Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study.
Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study.
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DOI：
10.3389/fendo.2021.625083
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发表时间：
2021
影响因子：
5.2
通讯作者：
Jung CH
中科院分区：
文献类型：
--
作者：
Kim HS;Lee J;Cho YK;Park JY;Lee WJ;Kim YJ;Jung CH
代谢健康肥胖（MHO）个体及其与心脏代谢疾病的关系仍然存在争议。我们的目的是探讨基于基线代谢健康和肥胖状况的心力衰竭（HF）发生的风险，以及它们在2年内的转变。分析了514,886名参与者的韩国国民健康保险服务-国民健康筛查队列数据。根据韩国疾病控制与预防中心，肥胖的定义是BMI≥25 kg/m2。在基线和两年后评估代谢健康和肥胖状况。研究参与者被跟踪到新诊断的心衰或最后一次随访，以先发生者为准。MHO组占整个人群的9.1%，比代谢不健康的非肥胖组（MUNO）和代谢不健康的肥胖组（MUO）表现出更好的基线代谢谱。在中位71.3个月的随访期间，5406名（1.5%）参与者发生HF。与代谢健康的非肥胖（MHNO）组相比，MUNO、MHO和MUO组基线时HF的校正危险比[95% CI]分别为1.29[1.20-1.39]、1.37[1.22-1.53]和1.63[1.50-1.76]。以稳定的MHNO组为参照，无论基线状态如何，过渡到代谢不健康状态（MUNO和MUO）都会增加HF的风险。无论代谢健康状况如何，基线和随访时均为肥胖的受试者患心衰的风险均增加。代谢健康和肥胖状况及其转变可预测心衰发生的风险。基线非肥胖者和肥胖者代谢健康的丧失，以及基线肥胖者保持肥胖，表明心衰发生的风险显著增加。保持良好的代谢健康和苗条的身体可以预防心衰的发展。
Metabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years. The Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first. The MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20–1.39], 1.37 [1.22–1.53], and 1.63 [1.50–1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status. Metabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.
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