Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Eur J Public Health. 2020 Feb 1;30(1):195-199. doi: 10.1093/eurpub/ckz109.
Adiposity in childhood and adolescence (youth) has been shown to associate with adult metabolic health. What is not known, is whether youth body mass index (BMI) associates with metabolically healthy obesity (MHO) in adulthood, and if so, the age when the BMI to MHO association emerges. This study aimed to determine if BMI trajectories from youth to adulthood differed between adults with MHO and metabolically unhealthy obesity (MUHO).
The Cardiovascular Risk in Young Finns Study had measured weight and height up to eight times in individuals from youth (3-18 years in 1980) to adulthood (24-49 years). Adult MHO was defined as BMI ≥ 30 kg m-2, normal fasting glucose (<5.6 mmol l-1), triglycerides (<1.695 mmol l-1), high density lipoprotein cholesterol (≥1.295 mmol l-1 females, ≥1.036 mmol l-1 males), blood pressure (<130/85 mmHg) and no medications for these conditions. BMI trajectories were compared for adults with MHO and MUHO using multilevel mixed models adjusted for age, sex and follow-up time.
Mean (SD) follow-up time was 29 (3) years. Five hundred and twenty-four participants were obese in adulthood, 66 (12.6%) had MHO. BMI was similar through childhood, adolescence and young adulthood. BMI trajectories diverged at age 33, when individuals with MHO had at least 1.0 kg m-2 lower BMI than those with MUHO, significantly lower at 36 (-2.1 kg m-2, P = 0.001) and 42 years (-1.7 kg m-2; P = 0.005).
Adult MHO was characterized by lower adult BMI, not youth BMI. Preventing additional weight gain among adults who are obese may be beneficial for metabolic health.
儿童和青少年时期的肥胖（青年）已被证明与成年人的代谢健康有关。目前尚不清楚的是，青年时期的体重指数（BMI）是否与成年期的代谢健康肥胖（MHO）相关，如果相关，那么 BMI 与 MHO 相关的年龄是多少。本研究旨在确定从青年到成年的 BMI 轨迹在 MHO 和代谢不健康肥胖（MUHO）的成年人之间是否存在差异。
心血管风险在年轻的芬兰人研究中已经在个体从青年（1980 年 3-18 岁）到成年（24-49 岁）期间测量了体重和身高多达 8 次。成年 MHO 的定义为 BMI≥30kg/m2，空腹血糖正常（<5.6mmol/l），甘油三酯（<1.695mmol/l），高密度脂蛋白胆固醇（女性≥1.295mmol/l，男性≥1.036mmol/l），血压（<130/85mmHg），并且没有这些疾病的药物治疗。使用多水平混合模型，根据年龄、性别和随访时间对 MHO 和 MUHO 成年人的 BMI 轨迹进行了比较。
平均（SD）随访时间为 29（3）年。524 名参与者在成年时肥胖，66 名（12.6%）患有 MHO。整个儿童期、青春期和成年早期的 BMI 相似。BMI 轨迹在 33 岁时出现分歧，此时 MHO 患者的 BMI 至少比 MUHO 患者低 1.0kg/m2，在 36 岁时（-2.1kg/m2，P=0.001）和 42 岁时（-1.7kg/m2；P=0.005）差异显著。
成年 MHO 的特征是成年 BMI 较低，而不是青年 BMI。预防肥胖成年人体重进一步增加可能对代谢健康有益。
