Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: A meta-analysis of prospective cohort studies
Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: A meta-analysis of prospective cohort studies
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DOI：
10.1016/j.ijcard.2013.07.230
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发表时间：
2013-10-12
影响因子：
3.5
通讯作者：
Zhang, Weili
中科院分区：
文献类型：
--
作者：
Fan, Jingyao;Song, Yiqing;Zhang, Weili
背景：由于代谢异常，正常体重、超重和肥胖个体的心血管风险不一致。方法：检索MEDLINE、EMBASE、科克伦图书馆及2013年5月以前的相关原始文献，寻找肥胖与代谢综合征或胰岛素抵抗联合作用下心血管疾病风险和死亡的前瞻性研究。合并相对危险度（RR）和95%置信区间（CI）计算使用随机效应或固定效应models.Results：14个前瞻性研究，共299,059参与者和12,125例CVD事件，2130例CVD死亡，7071例全因死亡被纳入荟萃分析。与正常体重的健康个体相比，代谢健康的超重（MHOW）和肥胖（MHOB）个体显示出CVD事件的风险增加，在N15年的长期随访期间，这种风险似乎更强，MHOW和MHOB的合并RR分别为1.47（95%CI 1.37-1.58）和2.00（95%CI 1.79-2.24）。体重正常但代谢异常的个体发生CVD（汇总RR 1.81，95% CI 1.56-2.10）、CVD相关死亡（汇总RR 1.55，95% CI 1.16-2.08）和全因死亡（汇总RR 1.27，95% CI 1.10-1.47）的风险增加。代谢异常的肥胖个体发生CVD和死亡的风险最高。结论：代谢异常的个体，尽管体重正常，但CVD和死亡的风险增加。健康的超重和肥胖者有更高的风险，这驳斥了代谢健康的肥胖表型是良性疾病的观点。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: Cardiovascular risk is inconsistent in the normal-weight, overweight, and obese individuals due to metabolic abnormality. We aimed to investigate combined effects of obesity and metabolic abnormality on the risk of cardiovascular disease and mortality.Methods: TheMEDLINE, EMBASE, Cochrane library, and references of relevant original articles prior to May 2013 were searched for prospective studies investigating cardiovascular risk and death associated with combined effects of obesity and metabolic syndrome or insulin resistance. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects or fixed-effect models when appropriate.Results: Fourteen perspective studieswith a total of 299,059 participants and 12,125 cases of incident CVD, 2130 cases of CVD death, and 7071 cases of all-cause deathwere included in themeta-analysis. Comparedwith healthy normal-weight individuals, metabolically healthy overweight (MHOW) and obese (MHOB) individuals showed increased risk for CVD events, which appeared much stronger during the long-term follow-up period of N15 years, with pooled RR of 1.47 (95% CI 1.37-1.58) in MHOW and 2.00 (95% CI 1.79-2.24) in MHOB. Normal-weight but metabolically abnormal individuals were at increased risk for CVD (pooled RR 1.81, 95% CI 1.56-2.10), CVD-related death (pooled RR 1.55, 95% CI 1.16-2.08), and all-cause death (pooled RR 1.27, 95% CI 1.10-1.47). Metabolically abnormal obese individuals were at the highest risk for CVD and mortality.Conclusion: Individualswithmetabolic abnormality, although at normal-weight, had an increased risk of CVDand mortality. Healthy overweight and obese persons had higher risk, which refuted the notion that metabolically healthy obese phenotype is a benign condition. (C) 2013 Elsevier Ireland Ltd. All rights reserved.