Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.
Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.
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DOI：
10.1002/oby.21344
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
Garvey WT
中科院分区：
文献类型：
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作者：
Guo F;Garvey WT
评估代谢状态和BMI状态的稳定性，以及它们对糖尿病、心血管事件和死亡率风险的相对贡献。14，685人来自ARIC，4，990人来自CARDIA。我们将健康肥胖（HO）人群定义为满足血压、血糖和血脂的所有3项指标。不健康肥胖的人超过了所有3个标准的风险阈值。在平均18.7年的随访中，在健康和不健康的亚组中，CHD、中风和死亡率的风险在BMI状态之间是相当的。与HO相比，不健康肥胖人群中糖尿病（5.56，95%CI 4.12-7.48）、CHD（5.60，CI 3.14-9.98）、卒中（4.84，CI 2.13-10.97）和死亡率（2.6，CI 1.88-3.61）的风险比增加。BMI仅适度增加健康受试者患糖尿病的风险。在20年的CARDIA研究中，基线时17.5%的瘦受试者和67.3%的超重受试者在随访期间变得肥胖。尽管BMI增加，代谢状态保持相对稳定。尽管BMI增加，但代谢状态相对稳定。高血压患者患糖尿病、冠心病、中风和死亡的风险低于不健康的受试者，但比健康的瘦人增加了糖尿病的风险。心脏代谢危险因素比肥胖本身带来更高的风险。
To assess the stability of metabolic status and BMI status, and their relative contribution to risk of diabetes, cardiovascular events, and mortality. 14,685 participants from ARIC, and 4,990 from CARDIA. We defined people with healthy obesity (HO) as meeting all 3 indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all 3 criteria. In both healthy and unhealthy subgroups, risks for CHD, stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% CI 4.12–7.48), CHD (5.60, CI 3.14–9.98), stroke (4.84, CI 2.13–10.97), and mortality (2.6, CI 1.88–3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In CARDIA over 20 years, 17.5 % of lean subjects and 67.3% of overweight subjects at baseline became obese during follow-up. Despite rising BMI, metabolic status remained relatively stable. Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects, but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se.