Yang Yan, Wan Yan-Ping, Fan Zhu-Ping, Gao Xiang, Jiang An-Li, Xu Ren-Ying
School of Nursing, Second Military Medical University, Shanghai, 200433, China.
Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
Eat Weight Disord. 2021 Feb;26(1):263-272. doi: 10.1007/s40519-020-00847-1. Epub 2020 Jan 30.
Whether metabolically healthy obesity (MHO) is associated with longitudinal changes in high-density lipoprotein cholesterol (HDL-C) remains unclear.
MHO was defined as participants with overweight and obesity (BMI ≥ 24.0 kg/m, n = 2921), free of history of metabolic diseases, and without abnormalities of blood pressure, fasting blood glucose, hemoglobin A1c, lipid profile, carotid artery and liver ultrasonographic findings at baseline. Metabolically healthy normal weight (MHN) was defined as participants with normal weight (BMI < 24.0 kg/m, n = 9578) and without above-mentioned abnormalities. HDL-C, fasting blood glucose, hemoglobin A1c, and blood pressure were assessed annually. Glucose abnormality was considered if either FBG ≥ 5.6 mmol/L or HbA1c ≥ 5.7%; while, high blood pressure (HBP) was considered if either systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg during 5 years of follow-up.
Compared with the MHN group, the adjusted mean difference in HDL-C change rate was - 0.005 mmol/L per year [95% confidence interval (CI) - 0.007, - 0.003] for MHO after adjustment for a series of potential confounders. Furthermore, transiting to abnormality of blood glucose, but not high blood pressure, was associated with lower cumulative average of HDL-C in MHN group, compared with those remained in metabolically healthy status.
MHO and transiting from metabolically healthy to abnormality of blood glucose were associated with HDL-C in Chinese adults.
III, cohort study.
代谢健康型肥胖（MHO）是否与高密度脂蛋白胆固醇（HDL-C）的纵向变化相关尚不清楚。
MHO定义为超重和肥胖参与者（BMI≥24.0kg/m²，n = 2921），无代谢疾病史，且基线时血压、空腹血糖、糖化血红蛋白A1c、血脂谱、颈动脉和肝脏超声检查结果无异常。代谢健康正常体重（MHN）定义为体重正常参与者（BMI＜24.0kg/m²，n = 9578）且无上述异常。每年评估HDL-C、空腹血糖、糖化血红蛋白A1c和血压。若空腹血糖（FBG）≥5.6mmol/L或糖化血红蛋白A1c（HbA1c）≥5.7%，则视为血糖异常；而在5年随访期间，若收缩压≥130mmHg或舒张压≥80mmHg，则视为高血压（HBP）。
在调整一系列潜在混杂因素后，与MHN组相比，MHO组HDL-C变化率的校正平均差异为每年-0.005mmol/L[95%置信区间（CI）-0.007，-0.003]。此外，与保持代谢健康状态的人相比，MHN组血糖转变为异常而非高血压与较低的HDL-C累积平均值相关。
在中国成年人中，MHO以及从代谢健康转变为血糖异常与HDL-C相关。
III，队列研究。
