代谢健康型肥胖对动脉僵硬度发展的影响：一项前瞻性队列研究。
Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study.
作者信息
Yuan Yue, Mu Jian-Jun, Chu Chao, Zheng Wen-Ling, Wang Yang, Hu Jia-Wen, Ma Qiong, Yan Yu, Liao Yue-Yuan, Chen Chen
机构信息
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.
Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
出版信息
Nutr Metab (Lond). 2020 Jul 2;17:50. doi: 10.1186/s12986-020-00474-8. eCollection 2020.
BACKGROUND
Metabolically healthy obesity (MHO) has been reported to be associated with the development of vascular damage by the carotid intima-media thickness, but the relationship between metabolic health and obesity phenotypes and arterial stiffness is still unknown. Our hypothesized that different metabolic health and obesity phenotypes might be associated with the development of arterial stiffness, and that subjects in MHO phenotype might not have increased risks of arterial stiffness compared with those in metabolically healthy nonobesity phenotype (MHNO), while metabolic unhealthy individuals might have increased risks of arterial stiffness.
METHODS
A prospective cohort of 2076 participants (aged 36-48 years) who were enrolled in the Hanzhong Adolescent Hypertension Cohort Study in 2017 was analyzed in a cross-sectional analysis. A subgroup of 202 participants from 2005 to 2017 was selected by an isometric sampling method and was included in the final longitudinal analysis.
RESULTS
We identified four metabolic health and obesity phenotypes for both the cross-sectional and longitudinal analyses as follows: MHNO, metabolically unhealthy nonobesity (MUNO), MHO, and metabolically unhealthy obesity (MUO). In the cross-sectional analysis, individuals with the MHO phenotype had the lowest brachial-ankle pulse wave velocity (baPWV) levels of the four phenotypes ( < 0.001), and participants with the MHO phenotype had a similar risk of arterial stiffness after fully adjustment [odds ratio (OR) = 0.99 (0.61-1.60)] as the MUNO subjects. Subjects with metabolically unhealthy status had a significantly higher risk of arterial stiffness than the MHNO individuals, particularly females ( < 0.005). In the longitudinal analysis, subjects with the MUNO and MUO phenotypes had a significantly higher risk of arterial stiffness than the MHNO individuals after adjustment for age and sex [OR = 5.21 (2.26-12.02), OR = 3.32 (1.18-9.32), respectively].
CONCLUSIONS
The MHO phenotype did not significantly increase the progression of arterial stiffness. Metabolically unhealthy individuals (MUNO, MUO), regardless of obesity status, showed a worse effect for the development of arterial stiffness, particularly females.
TRIAL REGISTRATION
NCT02734472. Registered 12 April 2016 - Retrospectively registered, http:www.clinicaltrials.gov.
背景
据报道，代谢健康的肥胖（MHO）与通过颈动脉内膜中层厚度衡量的血管损伤发展相关，但代谢健康与肥胖表型及动脉僵硬度之间的关系仍不明确。我们假设不同的代谢健康和肥胖表型可能与动脉僵硬度的发展相关，并且与代谢健康的非肥胖表型（MHNO）相比，MHO表型的受试者动脉僵硬度风险可能不会增加，而代谢不健康的个体动脉僵硬度风险可能会增加。
方法
对2017年纳入汉中青少年高血压队列研究的2076名参与者（年龄36 - 48岁）进行前瞻性队列的横断面分析。通过等距抽样方法从2005年至2017年的参与者中选取202名亚组纳入最终的纵向分析。
结果
我们在横断面和纵向分析中均确定了四种代谢健康和肥胖表型，如下：MHNO、代谢不健康的非肥胖（MUNO）、MHO和代谢不健康的肥胖（MUO）。在横断面分析中，MHO表型的个体在四种表型中肱踝脉搏波速度（baPWV）水平最低（P < 0.001），并且在完全调整后，MHO表型的参与者与MUNO受试者相比，动脉僵硬度风险相似[比值比（OR）= 0.99（0.61 - 1.60）]。代谢不健康状态的受试者动脉僵硬度风险显著高于MHNO个体，尤其是女性（P < 0.005）。在纵向分析中，调整年龄和性别后，MUNO和MUO表型的受试者动脉僵硬度风险显著高于MHNO个体[OR分别为5.21（2.26 - 12.02），OR为3.32（1.18 - 9.32）]。
结论
MHO表型并未显著增加动脉僵硬度的进展。代谢不健康的个体（MUNO、MUO），无论肥胖状态如何，在动脉僵硬度发展方面表现出更差的影响，尤其是女性。
试验注册
NCT02734472。2016年4月12日注册 - 回顾性注册，http:www.clinicaltrials.gov。
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