Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa.
Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Pediatric Epidemiology, Department of Pediatrics, Leipzig University, Germany.
Nutr Metab Cardiovasc Dis. 2021 Jun 30;31(7):2023-2032. doi: 10.1016/j.numecd.2021.03.017. Epub 2021 Mar 26.
Obesity is associated with an increasing prevalence of cardiovascular diseases in Africa, but some obese individuals maintain cardiometabolic health. The aims were to track metabolically healthy overweight or obesity (MHO) over 10 years in African adults and to identify factors associated with a transition to metabolically unhealthy overweight or obesity (MUO).
The participants were the South African cohort of the international Prospective Urban and Rural Epidemiological study. From the baseline data of 1937 adults, 649 women and 274 men were followed for 10 years. The combined overweight and obesity prevalence of men (19.2%-23.8%, p = .02) and women (58%-64.7%, p < .001), and the prevalence of the metabolic syndrome in all participants (25.4%-40.2%, p < .001) increased significantly. More than a quarter (26.2%) of the women and 10.9% of men were MHO at baseline, 11.4% of women and 5.1% of men maintained MHO over 10 years, while similar proportions (12.3% of women, 4.7% of men) transitioned to MUO. Female sex, age, and total fat intake were positively associated with a transition to MUO over 10 years, while physical activity was negatively associated with the transition. HIV positive participants were more likely to be MHO at follow-up than their HIV negative counterparts.
One in two black adults with BMI ≥25 kg/m maintained MHO over 10 years, while a similar proportion transitioned into MUO. Interventions should focus on lower fat intakes and higher physical activity to prevent the transition to MUO.
肥胖与非洲心血管疾病的患病率不断上升有关，但一些肥胖个体保持着代谢健康。本研究的目的是在非洲成年人中追踪代谢健康型超重或肥胖（MHO）超过 10 年，并确定与代谢不健康型超重或肥胖（MUO）转变相关的因素。
参与者是国际前瞻性城乡流行病学研究的南非队列。从 1937 名成年人的基线数据中，对 649 名女性和 274 名男性进行了 10 年的随访。男性（19.2%-23.8%，p=0.02）和女性（58%-64.7%，p<0.001）的超重和肥胖总患病率以及所有参与者的代谢综合征患病率（25.4%-40.2%，p<0.001）均显著增加。超过四分之一（26.2%）的女性和 10.9%的男性在基线时为 MHO，11.4%的女性和 5.1%的男性在 10 年内保持 MHO，而相似比例（12.3%的女性，4.7%的男性）转变为 MUO。女性性别、年龄和总脂肪摄入量与 10 年内向 MUO 转变呈正相关，而体力活动与向 MUO 转变呈负相关。HIV 阳性参与者在随访时更有可能为 MHO，而 HIV 阴性参与者则不然。
在 BMI≥25kg/m2的黑人成年人中，有 1/2以上的人在 10 年内保持 MHO，而同样比例的人转变为 MUO。干预措施应侧重于降低脂肪摄入量和增加体力活动，以预防向 MUO 转变。
