代谢健康和不健康肥胖与绝经前妇女血管舒缩症状风险的关系：横断面和队列研究。
Metabolically healthy and unhealthy obesity and risk of vasomotor symptoms in premenopausal women: cross-sectional and cohort studies.
机构信息
Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of The Environmental Health Centre, Wonju Severance Christian Hospital, Yonsei University School of Medicine, Wonju, Korea.
出版信息
BJOG. 2022 Oct;129(11):1926-1934. doi: 10.1111/1471-0528.17224. Epub 2022 Jun 7.
OBJECTIVE
To examine the relationship between metabolically healthy and unhealthy obesity phenotypes and risk of vasomotor symptoms (VMS) in premenopausal women.
DESIGN
Prospective cohort study.
SETTING
Middle-aged women in a cohort based on regular health screening examinations.
POPULATION
Premenopausal Korean women aged 42-52 years were recruited and were followed up for a median of 4.2 years. The cross-sectional and cohort studies comprised 4672 women and 2590 women without VMS at baseline, respectively.
METHODS
Adiposity measures included body mass index (BMI), waist circumference and percentage body fat. Being metabolically healthy was defined as not having any metabolic syndrome components or a homeostasis model assessment of insulin resistance of 2.5 or more.
MAIN OUTCOMES MEASURES
VMS (hot flushes and night sweats) assessed using the questionnaire.
RESULTS
All adiposity measures were positively associated with an increased risk of VMS in both cross-sectional and longitudinal studies. The multivariable-adjusted prevalence ratio (95% confidence interval [CI]) for VMS comparing percentage body fat of 35% or more with the reference was 1.47 (95% CI 1.14-1.90) in metabolically healthy women, and the corresponding prevalence ratio was 2.32 (95% CI 1.42-3.78) in metabolically unhealthy women (P = 0.334). The multivariable-adjusted hazard ratio for incident VMS comparing percentage body fat of 35% or more with the reference was 1.34 (95% CI 1.00-1.79) in metabolically healthy women, whereas the corresponding hazard ratio was 3.61 (95% CI 1.81-7.20) in metabolically unhealthy women (P = 0.036). The association between BMI, waist circumference and VMS did not significantly differ by metabolic health status.
CONCLUSIONS
Maintaining normal weight and being metabolically healthy may help to prevent VMS in premenopausal women.
TWEETABLE ABSTRACT
Avoiding obesity and a metabolically unhealthy status may help reduce vasomotor symptoms in premenopausal women.
目的
研究绝经前女性代谢健康型和代谢不健康型肥胖表型与血管舒缩症状（VMS）风险之间的关系。
设计
前瞻性队列研究。
地点
基于常规健康筛查检查的中年女性队列。
人群
招募年龄在 42-52 岁的绝经前韩国女性，中位随访时间为 4.2 年。横断面研究和队列研究分别纳入了 4672 名和 2590 名基线时无 VMS 的女性。
方法
肥胖指标包括体重指数（BMI）、腰围和体脂百分比。代谢健康定义为无任何代谢综合征成分或胰岛素抵抗稳态模型评估值（HOMA-IR）≥2.5。
主要结局指标
采用问卷调查评估 VMS（热潮红和盗汗）。
结果
在横断面和纵向研究中，所有肥胖指标均与 VMS 风险增加呈正相关。与参考值相比，在代谢健康的女性中，体脂百分比为 35%或更高的 VMS 多变量调整患病率比（95%置信区间[CI]）为 1.47（95%CI 1.14-1.90），而在代谢不健康的女性中，相应的患病率比为 2.32（95%CI 1.42-3.78）（P=0.334）。与参考值相比，在代谢健康的女性中，体脂百分比为 35%或更高的新发 VMS 的多变量调整风险比为 1.34（95%CI 1.00-1.79），而在代谢不健康的女性中，相应的风险比为 3.61（95%CI 1.81-7.20）（P=0.036）。BMI、腰围与 VMS 之间的关联与代谢健康状况无关。
结论
保持正常体重和代谢健康可能有助于预防绝经前女性 VMS。
推文摘要
避免肥胖和代谢不健康状态可能有助于减少绝经前女性的血管舒缩症状。
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