Subclinical atherosclerosis and obesity phenotypes among Mexican Americans.
Subclinical atherosclerosis and obesity phenotypes among Mexican Americans.
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DOI：
10.1161/jaha.114.001540
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发表时间：
2015-03-18
影响因子：
5.4
通讯作者：
Fisher-Hoch SP
中科院分区：
文献类型：
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作者：
Laing ST;Smulevitz B;Vatcheva KP;Rahbar MH;Reininger B;McPherson DD;McCormick JB;Fisher-Hoch SP
肥胖对西班牙裔人动脉粥样硬化影响的数据不一致，可能与肥胖个体不同的心脏代谢风险有关。我们的目的是确定肥胖和心脏代谢风险与墨西哥裔美国人亚临床动脉粥样硬化的关系。参与者（n=503）来自卡梅隆县西班牙裔队列。代谢健康定义为以下各项中的<2项：血压≥130/85;甘油三酯≥150 mg/dL;高密度脂蛋白胆固醇<40 mg/dL（男性）或<50 mg/dL（女性）;空腹血糖≥100 mg/dL;稳态模型评估的胰岛素抵抗值>5.13;或高敏C反应蛋白>3 mg/L。测量颈动脉内膜中层厚度（cIMT）。很高比例的参与者（77.8%）代谢不健康;他们更可能是男性，年龄较大，受教育年限较短，并且不太可能满足有关水果和蔬菜的日常建议。三分之一（31.8%）的颈动脉超声检查结果异常。在调整协变量后，平均cIMT在肥胖表型之间存在差异（P=0.0001）;代谢不健康者之间没有差异，无论他们是否肥胖。在多变量分析中，校正协变量后，心脏代谢风险（P=0.0159），而不是肥胖（P=0.1446），与亚临床动脉粥样硬化显著相关。在墨西哥裔美国人中，心脏代谢风险对早期动脉粥样硬化发展的影响大于体重指数。非肥胖但代谢不健康的参与者与肥胖者相比，亚临床动脉粥样硬化的发展相似。在肥胖和非肥胖患者中维持代谢健康的干预可能是比单纯减肥更重要的目标。
Data on the influence of obesity on atherosclerosis in Hispanics are inconsistent, possibly related to varying cardiometabolic risk among obese individuals. We aimed to determine the association of obesity and cardiometabolic risk with subclinical atherosclerosis in Mexican‐Americans. Participants (n=503) were drawn from the Cameron County Hispanic Cohort. Metabolic health was defined as <2 of the following: blood pressure ≥130/85; triglyceride ≥150 mg/dL; high‐density lipoprotein cholesterol <40 mg/dL (men) or <50 mg/dL (women); fasting glucose ≥100 mg/dL; homeostasis model assessment of insulin resistance value >5.13; or high‐sensitivity C‐reactive protein >3 mg/L. Carotid intima media thickness (cIMT) was measured. A high proportion of participants (77.8%) were metabolically unhealthy; they were more likely to be male, older, with fewer years of education, and less likely to meet daily recommendations regarding fruit and vegetable servings. One‐third (31.8%) had abnormal carotid ultrasound findings. After adjusting for covariates, mean cIMT varied across the obesity phenotypes (P=0.0001); there was no difference among the metabolically unhealthy regardless of whether they were obese or not. In multivariable analysis, after adjusting for covariates, cardiometabolic risk (P=0.0159), but not obesity (P=0.1446), was significantly associated with subclinical atherosclerosis. In Mexican‐Americans, cardiometabolic risk has a greater effect on early atherosclerosis development than body mass index. Non‐obese but metabolically unhealthy participants had similar development of subclinical atherosclerosis as their obese counterparts. Interventions to maintain metabolic health among obese and non‐obese patients may be a more important goal than weight loss alone.