不同代谢肥胖表型与颈动脉内膜中层厚度的相关性研究

Association of carotid intima-media thickness and metabolic health and obesity status

目的探讨不同代谢肥胖表型与颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)的关系。方法对北京市社区居民进行一般人口学调查,血糖、血脂等检测,CIMT测量及身高、体重等体格检查。根据代谢正常或异常及体质指数(body mass index,BMI)正常或肥胖组合形成的四种代谢肥胖表型将研究对象分组,分析其与CIMT的相关性。结果共纳入1 648名研究对象,平均年龄为(55.4±11.0)岁,男性占45.8%。多因素Logistic回归显示,在调整了年龄、性别、教育程度、吸烟、饮酒、活动情况、糖尿病家族史、低密度脂蛋白胆固醇(lowdensity lipoprotein cholesterol,LDL-C)后,与代谢正常体重正常组相比,代谢异常体重正常(OR=1.61,95%CI:1.01~2.56,P=0.046)和代谢异常肥胖组(OR=2.10,95%CI:1.32~3.32,P=0.002)CIMT增厚的风险较大。结论代谢异常体重正常表型和代谢异常肥胖表型可能是CIMT增厚的危险因素,而代谢正常肥胖表型的CIMT增厚风险无差异,提示代谢异常相较肥胖可能对动脉粥样硬化风险影响更大。

Objective To explore the relationship between carotid intima-media thickness （CIMT） and metabolic health and obesity status. Methods A community-based study was conducted in rural communities in Beijing. Biochemical test, CIMT measurement, physical examination and questionnaire investigation were performed, Participants were divided into four groups according to their metabolic status and body mass index （BMI） to analyze the relationship between CI- MT and metabolic health and obesity status. Results A total of 1 648 participants were recruited. The average age was （55.4 ± 11.0） years old and men accounted for 45.8%. Logistic regression analysis showed that after adjusting for age, gender, smoke, drink, education, physical activity, diabetes family history and low-density lipoprotein cholesterol （LDL- C） , the CIMT thickening rate were higher in metabolically unhealthy normal weight group （OR = 1.61, 95% CI： 1.01- 2. 56, P =0. 046） and metabolically unhealthy obesity group （ OR =2.10, 95% CI： 1.32-3.32, P =0. 002） than that in metabolically healthy normal weight group. Conclusion Metabolically unhealthy normal weight and metabolically unhealthy obesity might be risk factors for CIMT thickening, indicating that metabolically unhealthy status might have more in- fluence on the development of atherosclerosis than obesity.