Metabolically healthy and unhealthy obesity phenotypes in the general population: the FIN-D2D Survey.
Metabolically healthy and unhealthy obesity phenotypes in the general population: the FIN-D2D Survey.
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DOI：
10.1186/1471-2458-11-754
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发表时间：
2011-10-01
影响因子：
4.5
通讯作者：
Peltonen M
中科院分区：
文献类型：
--
作者：
Pajunen P;Kotronen A;Korpi-Hyövälti E;Keinänen-Kiukaanniemi S;Oksa H;Niskanen L;Saaristo T;Saltevo JT;Sundvall J;Vanhala M;Uusitupa M;Peltonen M
这项工作的目的是检查不同肥胖代谢表型的患病率，并通过使用不同的风险评分来分析代谢综合征 (MetS) 的定义如何区分不同肥胖类别中不健康和健康的代谢表型。芬兰 2 型糖尿病 (FIN-D2D) 调查是 2007 年开展的更大规模实施研究的一部分。目前的横断面分析包括 2,849 名年龄在 45-74 岁之间的个体。 MetS 是根据新的协调定义进行定义的。心血管风险通过 Framingham 和 SCORE 风险评分进行评估。糖尿病风险通过 FINDRISK 评分进行评估。非酒精性脂肪性肝病 (NAFLD) 通过 NAFLD 评分进行评估。患有和不患有MetS的参与者被分为不同的体重类别，并使用回归模型分析来测试体重指数（BMI）与患有和不患有MetS的个体的各种特征之间的线性趋势； BMI 和 MetS 之间的相互作用。在 9.2% 的肥胖男性和 16.4% 的肥胖女性中观察到代谢健康但肥胖的表型。 MetS-BMI 的相互作用对于空腹血糖、2 小时血浆葡萄糖、空腹血浆胰岛素和胰岛素抵抗 (HOMA-IR) 具有显着意义（全部 p < 0.001）。患有 MetS 的肥胖个体的总体糖尿病患病率（在调查之前或调查期间检测到）为 37.0%，而没有 MetS 的肥胖个体为 4.3% (p < 0.001)。 MetS-BMI 交互作用对于 Framingham 10 年 CVD 风险评分、NAFLD 评分和估计肝脏脂肪百分比也显着 (p < 0.001)，表明与没有 MetS 的参与者相比，增加 BMI 对 MetS 参与者的影响更大。与体重正常且患有 MetS 的个体相比，代谢健康但肥胖的个体具有较低的 2 小时负荷后血糖水平 (p = 0.0030)、较低的 NAFLD 评分 (p < 0.001) 和较低的 CVD 风险评分 (Framingham，p < 0.001；SCORE，p = 0.002)。无论 BMI 等级如何，未检测到的 2 型糖尿病在 MetS 患者中更为普遍，与没有 MetS 的参与者相比，增加 BMI 对 MetS 患者肝脏脂肪和未来 CVD 风险的估计影响显着更大。与体重正常的 MetS 患者相比，健康的肥胖表型与更好的代谢特征相关。
The aim of this work was to examine the prevalence of different metabolical phenotypes of obesity, and to analyze, by using different risk scores, how the metabolic syndrome (MetS) definition discriminates between unhealthy and healthy metabolic phenotypes in different obesity classes. The Finnish type 2 diabetes (FIN-D2D) survey, a part of the larger implementation study, was carried out in 2007. The present cross-sectional analysis comprises 2,849 individuals aged 45-74 years. The MetS was defined with the new Harmonization definition. Cardiovascular risk was estimated with the Framingham and SCORE risk scores. Diabetes risk was assessed with the FINDRISK score. Non-alcoholic fatty liver disease (NAFLD) was estimated with the NAFLD score. Participants with and without MetS were classified in different weight categories and analysis of regression models were used to test the linear trend between body mass index (BMI) and various characteristics in individuals with and without MetS; and interaction between BMI and MetS. A metabolically healthy but obese phenotype was observed in 9.2% of obese men and in 16.4% of obese women. The MetS-BMI interaction was significant for fasting glucose, 2-hour plasma glucose, fasting plasma insulin and insulin resistance (HOMA-IR)(p < 0.001 for all). The prevalence of total diabetes (detected prior to or during survey) was 37.0% in obese individuals with MetS and 4.3% in obese individuals without MetS (p < 0.001). MetS-BMI interaction was significant (p < 0.001) also for the Framingham 10 year CVD risk score, NAFLD score and estimated liver fat %, indicating greater effect of increasing BMI in participants with MetS compared to participants without MetS. The metabolically healthy but obese individuals had lower 2-hour postload glucose levels (p = 0.0030), lower NAFLD scores (p < 0.001) and lower CVD risk scores (Framingham, p < 0.001; SCORE, p = 0.002) than normal weight individuals with MetS. Undetected Type 2 diabetes was more prevalent among those with MetS irrespective of the BMI class and increasing BMI had a significantly greater effect on estimates of liver fat and future CVD risk among those with MetS compared with participants without MetS. A healthy obese phenotype was associated with a better metabolic profile than observed in normal weight individuals with MetS.
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影响因子：
37.8
作者：
Alberti, K. G. M. M.;Eckel, Robert H.;Smith, Sidney C., Jr.
通讯作者：
Smith, Sidney C., Jr.
影响因子：
29.4
作者：
Kotronen, Anna;Peltonen, Markku;Yki-Jarvinen, Hannele
通讯作者：
Yki-Jarvinen, Hannele
影响因子：
8.2
作者：
Karelis, A. D.;Messier, V.;Rabasa-Lhoret, R.
通讯作者：
Rabasa-Lhoret, R.
影响因子：
2.2
作者：
Pajunen, P;Pääkkönen, R;Salomaa, V
通讯作者：
Salomaa, V
影响因子：
5.8
作者：
Brochu, M;Tchernof, A;Poehlman, ET
通讯作者：
Poehlman, ET