5.2%）和 Karelis（4.2%）标准；然而，MUO 的患病率与 MHO 患病率呈相反趋势。MHO 和 MUO 的年龄特异性患病率的差异幅度差异很大，且排名顺序也不同。无论使用哪种代谢标准，MHO 和 MUO 个体的胰岛素抵抗比例都有显著差异。
根据肥胖和代谢紊乱的不同定义，中国人群中 MHO 和 MUO 的患病率存在差异。
