Koo Hye Yeon, Lee Jae-Ryun, Lee Jin Yong, Lee Hyejin
Department of Family Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea.
Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Arch Public Health. 2024 Aug 23;82(1):131. doi: 10.1186/s13690-024-01372-8.
Obesity has been suggested to be associated with the coronavirus disease 2019 (COVID-19); however, it is unclear whether obesity or metabolic abnormalities accompanied by obesity have a stronger association with COVID-19 risk.
This study used the Korea Disease Control and Prevention Agency database, which includes information about the COVID-19 diagnosis and mortality dates of the entire Korean population between October 2020 and December 2021 (for diagnosis) or March 2022 (for mortality). A total of 24,310,283 adults were included and classified into four metabolic obesity phenotypes: (1) metabolically healthy and normal weight (MHNW), (2) metabolically unhealthy and normal weight (MUNW), (3) metabolically healthy and obese (MHO), and (4) metabolically unhealthy and obese (MUO). COVID-19 mortality and severity were compared according to metabolic obesity phenotypes in the total population and in each age group (20-<50 years, 50-<70 years, and ≥ 70 years). Additionally, major adverse cardiovascular events (MACE) after COVID-19 infection were compared according to metabolic obesity phenotypes.
A total of 3, 956, 807 participants (16.3%) were diagnosed with COVID-19 during the study period. Among them, metabolically unhealthy subjects had higher mortality rates than metabolically healthy subjects (0.81% for MUNW, 0.40% for MUO, 0.23% for MHNW, and 0.19% for MHO). The rates of severe hospitalized disease were also higher in metabolically unhealthy subjects than in healthy subjects (0.59% for MUNW, 0.55% for MUO, 0.19% for MHNW, and 0.31% for MHO). In the subgroup analyses by age, similar trends were observed in subjects aged 20-50 and 50-70 years, respectively. Additionally, the incidence of total MACE was increased in metabolically unhealthy individuals.
The study shows that metabolic health is more strongly associated with COVID-19 mortality and severity than obesity, particularly in adults aged < 70 years.
肥胖被认为与2019冠状病毒病（COVID-19）有关；然而，尚不清楚肥胖或伴随肥胖的代谢异常是否与COVID-19风险有更强的关联。
本研究使用了韩国疾病控制与预防机构的数据库，该数据库包含2020年10月至2021年12月（用于诊断）或2022年3月（用于死亡数据）期间全体韩国人口的COVID-19诊断和死亡日期信息。共纳入24310283名成年人，并将其分为四种代谢性肥胖表型：（1）代谢健康且体重正常（MHNW），（2）代谢不健康且体重正常（MUNW），（3）代谢健康且肥胖（MHO），以及（4）代谢不健康且肥胖（MUO）。根据代谢性肥胖表型，比较了总人群和各年龄组（20-<50岁、50-<70岁和≥70岁）中COVID-19的死亡率和严重程度。此外，还根据代谢性肥胖表型比较了COVID-19感染后的主要不良心血管事件（MACE）。
在研究期间，共有3956807名参与者（16.3%）被诊断为COVID-19。其中，代谢不健康的受试者死亡率高于代谢健康的受试者（MUNW为0.81%，MUO为0.40%，MHNW为0.23%，MHO为0.19%）。代谢不健康的受试者中重症住院疾病的发生率也高于健康受试者（MUNW为0.59%，MUO为0.55%，MHNW为0.19%，MHO为0.31%）。在按年龄进行的亚组分析中，20-50岁和50-70岁的受试者中分别观察到类似趋势。此外，代谢不健康个体中总MACE的发生率增加。
该研究表明，与肥胖相比，代谢健康与COVID-19死亡率和严重程度的关联更强，尤其是在70岁以下的成年人中。
