Mendes Fernanda Duarte, Dos Santos Hully Cantão, Mill José Geraldo, Molina Maria Del Carmen Bisi, Diniz Maria de Fátima H Sander, Quintino Carla Romagnolli, Bittencourt Márcio Sommer, Faria Carolina Perim de
Post-Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
Post-Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
PLOS Glob Public Health. 2025 Apr 29;5(4):e0004325. doi: 10.1371/journal.pgph.0004325. eCollection 2025.
Despite obesity being associated with negative metabolic and cardiovascular outcomes, there is a subgroup of individuals considered healthy. However, there are questions about the stability of the Metabolically Healthy Obesity phenotype. This is a longitudinal study using the ELSA-Brasil cohort, conducted from 2008/10-2017/19 aiming to describe the trajectory of metabolic status of individuals with obesity, as well as the factors associated with the transition into the unhealthy status. Metabolic status was determined using measures of blood pressure, fasting glucose/glycated hemoglobin, triglycerides, and HDL-cholesterol, no previous diagnosis of alteration in any of these parameters nor taking medication to control them. SPSS v.21.0 was used, considering p < 0.05 as significant. The sample consisted of 190 Metabolically Healthy Individuals with Obesity at baseline, of whom 75.8% transitioned to Metabolically Unhealthy status on the third wave of the study. The baseline data indicates that 8.6% of individuals with obesity were metabolically healthy, and in the follow-up, the prevalence was 5.5%. Alcohol use was a risk factor for metabolic status transition [RR: 1.359 (95%CI: 1.005-1.838)]. Also, each 1 cm increase in waist circumference contributed to a 1% increase in the risk of transitioning from healthy to unhealthy metabolic status [RR: 1.011 (95%CI: 1.004-1.018)]. Being a metabolically healthy individual with obesity is a transient state and alcohol consumption as well as increases in waist circumference are risk factors for the metabolic transition.
尽管肥胖与负面的代谢和心血管结果相关，但仍有一部分人被认为是健康的。然而，代谢健康肥胖表型的稳定性存在疑问。这是一项使用巴西成人健康纵向研究（ELSA-Brasil）队列进行的纵向研究，研究时间为2008/10 - 2017/19，旨在描述肥胖个体的代谢状态轨迹，以及与转变为不健康状态相关的因素。代谢状态通过测量血压、空腹血糖/糖化血红蛋白、甘油三酯和高密度脂蛋白胆固醇来确定，此前没有这些参数中任何一项改变的诊断，也未服用药物来控制它们。使用SPSS v.21.0软件，将p < 0.05视为具有统计学意义。样本包括190名基线时代谢健康的肥胖个体，其中75.8%在研究的第三阶段转变为代谢不健康状态。基线数据表明，8.6%的肥胖个体代谢健康，而在随访中，这一患病率为5.5%。饮酒是代谢状态转变的一个风险因素[风险比（RR）：1.359（95%置信区间：1.005 - 1.838）]。此外，腰围每增加1厘米，从健康代谢状态转变为不健康代谢状态的风险增加1%[RR：1.011（95%置信区间：1.004 - 1.018）]。作为代谢健康的肥胖个体是一种短暂状态，饮酒以及腰围增加是代谢转变的风险因素。
