Ma Ling-Zhi, Sun Fu-Rong, Wang Zuo-Teng, Tan Lin, Hou Xiao-He, Ou Ya-Nan, Dong Qiang, Yu Jin-Tai, Tan Lan
Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Ann Transl Med. 2021 Feb;9(3):197. doi: 10.21037/atm-20-4387.
Metabolic healthy obesity (MHO) is a unique subgroup of overweight and obese individuals with normal metabolic characteristics. Its association with the risk of stroke remains unclear. We aimed to examine the risk of stroke in MHO individuals and the further associations between stroke and metabolic abnormalities under different bodyweight conditions.
We systematically searched PubMed, Embase and Cochrane Library from December 1946 to January 2019, and only included prospective cohort studies. Random effects models were used to evaluate the pooled risk ratios (RR) and 95% confidence intervals (95% CI) of incident stroke.
A total of eight studies comprising 4,256,888 participants were included in the meta-analysis. MHO individuals had an increased risk of stroke compared with metabolically healthy normal weight (MH-NW) individuals (RR =1.17, 95% CI: 1.11-1.23). However, the stroke risk of metabolically healthy overweight individuals was the same (RR =1.02, 95% CI: 0.84-1.23). All groups with unhealthy metabolism had a similarly elevated risk: normal weight (RR =1.83, 95% CI: 1.57-2.14), overweight (RR =1.93, 95% CI: 1.44-2.58), and obesity (RR =2.00, 95% CI: 1.40-2.87).
The meta-analysis confirms a positive association between MHO phenotype and the risk of stroke. Individuals with metabolic abnormalities under different bodyweight conditions are at elevated risk.
代谢健康型肥胖（MHO）是超重和肥胖个体中具有正常代谢特征的一个独特亚组。其与中风风险的关联仍不明确。我们旨在研究MHO个体的中风风险，以及在不同体重条件下中风与代谢异常之间的进一步关联。
我们系统检索了1946年12月至2019年1月期间的PubMed、Embase和Cochrane图书馆，仅纳入前瞻性队列研究。采用随机效应模型评估中风发生的合并风险比（RR）和95%置信区间（95%CI）。
荟萃分析共纳入8项研究，涉及4256888名参与者。与代谢健康的正常体重（MH-NW）个体相比，MHO个体中风风险增加（RR =1.17，95%CI：1.11-1.23）。然而，代谢健康的超重个体的中风风险相同（RR =1.02，95%CI：0.84-1.23）。所有代谢不健康的组中风风险均有相似程度的升高：正常体重（RR =1.83，95%CI：1.57-2.14）、超重（RR =1.93，95%CI：1.44-2.58）和肥胖（RR =2.00，95%CI：1.40-2.87）。
荟萃分析证实MHO表型与中风风险之间存在正相关。不同体重条件下有代谢异常的个体中风风险升高。
