正常体重肥胖表型与炎症标志物的关联：系统评价和荟萃分析。
Association of normal weight obesity phenotype with inflammatory markers: A systematic review and meta-analysis.
机构信息
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
出版信息
Front Immunol. 2023 Feb 27;14:1044178. doi: 10.3389/fimmu.2023.1044178. eCollection 2023.
BACKGROUND
Individuals with normal weight could suffer from obesity based on their body fat percentage (also known as normal weight obesity (NWO)), thus being at risk of significant morbidity and mortality compared to the general population. It seems that inflammatory pathways and chronic inflammation are significant contributors to the pathogenicity of NWO. This study aimed to assess and pool the association of proinflammatory and anti-inflammatory cytokines with NWO.
METHODS
In this systematic review and meta-analysis, online international databases (PubMed, Scopus, EMBASE, Web of Science, and Google Scholar) were searched until August 2022. All observational studies with an English full text comparing the mean levels of proinflammatory and anti-inflammatory cytokines (e.g., C-reactive protein (CRP), various types of interleukins (IL) s, tumor necrosis factor-alpha (TNF)) and white blood cell (WBC) count, in subjects with NWO and "normal weight non-obese (NWNO)" were included. Two researchers independently screened, reviewed and assessed the quality of included studies. The remaining articles' data were extracted post-screening. The heterogeneity between studies was assessed using the I and Cochran's Q tests. A random effect model meta-analysis was used to pool the standardized mean difference (SMD) as an effect size.
RESULTS
From the initial 559 studies, 21 and 19 were included in the qualitative and quantitative synthesis, respectively. In the systematic review, 8 studies reported a significant association between various proinflammatory cytokines (CRP, IL, IL, and TNFα) and NWO. According to random-effect meta-analysis, the association between NWO with CRP (SMD: 0.60, 95% CI: 0.30, 0.91) and IL6 (SMD: 0.90, 95%CI: 0.14, 1.66) was statistically significant. Moreover, the mean level of TNF in subjects with NWO and NWNO did not differ significantly (SMD: 0.67, 95% CI: -0.36, 1.70).
CONCLUSION
The findings of this study show that NWO was associated with high levels of CRP and IL6. Therefore, inflammatory pathways may play a role in the pathogenicity of NWO.
背景
体重正常的个体可能由于体脂百分比（也称为正常体重肥胖症（NWO））而患有肥胖症，因此与一般人群相比，他们有患重大疾病和死亡的风险。似乎炎症途径和慢性炎症是 NWO 发病机制的重要因素。本研究旨在评估和汇总促炎和抗炎细胞因子与 NWO 的关联。
方法
在这项系统评价和荟萃分析中，我们检索了在线国际数据库（PubMed、Scopus、EMBASE、Web of Science 和 Google Scholar），直到 2022 年 8 月。所有比较 NWO 患者和“正常体重非肥胖（NWNO）”患者促炎和抗炎细胞因子（例如 C 反应蛋白（CRP）、各种类型的白细胞介素（IL）s、肿瘤坏死因子-α（TNF））和白细胞（WBC）计数均值的观察性研究，均包含在本研究中。两位研究人员独立筛选、审查和评估纳入研究的质量。筛选后提取其余文章的数据。使用 I ²和 Cochran's Q 检验评估研究之间的异质性。使用随机效应模型荟萃分析汇总标准化均数差（SMD）作为效应量。
结果
从最初的 559 项研究中，有 21 项和 19 项分别被纳入定性和定量综合分析。在系统评价中，有 8 项研究报道了各种促炎细胞因子（CRP、IL、IL 和 TNFα）与 NWO 之间存在显著关联。根据随机效应荟萃分析，NWO 与 CRP（SMD：0.60，95%CI：0.30，0.91）和 IL6（SMD：0.90，95%CI：0.14，1.66）之间存在统计学显著关联。此外，NWO 患者和 NWNO 患者的 TNF 平均水平无显著差异（SMD：0.67，95%CI：-0.36，1.70）。
结论
本研究结果表明，NWO 与 CRP 和 IL6 水平升高有关。因此，炎症途径可能在 NWO 的发病机制中起作用。
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