Different metabolic phenotypes of obesity and risk of coronary artery calcium progression and incident cardiovascular disease events: the CARDIA study
Different metabolic phenotypes of obesity and risk of coronary artery calcium progression and incident cardiovascular disease events: the CARDIA study
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肥胖的不同代谢表型以及冠状动脉钙进展和心血管疾病事件的风险：CARDIA 研究
DOI：
10.1161/atvbaha.122.317526
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Liu Pinming
中科院分区：
文献类型：
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作者：
Gao Jingwei;You Si;Liu Zhaoyu;Hao Qingyun;Wang Jingfeng;Dominique A. Vuitton;Zhang Shaoling;Liu Pinming
背景：。调查肥胖伴或不伴代谢综合征是否与冠状动脉钙化 (CAC) 进展和心血管疾病事件前瞻性相关。 CARDIA 研究（年轻人冠状动脉风险发展）共有 1730 名参与者（年龄，40.1±3.6 岁；38.3% 为男性），他们在基线（第 15 年：2000-2001 年）和随访（第 20 或 25 年）完成了 CAC 计算机断层扫描。代谢健康肥胖（MHO）定义为体重指数≥30 kg/m。 2.在我们的主要分析中没有任何代谢综合征成分。对表征 4 种代谢表型的几种条件进行了敏感性分析。结果：。在平均 9.1 年的随访期间，439 名参与者出现了 CAC 进展。 MHO 受试者的 CAC 进展风险显着高于代谢健康的正常体重受试者（调整后的风险比 [95% CI] 从 1.761 [1.369–2.264] 到 2.047 [1.380–3.036]），具体取决于采用的 MHO 定义。无论代谢不健康状态采用何种定义，代谢不健康的肥胖仍然是 CAC 进展和心血管疾病事件的最高显着风险。高达 60% 的 MHO 参与者从第 15 年到第 20 年或第 25 年转变为代谢不健康肥胖。进一步的敏感性分析表明，与代谢健康的正常体重相比，MHO 自始至终具有相似的心血管疾病事件风险。从年轻时开始的不同肥胖代谢表型在中年后期表现出不同的 CAC 进展和随后的心血管疾病事件的风险。 MHO 代表代谢低风险至高风险肥胖个体之间的中间表型。注册：。网址:. https://www.clinicaltrials.gov。 ;唯一标识符：NCT00005130。
Background:. To investigate whether obesity with or without metabolic syndrome is prospectively associated with coronary artery calcium (CAC) progression and incident cardiovascular disease events.. Methods:. A total of 1730 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included (age, 40.1±3.6 years; 38.3% men), who completed computed tomography of CAC at baseline (year 15: 2000–2001) and follow-up (year 20 or 25). Metabolically healthy obesity (MHO) was defined as body mass index≥30 kg/m. 2. without any metabolic syndrome components in our main analysis. Sensitivity analyses were conducted for several conditions characterizing 4 metabolic phenotypes.. Results:. During a mean follow-up of 9.1 years, 439 participants had CAC progression. MHO subjects had a significantly higher risk of CAC progression than their metabolically healthy normal weight counterparts (adjusted hazard ratios [95% CIs] from 1.761 [1.369–2.264] to 2.047 [1.380–3.036]) depending on the definition of MHO adopted. Obesity with unhealthy metabolic profile remained the highest significant risk of CAC progression and cardiovascular disease events whatever the definitions adopted for metabolically unhealthy status. Up to 60% of participants with MHO converted to metabolically unhealthy obesity from year 15 to year 20 or year 25. Further sensitivity analysis showed that MHO throughout carried a similar risk of incident cardiovascular disease events compared with metabolically healthy normal weight throughout.. Conclusions:. Different metabolic phenotypes of obesity beginning at a young age exhibit distinct risks of CAC progression and subsequent cardiovascular disease events in later midlife. MHO represents an intermediate phenotype between metabolically low- to high-risk obese individuals.. Registration:. URL:. https://www.clinicaltrials.gov. ; Unique identifier: NCT00005130.