Central Obesity as a Precursor to the Metabolic Syndrome in the AusDiab Study and Mauritius
Central Obesity as a Precursor to the Metabolic Syndrome in the AusDiab Study and Mauritius
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DOI：
10.1038/oby.2008.412
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发表时间：
2008-12-01
期刊：
影响因子：
6.9
通讯作者：
Shaw, Jonathan E.
中科院分区：
文献类型：
--
作者：
Cameron, Adrian J.;Boyko, Edward J.;Shaw, Jonathan E.
来自流行病学研究的证据表明，中心性肥胖先于未来的代谢变化，并且不会与代谢综合征（MetS）特征的血压、葡萄糖和脂质异常同时发生。纵向调查分别于1987年、1992年和1998年在毛里求斯进行，2000年和2005年在澳大利亚进行（AusDiab）。该分析包括三个队列中的男性和女性（年龄为25岁）：澳大利亚2000-2005年（n = 5039），毛里求斯1987-1992年（n = 2849）和毛里求斯1987-1998年（n = 1999）。MetS成分包括腰围、收缩压、空腹和负荷后2小时血浆葡萄糖、高密度脂蛋白（HDL）胆固醇、甘油三酯和胰岛素敏感性稳态模型评估（HOMA-S）（代表胰岛素敏感性）。根据年龄、性别和种族进行调整后，使用线性回归来确定哪些基线成分预测了澳大利亚5年、毛里求斯5年和11年其他met成分的恶化。基线腰围预测其他6个MetS变量中的4个恶化（P < 0.01），毛里求斯1987-1992年6个变量中有5个，毛里求斯1987-1998年6个变量中有4个。相比之下，基线和随访期间腰围的增加仅通过基线时的胰岛素敏感性（HOMA-S）预测，并且仅在三个队列中的一个中。这些结果表明，中心性肥胖在代谢代谢的发展中起着核心作用，似乎先于其他代谢代谢成分的出现。
Evidence from epidemiologic studies that central obesity precedes future metabolic change and does not occur concurrently with the appearance of the blood pressure, glucose, and lipid abnormalities that characterize the metabolic syndrome (MetS) has been lacking. Longitudinal surveys were conducted in Mauritius in 1987, 1992, and 1998, and in Australia in 2000 and 2005 (AusDiab). This analysis included men and women (aged >= 25 years) in three cohorts: AusDiab 2000-2005 (n = 5,039), Mauritius 1987-1992 (n = 2,849), and Mauritius 1987-1998 (n = 1,999). MetS components included waist circumference, systolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and homeostasis model assessment of insulin sensitivity (HOMA-S) (representing insulin sensitivity). Linear regression was used to determine which baseline components predicted deterioration in other MetS components over 5 years in AusDiab and 5 and 11 years in Mauritius, adjusted for age, sex, and ethnic group. Baseline waist circumference predicted deterioration (P < 0.01) in four of the other six MetS variables tested in AusDiab, five of six in Mauritius 1987-1992, and four of six in Mauritius 1987-1998. In contrast, an increase in waist circumference between baseline and follow-up was only predicted by insulin sensitivity (HOMA-S) at baseline, and only in one of the three cohorts. These results suggest that central obesity plays a central role in the development of the MetS and appears to precede the appearance of the other MetS components.