在中国 500 万成年人中，代谢健康型肥胖、向不健康表型转变与 2 型糖尿病：中国科克伦协作生物样本库研究。

Metabolically healthy obesity, transition to unhealthy phenotypes, and type 2 diabetes in 0.5 million Chinese adults: the China Kadoorie Biobank.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.

Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.

出版信息

Eur J Endocrinol. 2022 Jan 6;186(2):233-244. doi: 10.1530/EJE-21-0743.

DOI:10.1530/EJE-21-0743

PMID:34874895

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8789025/

Abstract

OBJECTIVES

To prospectively assess the association of metabolic health status and its transition with incident diabetes risk across BMI categories.

DESIGN

Cohort study based on the China Kadoorie Biobank (CKB).

METHODS

The CKB study enrolled 512 715 adults aged 30-79 years from ten diverse areas in China during 2004-2008. After exclusion, 432 763 participants were cross-classified by BMI categories and the metabolic status was followed up for incident diabetes disease. The changes in BMI and metabolic health status were defined from baseline to the second resurvey.

RESULTS

Type 2 diabetes risk is higher for metabolically healthy obese (MHO) subjects than metabolically healthy normal weight (MHN) individuals (HR: 3.97, 95% CI: 3.64-3.66), and it is highest for those affected by metabolically unhealthy obese (MUO) (HR: 6.47, 95% CI: 6.17-6.79). About 15.26% of participants with MHN converted to metabolically healthy overweight or obesity (MHOO), whereas 48.40% of MHOO remained unconverted throughout the follow-up. In obese or overweight people, the conversion from metabolically healthy to unhealthy might increase the chances of developing diabetes as compared to those with a stable metabolic healthy state (HR: 3.70, 95% CI: 2.99-4.59), while those with persistent metabolic disorders are most likely to have diabetes (HR: 8.32, 95% CI: 7.08-9.78).

CONCLUSIONS

Metabolic healthy is a transient state, and individuals converted from metabolically healthy status to unhealthy phenotypes across all BMI categories might raise the risk of diabetes.

摘要

目的

前瞻性评估代谢健康状况及其在 BMI 类别中的变化与糖尿病发病风险之间的关联。

设计

基于中国慢性病前瞻性研究（CKB）的队列研究。

方法

2004-2008 年，在中国十个不同地区招募了 512715 名年龄在 30-79 岁的成年人参加 CKB 研究。排除后，432763 名参与者根据 BMI 类别进行交叉分类，并对新发糖尿病进行随访。BMI 和代谢健康状况的变化是从基线到第二次复查定义的。

结果

与代谢健康正常体重（MHN）个体相比，代谢健康肥胖（MHO）患者的 2 型糖尿病风险更高（HR：3.97，95%CI：3.64-3.66），而代谢不健康肥胖（MUO）患者的风险最高（HR：6.47，95%CI：6.17-6.79）。大约 15.26%的 MHN 参与者转变为代谢健康超重或肥胖（MHOO），而在整个随访期间，48.40%的 MHOO 保持不变。在肥胖或超重人群中，与代谢健康状态稳定的人群相比，从代谢健康向不健康的转变可能会增加发生糖尿病的几率（HR：3.70，95%CI：2.99-4.59），而持续存在代谢紊乱的人群最有可能患有糖尿病（HR：8.32，95%CI：7.08-9.78）。