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  • 江 浩,蒋晓敏,沈秀华,等.上海市体检人群代谢健康型超重和肥胖检出率及其5年随访分析[J].同济大学学报(医学版),2020,41(4):454-459.    [点击复制]
  • JIANG Hao,JIANG Xiao-min,SHEN Xiu-hua,et al.Prevalence of metabolically healthy overweight/obesity in health check-up population: a five-year follow-up[J].同济大学学报(医学版),2020,41(4):454-459.   [点击复制]
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上海市体检人群代谢健康型超重和肥胖检出率及其5年随访分析
江浩,蒋晓敏,沈秀华,万燕萍,范竹萍,徐仁应
0
(上海交通大学医学院附属仁济医院临床营养科,上海 200127;上海交通大学医学院营养系,上海 200025;上海交通大学医学院附属仁济医院消化科,上海 200127)
摘要:
目的 研究体检人群中代谢健康型超重和肥胖检出率及5年随访期间内代谢健康型超重和肥胖的演变情况。方法 以2013—2018年间在上海交通大学医学院附属仁济医院体检中心进行体检的人群作为研究对象。采集身高、体重并计算BMI,测量血压,收集糖代谢指标、脂代谢指标、超敏C反应蛋白、血清尿酸和肝脏B超结果。代谢健康型定义为血压、糖代谢、脂代谢、血清尿酸均正常且无脂肪肝。所有代谢健康型人群进一步根据基线时(2013年)BMI分为体重和代谢均正常、代谢健康型超重和代谢健康型肥胖3组。结果 共64164人(男性38134人,女性26030人)纳入本研究。平均年龄(42.0±12.0)岁,BMI为(23.8±3.2) kg/m2。本组人群中代谢健康型检出率28.7%(18448人),其中代谢和BMI均正常占78.9%、代谢健康型超重占19.0%,代谢健康型肥胖2.1%。5年随访期间内,代谢健康型的人群中共9318人转变为代谢不健康型(50.5%)。在控制多种混杂因素后,与体重和代谢均正常的人群相比,代谢健康型超重和代谢健康型肥胖的人群转化为代谢不健康型的危险性分别增加11.0%(HR=1.11;95%CI: 1.05~1.18)和16.0%(HR=1.16;95%CI: 1.01~1.33)。结论 代谢健康型超重和肥胖的合计检出率为6.1%。与代谢与BMI均正常的人群相比,代谢健康型超重和肥胖转化为不健康的危险性显著增加。
关键词:  代谢健康型  超重  肥胖  代谢不健康型  随访研究
DOI:10.16118/j.1008-0392.2020.04.009
投稿时间:2020-02-04
基金项目:
Prevalence of metabolically healthy overweight/obesity in health check-up population: a five-year follow-up
JIANG Hao,JIANG Xiao-min,SHEN Xiu-hua,WAN Yan-ping,FAN Zhu-ping,XU Ren-ying
(Dept. of Clinical Nutrition, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Dept. of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Dept. of Gatroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China)
Abstract:
Objective To evaluate the prevalence of metabolically healthy overweight and obesity in health check-up population and the risk of developing metabolically unhealthy status in five years. Methods Participants were recruited from people undergoing health check-up in Healthy Management Center, Renji Hospital, School of medicine, Shanghai Jiao Tong University from 2013 to 2018. The information of age, sex, height, body weight, BMI, blood pressure, glucose parameters, lipid profile, serum uric acid, and liver echography were collected. Metabolically healthy was defined as subjects with normal blood pressure, glucose parameters, lipid profile, high sensitivity C-reactive protein (hs-CRP),uric acid level, and without fatty liver. Participants with metabolically healthy were further classified into three groups based on baseline BMI: metabolically healthy and normal BMI, metabolically healthy overweight, and metabolically healthy obesity. Results A total of 64164 participants (38134 males and 26030 females) were included in the study. The average age and BMI was 42.0±12.0 years and 23.8±3.2kg/m2, respectively. The prevalence of overall metabolically healthy was 28.7% (18448/64164): metabolically healthy and normal BMI (78.9%), metabolically overweight (19.0%), and metabolically healthy obesity (2.1%). During five years of follow-up, 9318 out of 18448 metabolically healthy subjects (50.5%) were converting to metabolically unhealthy. Compared with participants whose BMI and metabolic status were normal, metabolically healthy overweight and obesity participants were associated with 11.0% (HR=1.11; 95%CI: 1.05-1.18) and 16.0% (HR=1.16; 95%CI: 1.01-1.33) increasing risk of converting to metabolically unhealthy status after adjusting for a series of potential confounders. Conclusion The overall prevalence of metabolically overweight and obesity was 6.1% in this healthy check-up population. Compared with subjects whose BMI and metabolic status were normal, metabolically healthy overweight and obesity subjects are associated with a increasing risk of converting to metabolically unhealthy status.
Key words:  metabolically healthy phenotype  overweight  obesity  metabolically unhealthy phenotype  cohort study

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