Increased Cardiometabolic Risk Factors and Inflammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy
Increased Cardiometabolic Risk Factors and Inflammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy
复制标题
DOI：
10.2337/dc14-0937
复制
发表时间：
2014-10-01
期刊：
影响因子：
16.2
通讯作者：
Fruehbeck, Gema
中科院分区：
文献类型：
--
作者：
Gomez-Ambrosi, Javier;Catalan, Victoria;Fruehbeck, Gema
有研究表明，患有代谢健康肥胖症（MHO）的个体可能不会像非代谢健康的个体那样具有相同的代谢异常风险增加。然而，这一概念的有效性最近受到质疑，因为它可能不会转化为较低的发病率和死亡率。本研究的目的是比较心脏代谢/炎症概况和葡萄糖耐量减低（IGT）和2型糖尿病（T2 D）的患病率，这些患者被归类为患有MHO或代谢异常肥胖（MAO）。研究设计和方法我们进行了一项横断面分析，以比较222名MHO和222名MAO患者的心脏代谢/炎症概况（62%女性）按年龄匹配，包括255名瘦受试者作为参考（队列1）。在第二组中，我们分析了脂肪因子谱和内脏脂肪组织（VAT; n = 82）和肝脏（n = 55）中涉及炎症和细胞外基质重塑的基因的表达。在两个组中，MHO和MAO的心脏代谢和炎症谱（CRP、纤维蛋白原、尿酸、白细胞计数和肝酶）类似地增加。此外，根据空腹血糖分类为MHO的患者中有30%以上表现为IGT或T2 D。在队列2中，MHO和MAO组中经典脂肪因子（瘦素、脂联素、β-内酰胺酶）以及新型脂肪因子（血清淀粉样蛋白A和基质金属肽酶9）的分布几乎相同。参与炎症和组织重塑的基因在增值税和肝脏的表达表现出类似的改变模式在MHO和MAO individual.CONCLUSIONSThe目前的研究提供了证据，存在一个可比的不良心脏代谢的档案在MHO和MAO患者，因此MHO的概念应谨慎应用。更好地识别肥胖表型和更精确的诊断是改善肥胖个体管理的需要。
OBJECTIVEIt has been suggested that individuals with the condition known as metabolically healthy obesity (MHO) may not have the same increased risk for the development of metabolic abnormalities as their non-metabolically healthy counterparts. However, the validity of this concept has recently been challenged, since it may not translate into lower morbidity and mortality. The aim of the current study was to compare the cardiometabolic/inflammatory profile and the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes (T2D) in patients categorized as having MHO or metabolically abnormal obesity (MAO).RESEARCH DESIGN AND METHODSWe performed a cross-sectional analysis to compare the cardiometabolic/inflammatory profile of 222 MHO and 222 MAO patients (62% women) matched by age, including 255 lean subjects as reference (cohort 1). In a second cohort, we analyzed the adipokine profile and the expression of genes involved in inflammation and extracellular matrix remodeling in visceral adipose tissue (VAT; n = 82) and liver (n = 55).RESULTSThe cardiometabolic and inflammatory profiles (CRP, fibrinogen, uric acid, leukocyte count, and hepatic enzymes) were similarly increased in MHO and MAO in both cohorts. Moreover, above 30% of patients classified as MHO according to fasting plasma glucose exhibited IGT or T2D. The profile of classic (leptin, adiponectin, resistin) as well as novel (serum amyloid A and matrix metallopeptidase 9) adipokines was almost identical in MHO and MAO groups in cohort 2. Expression of genes involved in inflammation and tissue remodeling in VAT and liver showed a similar alteration pattern in MHO and MAO individuals.CONCLUSIONSThe current study provides evidence for the existence of a comparable adverse cardiometabolic profile in MHO and MAO patients; thus the MHO concept should be applied with caution. A better identification of the obesity phenotypes and a more precise diagnosis are needed for improving the management of obese individuals.