Postgraduate Program, Nutritional Sciences, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
Center for Research on Micronutrients (NPqM), Institute of NutritionJosué de Castro of UFRJ, Rio de Janeiro 21.941-902, Brazil.
Nutrients. 2019 Sep 6;11(9):2125. doi: 10.3390/nu11092125.
Obesity negatively affects the relationship between markers and micronutrients of bone metabolism. Testing the hypothesis that the metabolically healthy obese phenotype might be protected by those alterations was the aim of this study. A cross-sectional study was carried out in adults with class III obesity classified in Metabolically Healthy Obese (MHO) and Metabolically Unhealthy Obese (MUHO), according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) criteria. Anthropometric, biochemical, and clinical variables were analyzed for sample characterization. To evaluate bone metabolism, markers (alkaline phosphatase and parathyroid hormone-PTH) and related nutrients (vitamin D, vitamin B12, calcium, phosphorus, magnesium, potassium and zinc) were analyzed. A total of 223 adults with class III obesity aged 41.20 ± 10.15 years were included. The MHO phenotype was identified in 32.73% of the sample. After logistic regression, it was observed that inadequacies of calcium (OR: 4.11; 95% CI: 2.33-6.66), phosphorus (OR: 3.03; 95% CI: 1.98-5.79), vitamin D (OR: 5.01; 95% CI: 2.92-6.71) and PTH (OR: 5.45; 95% CI: 4.49-6.74) were significantly higher in the MUHO group compared to the MHO Group. This study showed that the MHO phenotype does not protect adults from alterations in markers and micronutrients of bone metabolism. However, the MUHO phenotype presents a higher risk for alterations related to bone metabolism, which can favor the emergence of metabolic bone diseases.
肥胖会对骨代谢标志物和微量营养素之间的关系产生负面影响。本研究旨在检验“代谢健康型肥胖表型可能受到这些改变保护”的假说。这项横断面研究纳入了根据美国国家胆固醇教育计划专家委员会（NCEP ATP III）标准被分类为代谢健康型肥胖（MHO）和代谢不健康型肥胖（MUHO）的 III 级肥胖成年人。分析了人体测量学、生化和临床变量以进行样本特征描述。为了评估骨代谢，分析了标志物（碱性磷酸酶和甲状旁腺激素-PTH）和相关营养素（维生素 D、维生素 B12、钙、磷、镁、钾和锌）。共纳入了 223 名年龄为 41.20±10.15 岁的 III 级肥胖成年人。在该样本中，有 32.73%的人表现出 MHO 表型。经过逻辑回归分析，发现钙（OR：4.11；95%CI：2.33-6.66）、磷（OR：3.03；95%CI：1.98-5.79）、维生素 D（OR：5.01；95%CI：2.92-6.71）和 PTH（OR：5.45；95%CI：4.49-6.74）的不足在 MUHO 组中明显高于 MHO 组。本研究表明，MHO 表型并不能使成年人免受骨代谢标志物和微量营养素变化的影响。然而，MUHO 表型发生与骨代谢相关的变化的风险更高，这可能有利于代谢性骨病的发生。
