Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai200127, People's Republic of China.
Department of Ultrasound, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Public Health Nutr. 2021 Sep;24(13):4124-4131. doi: 10.1017/S136898002000289X. Epub 2020 Aug 25.
We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults.
Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up.
Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis.
BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.
我们进行了队列研究，以评估 BMI、高敏 C 反应蛋白（hs-CRP）与中国成年人从代谢健康表型向代谢不健康表型转变之间的关系。
代谢健康定义为参与者无代谢疾病史，且在基线时空腹血糖水平、糖化血红蛋白 A1c 水平、血压、血脂谱、血清尿酸水平和肝脏超声检查结果正常。根据基线 BMI 将参与者分为正常体重（18.5≤BMI<24.0kg/m2）和超重（BMI≥24.0kg/m2），或根据基线 hs-CRP 分为低（<1mg/l）和高（≥1mg/l）组。如果在 5 年随访期间有任何代谢异常被两次或更多次确诊，则被认为从代谢健康表型转变为代谢不健康表型。
共纳入 4855 名（1942 名男性和 2913 名女性，年龄 36.0±8.9 岁）代谢健康的中国成年人。我们发现 1692 名参与者在随访期间转变为代谢不健康表型。与对照组相比，超重者转变为代谢不健康表型的调整后危险比为 1.19（95%CI 1.07，1.33），而 hs-CRP 水平较高（≥1mg/l）者为 1.15（95%CI 1.03，1.29）。进一步调整 hs-CRP 并没有改变 BMI 与转变之间的关联。然而，进一步调整 BMI 后，hs-CRP 与转变之间的关联不再显著。敏感性分析得到的结果与主要分析相似。
BMI 与中国成年人从代谢健康表型向代谢不健康状态转变的风险相关。
