代谢健康型肥胖与动脉粥样硬化的相关性研究  

Relationship between metabolically healthy obesity and atherosclerosis

作　　者：尉然 朱元悦 胡春艳 齐红焱 张怡[1] 杜瑞[1] 张婕[1] 陆洁莉[1] 毕宇芳[1] 陈宇红[1] 林琳[1] Wei Ran;Zhu Yuanyue;Hu Chunyan;Qi Hongyan;Zhang Yi;Du Rui;Zhang Jie;Lu Jieli;Bi Yufang;Chen Yuhong;Lin Lin(Department of Endocrine and Metabolic Diseases,Shanghai Institute of Endocrine and Metabolic Diseases,National Clinical Research Center for Metabolic Diseases,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科,上海市内分泌代谢病研究所,国家代谢性疾病临床医学研究中心,200025

出　　处：《中华内分泌代谢杂志》2021年第2期100-105,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81870604,81900741)。

摘　　要：目的探讨在40岁以上的中国社区人群中,代谢健康型肥胖与动脉粥样硬化患病风险的相关性。方法来自上海嘉定社区共9525名不伴有心血管疾病的居民(男性3621名、女性5904名)参与了本项研究。每位参与者均完成了调查问卷、体格检查[包括肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)和血压(blood pressure,BP)的测量],以及实验室检查。根据体重指数(body mass index,BMI)和代谢水平,将参与者分为4组,分别是代谢健康型非肥胖(metabolically healthy non-obese,MHNO)、代谢不健康型非肥胖(metabolically unhealthy non-obese,MUNO)、代谢健康型肥胖(metabolically healthy obese,MHO)和代谢不健康型肥胖(metabolically unhealthy obese,MUO)。baPWV>1400 mm/s被定义为高baPWV水平,脉压差(pulse pressure,PP)高于人群上四分位数被定义为高PP水平。利用多元logistic回归分析模型探究MHO与高baPWV水平以及高PP水平之间的相关性。结果多元logistic回归分析显示,在校正性别、年龄、当前吸烟、当前饮酒及受教育程度之后,与MHNO组比较,MHO组人群与高baPWV水平(OR=1.18,95%CI 1.02~1.37)和高PP水平(OR=1.72,95%CI 1.43~2.08)有显著相关性。另外,MUNO和MUO组人群的高baPWV水平(MUNO为OR=3.02,95%CI 2.60~3.50;MUO为OR=3.26,95%CI 2.87~3.70)和高PP水平(MUNO为OR=2.56,95%CI 2.17~3.02;MUO为OR=3.49,95%CI 3.01~4.06)患病风险显著升高。结论中国社区中老年人群中,MHO与动脉粥样硬化患病风险升高有显著相关性。Objective To investigate the association between metabolically healthy obesity(MHO)and atherosclerosis risk among Chinese community population aged 40 or older.Methods A total of 9525 participants without cardiovascular diseases(3621 men and 5904 women)from Jiading community in Shanghai were enrolled to complete questionnaires,undergo extensive physical examination including brachial-ankle pulse wave velocity(baPWV)and blood pressure(BP)assessment,and laboratory screening.According to body mass index(BMI)and metabolic status,these participants were categorized into 4 groups including metabolically healthy non-obese(MHNO),metabolically unhealthy non-obese(MUNO),MHO,and metabolically unhealthy obese(MUO).High baPWV was defined as baPWV>1400 mm/s,and high pulse pressure(PP)was defined as PP above fourth quartile of the population.Multivariate logistic regression model was conducted to explore the relationship between MHO and high baPWV as well as high PP after adjusting for confounders.Results After multivariable adjustment,such as sex,age,current smoking,current drinking,and education,logistic regression analysis showed that MHO was significantly correlated with high baPWV(OR=1.18,95%CI 1.02-1.37)and high PP(OR=1.72,95%CI 1.43-2.08)in comparison with MHNO.Otherwise,both MUNO and MUO subjects were at higher risk for suffering from high baPWV(MUNO:OR=3.02,95%CI 2.60-3.50;MUO:OR=3.26,95%CI 2.87-3.70)and high PP(MUNO:OR=2.56,95%CI 2.17-3.02;MUO:OR=3.49,95%CI 3.01-4.06).Conclusion On the basis of Chinese community population,there was a pronounced correlation between the MHO phenotype and the increased risk of developing atherosclerosis.

关 键 词：代谢健康型肥胖 动脉粥样硬化 肱踝脉搏波传导速度 脉压差 

分 类 号：R589.2[医药卫生—内分泌] R543.5[医药卫生—内科学]