Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Public Health. 2022 Oct 5;22(1):1859. doi: 10.1186/s12889-022-14253-y.
China has the world's highest rail transportation network density, and the prevalence of obesity among railway workers in China is more than twice that of adults in the world. Carotid artery plaque (CAP) is a simple and noninvasive predictor of early atherosclerosis, while the association between different obese phenotypes and CAP risk among Chinese male railway drivers is unclear.
This cross-sectional study was performed among 8,645 Chinese male railway drivers. Obese phenotypes were assessed based on the obesity status (the body mass index ≥ 28 kg/m as obesity vs. < 28 kg/m as non-obesity) and metabolic status (metabolically healthy vs. metabolically unhealthy). Metabolically unhealthy was defined as the presence of at least one dysfunction, including elevated blood pressure, elevated fasting blood glucose, elevated triglyceride, and reduced high-density-lipoprotein cholesterol. Four obese phenotypes were defined based on the body mass index and metabolic status, i.e., metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), and metabolically unhealthy non-obesity (MUNO). Multivariable logistic regression was employed to estimate the association between different obese phenotypes and the risk of CAP. Subgroup analysis was performed to examine the variation of the association by age, circadian rhythm disorders, and history of smoking and drinking.
The prevalence of CAP among male railway drivers in MHO, MUO, MUNO, and MHNO was 8.75%, 18.67%, 17.82%, and 5.36%, respectively. Compared to those with MHNO, an increased risk for CAP was observed among those with MHO (OR = 2.18, 95% CI: 0.82, 5.10), MUO (OR = 1.78, 95% CI:1.44, 2.21), and MUNO (OR = 2.20, 95% CI: 1.67, 2.89). The subgroup analysis showed that both of the metabolically unhealthy groups (MUNO and MUO) aged < 45 years were prone to a higher risk of CAP (for the MUNO group, OR = 4.27, 95% CI:2.71, 7.10; for the MUO group, OR = 4.00, 95%CI: 2.26, 7.17).
The obese phenotypes are associated with CAP risk in male railway drivers, especially those with metabolically unhealthy conditions aged < 45 years.
中国拥有全球最高的铁路运输网络密度，中国铁路职工的肥胖患病率是世界成年人肥胖率的两倍多。颈动脉斑块（CAP）是早期动脉粥样硬化的简单且无创预测指标，而中国男性铁路司机不同肥胖表型与 CAP 风险之间的关系尚不清楚。
本横断面研究纳入了 8645 名中国男性铁路司机。根据肥胖状况（体重指数≥28 kg/m2 为肥胖 vs. < 28 kg/m2 为非肥胖）和代谢状况（代谢健康 vs. 代谢不健康）评估肥胖表型。代谢不健康定义为至少存在一种功能障碍，包括血压升高、空腹血糖升高、甘油三酯升高和高密度脂蛋白胆固醇降低。基于体重指数和代谢状况，定义了四种肥胖表型，即代谢健康非肥胖（MHNO）、代谢健康肥胖（MHO）、代谢不健康肥胖（MUO）和代谢不健康非肥胖（MUNO）。采用多变量逻辑回归估计不同肥胖表型与 CAP 风险之间的关联。进行亚组分析，以检查年龄、昼夜节律紊乱以及吸烟和饮酒史对关联的变化。
男性铁路司机中 MHO、MUO、MUNO 和 MHNO 组的 CAP 患病率分别为 8.75%、18.67%、17.82%和 5.36%。与 MHNO 相比，MHO（OR=2.18，95%CI：0.82，5.10）、MUO（OR=1.78，95%CI：1.44，2.21）和 MUNO（OR=2.20，95%CI：1.67，2.89）组的 CAP 风险增加。亚组分析显示，代谢不健康的两个组（MUNO 和 MUO）年龄<45 岁者均有更高的 CAP 风险（对于 MUNO 组，OR=4.27，95%CI：2.71，7.10；对于 MUO 组，OR=4.00，95%CI：2.26，7.17）。
肥胖表型与男性铁路司机的 CAP 风险相关，特别是代谢不健康且年龄<45 岁者。
