Risk of Developing Diabetes and Cardiovascular Disease in Metabolically Unhealthy Normal-Weight and Metabolically Healthy Obese Individuals
Risk of Developing Diabetes and Cardiovascular Disease in Metabolically Unhealthy Normal-Weight and Metabolically Healthy Obese Individuals
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DOI：
10.1210/jc.2013-2832
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发表时间：
2014-02-01
影响因子：
5.8
通讯作者：
Haffner, Steven M.
中科院分区：
文献类型：
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作者：
Aung, Koko;Lorenzo, Carlos;Haffner, Steven M.
内容：与肥胖相关的心血管疾病（CVD）和2型糖尿病（DM）的风险似乎受到其他代谢异常共存的影响。目的：我们研究了代谢健康肥胖（MHO）和代谢不健康正常体重（MUH-NW）个体发生CVD和DM的风险。设计和设置：我们分析了圣安东尼奥心脏研究的前瞻性数据，这是一项在墨西哥裔美国人和非西班牙裔白人中进行的基于人群的研究（中位随访时间为7.4年）。参与者：分别对2814名和3700名年龄在25岁至64岁之间的参与者进行了糖尿病和心血管疾病事件评估。MHO定义为肥胖MUH-NW定义为体重指数< 25 kg/m2且有两项或两项以上代谢异常。结果：在逻辑回归模型中，在控制人口统计学、DM家族史和空腹血糖后，BMI与DM事件相关（比值比X 1 SD，1.7 [95% CI，1.5-2.0]）。MUH-NW和MHO个体的DM风险均增加（分别为2.5 [1.1-5.6]和3.9 [2.0-7.4]）。同样，在调整人口统计学和Fragrance风险评分后，BMI与CVD事件相关（1.3 [1.1-1.6]）。MUH-NW和MHO个体的CVD发病率也增加（分别为2.9 [1.3-6.4]和3.9 [1.9-7.8]）。结果是一致的跨性别和种族categoris.Conclusion：糖尿病和心血管疾病的风险增加，在MUH-NW和MHO个人。在临床实践中应常规进行肥胖和其他代谢异常筛查，以制定适当的预防措施。
Context: The risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (DM) associated with obesity appears to be influenced by the coexistence of other metabolic abnormalities.Objective: We examined the risk of developing CVD and DM in metabolically healthy obese (MHO) and metabolically unhealthy normal weight (MUH-NW) individuals.Design and Setting: We analyzed prospective data of the San Antonio Heart Study, a population-based study among Mexican Americans and non-Hispanic whites (median follow-up, 7.4 y).Participants: Incident DM and CVD were assessed in 2814 and 3700 participants aged 25 to 64 years, respectively.Main Measures: MHO was defined as obesity (body mass index >= 30 kg/m(2)) with no more than one metabolic abnormality, and MUH-NW was defined as body mass index < 25 kg/m(2) with two or more abnormalities.Results: In logistic regression models, BMI was associated with incident DM after controlling for demographics, family history of DM, and fasting glucose (odds ratio X 1 SD, 1.7 [95% CI, 1.5-2.0]). Both MUH-NW and MHO individuals had an increased DM risk (2.5 [1.1-5.6] and 3.9 [2.0-7.4], respectively). Similarly, BMI was related to incident CVD after adjusting for demographics and Framingham risk score (1.3 [1.1-1.6]). Incident CVD was also increased in MUH-NW and MHO individuals (2.9 [1.3-6.4] and 3.9 [1.9-7.8], respectively). Results were consistent across gender and ethnic categories.Conclusion: The risk of developing DM and CVD is increased in MUH-NW and MHO individuals. Screening for obesity and other metabolic abnormalities should be routinely performed in clinical practice to institute appropriate preventive measures.