[Objectives]Metabolic obese normal weight(MONW)is becoming one of the pubic problems which are threatening human health.Whereas,MONW was facing a great challenge for limited attention,especially for the female in Chin...[Objectives]Metabolic obese normal weight(MONW)is becoming one of the pubic problems which are threatening human health.Whereas,MONW was facing a great challenge for limited attention,especially for the female in China.The aim of this research was to estimate the prevalence of MONW and its related risk components in South China.[Methods]A community-based cross-sectional study was performed on 3349 residents aged 18-93 years in The First Affiliated Hospital of Jinan University,Guangzhou,China,in 2019.Data was collected by physical examination data which included physical measurements and laboratory examinations.[Results]In all subjects,55%were females(M/F=1509/1840).The prevalence of MONW was 16.09%(0.04%for male,16.05%for female,P<0.001).The prevalence increased significantly with increasing age in both genders(P<0.001).The binary logistic regression analysis shows that among the risk factors with MONW,age,BMI,gender,systolic pressure,hypertension[Male:ORs=2.56,95%CI(1.23,5.32);Female:ORs=2.88,95%CI(1.76,4.71)]and hypertriglyceridemia[Male:ORs=3.23,95%CI(1.67,6.19);Female:ORs=2.57,95%CI(1.64,4.03)]were found to be statistically significant.The level of ALT in MONW group was(27.88±15.85)in male and(24.33±15.75)in female,which were significantly higher than those in the non-MetS group.[Conclusions]The prevalence of MONW was pretty high.We considered MONW be significantly associated with the increase of ALT.Female gender,advanced age,and elevated ALT were independent risk factors for MONW.It was high time that the government should raise the public attention toward metabolic function in normal weight population.Effective prevention and treatment strategies for MONW and its risk factors should be developed targeting different ages and genders.展开更多
Background Not only the obese, but also the non-obese adults have the high prevalence of metabolic syndrome in the upper normal weight. The aim of this study was to assess the prevalence rates of metabolic syndrome an...Background Not only the obese, but also the non-obese adults have the high prevalence of metabolic syndrome in the upper normal weight. The aim of this study was to assess the prevalence rates of metabolic syndrome and its individual components in non-obese adult Taiwan Residents （body mass index （BMI） ≤ 26.9 kg/m^2）. Methods A cross-sectional study was conducted from January 2006 to December 2007. One thousand six hundred and fifty-nine subjects （aged 47.5±12.4 years）, 60.8% of which were men, were enrolled. The prevalence and odds ratios of metabolic syndrome, defined by the American Heart Association/National Heart, Lung and Blood Institute （2005）, were analyzed in the BMI category according to 2.0 unit increments, in individuals seeking a health examination. Results The higher the BMI categories, the more prevalent the metabolic syndrome was in women and in men （P 〈0.001）. Compared with those women with a BMI ≤20.9 kg/m^2, the odds ratios for metabolic syndrome in women were 1.3 （95% CI： 0.5-3.2） with BMI 21.0-22.9 kg/m^2, 3.0 （1.3-7.1） with BMI 23.0-24.9 kg/m^2, and 8.6 （3.6-20.8） for women with BMI 25.0-26.9 kg/m^2, after controlling for age, smoking status, alcohol consumption, betel nut chewing, blood routine, biochemical data, hepatitis B virus surface antigen and anti-hepatitis C virus. The corresponding odds ratios in men were 1.6 （0.6-4.2）, 3.7 （1.6-8.8）, and 9.9 （4.2-23.2）. Conclusions Individuals in the upper normal weight and slightly overweight BMI range have relatively high prevalence and increased risk of having metabolic syndrome. Therefore, physicians should screen metabolic syndrome in not only obese but also non-obese individuals for the prevention of cardiovascular disease.展开更多
Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid...Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.展开更多
目的分析体重正常代谢性肥胖(MONW)人群的血糖、血脂、氧化应激反应指标水平变化情况。方法将本院体检的25名体重正常代谢正常人群及同期收治的26例MONW患者、25例超重/肥胖代谢正常患者、25例超重/肥胖伴代谢异常患者、25例单纯2型糖尿...目的分析体重正常代谢性肥胖(MONW)人群的血糖、血脂、氧化应激反应指标水平变化情况。方法将本院体检的25名体重正常代谢正常人群及同期收治的26例MONW患者、25例超重/肥胖代谢正常患者、25例超重/肥胖伴代谢异常患者、25例单纯2型糖尿病(T2DM)患者分别设为MHNW组、MONW组、MHO组、MAO组、T2DM组。比较五组的血糖、血脂、氧化应激反应指标水平。结果MONW组的FBG、2 h PG水平及HbA1c、HOMA-IR高于MHNW组和MHO组,但低于MAO组和T2DM组(P<0.05);MAO组、MONW组和MHO组的腰臀比比较,差异不显著(P>0.05),但该三组的腰臀比均大于其余两组(P<0.05)。MONW组的TC、TG水平均高于MHNW组、MHO组和T2DM组,但低于MAO组;HDL-C水平低于MHNW组、MHO组和T2DM组,但高于MAO组(P<0.05)。MONW组的MDA水平高于MHNW组和MHO组,但低于MAO组和T2DM组;SOD、T-AOC水平低于MHNW组和MHO组,但高于MAO组和T2DM组(P<0.05)。结论相较于MHNW人群,MONW人群具有较高的血糖、血脂水平,且氧化应激反应严重,代谢紊乱明显,糖尿病患病风险高,临床应重视MONW人群的早诊断及治疗。展开更多
A metabolically healthy status,whether obese or not,is a transient stage with the potential to develop into metabolic disor-ders during the course of life.We investigated the incidence of metabolic disorders in 1078 m...A metabolically healthy status,whether obese or not,is a transient stage with the potential to develop into metabolic disor-ders during the course of life.We investigated the incidence of metabolic disorders in 1078 metabolically healthy Chinese adults from the Shanghai Changfeng Study and looked for metabolites that discriminated the participants who would develop metabolic disorders in the future.Participants were divided into metabolically healthy overweight/obesity(MHO)and meta-bolically healthy normal weight(MHNW)groups according to their body mass index(BMI)and metabolic status.Their serum metabolomic profile was measured using a ^(1)H nuclear magnetic resonance spectrometer(^(1)H-NMR).The prevalence of diabetes,hypertriglyceridemia,hypercholesterolemia and metabolic syndrome was similar between the MHNW and MHO participants at baseline.After a median of 4.2 years of follow-up,more MHO participants became metabolically unhealthy than MHNW participants.However,a subgroup of MHO participants who remained metabolically healthy(MHO→MHO)had a similar prevalence of metabolic disorders as the MHNW participants at the follow-up examination,despite a signifi-cant reduction in their serum concentrations of high-density lipoprotein(HDL)and an elevation in valine,leucine,alanine and tyrosine.Further correlation analysis indicated that serum intermediate-density lipoprotein(IDL)and very low-density lipoprotein cholesterol(VLDL-CH)might be involved in the transition from metabolically healthy to unhealthy status and could be valuable to identify the MHNW and MHO with increased metabolic risks.展开更多
The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic.The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view,in which the overloaded a...The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic.The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view,in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver,elicits inflammation,and changes its adipokines profile promoting insulin resistance and the metabolic syndrome.Up to 40%of nonalcoholic fatty liver disease(NAFLD)patients are not obese and up to 20%are actually lean.Furthermore roughly 10%of lean subjects have NAFLD.In fact,adiposopathy can occur in patients with normal weight,and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance.This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction.Overweight/obese persons have higher probability of exceeding that threshold,explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese.In this article,the epidemiology,pathogenesis,and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals.展开更多
目的:探讨心率变异性(HRV)、心率减速力(DC)与正常体重肥胖(NWO)儿童青少年心血管代谢性疾病(CMD)的关系。方法:回顾性病例对照研究。纳入2022年12月至2023年6月在成都市妇女儿童中心医院正常体检的6~17岁儿童青少年200例,根据体重指数(...目的:探讨心率变异性(HRV)、心率减速力(DC)与正常体重肥胖(NWO)儿童青少年心血管代谢性疾病(CMD)的关系。方法:回顾性病例对照研究。纳入2022年12月至2023年6月在成都市妇女儿童中心医院正常体检的6~17岁儿童青少年200例,根据体重指数(BMI)和体脂比例(BF%)分为正常体重肥胖(NWO)组50例、正常体型(NWL)组51例、超重肥胖(OW-OB)组99例。均行24 h动态心电图记录,自动计算正常窦性N-N间期标准差(SDNN)、全部记录中每5 min N-N间期平均值的标准差(SDANN)、相邻N-N间期标准差的平均值(SDNNindex)、相邻N-N间期差值的均方根值(rMSSD)、相邻N-N间期差值>50 ms的心搏数占心搏总数的百分比(pNN50)等HRV指标和DC;测量血压,检测血糖和血脂,累计积分得出心血管代谢性疾病风险评分(CRS)。采用方差分析比较3组一般资料、SDNN、SDANN、SDNNindex、rMSSD、pNN50、DC和CRS指标,采用Spearman相关性分析和多元Logistic回归分析影响CRS的危险因素。结果:3组年龄、性别等一般资料比较差异均无统计学意义(均P>0.05)。NWO组、NWL组和OW-OB组的SDNN[(120.88±16.36)ms比(129.07±16.36)ms比(109.29±16.38)ms,F=26.231,P<0.001]、SDANN[(64.44±11.61)ms比(66.25±8.34)ms比(61.70±6.85)ms,F=5.048,P=0.007]、rMSSD[(27.02±3.87)ms比(27.51±5.92)ms比(25.12±6.78)ms,F=3.328,P=0.038]、pNN50[(12.62±4.04)%比(13.39±2.26)%比(11.22±2.93)%,F=9.099,P<0.001]、DC[(4.83±0.20)ms比(4.94±0.33)ms比(4.63±0.28)ms,F=23.496,P<0.001],CRS(0.94±0.87比0.69±0.19比1.57±1.07)比较差异均有统计学意义。Spearman相关性分析显示,BMI(r=0.211,P=0.003)、BF%(r=0.558,P<0.001)与CRS呈正相关,SDNN(r=-0.258,P<0.001)、DC(r=-0.499,P<0.001)与CRS呈负相关。多元Logistic回归分析显示,BF%(95%CI:0.098~0.265,P<0.001)和DC(95%CI:-3.962~-1.391,P<0.001)是预测CMD的独立危险因素。结论:BF%升高与DC下降是CMD的独立危险因素。对儿童青少年进行体成分和HRV分析有助于更准确地识别潜在高风险人群,早期干预,降低CMD患病风险。展开更多
基金Projects of Administration of Traditional Chinese Medicine of Guangdong Province of China(20182022,20182023,20191083)General Program of the National Natural Science Foundation of China(82074305)Laboratory Construction of Traditional Chinese Medicine of Guangdong Province of China(89017020).
文摘[Objectives]Metabolic obese normal weight(MONW)is becoming one of the pubic problems which are threatening human health.Whereas,MONW was facing a great challenge for limited attention,especially for the female in China.The aim of this research was to estimate the prevalence of MONW and its related risk components in South China.[Methods]A community-based cross-sectional study was performed on 3349 residents aged 18-93 years in The First Affiliated Hospital of Jinan University,Guangzhou,China,in 2019.Data was collected by physical examination data which included physical measurements and laboratory examinations.[Results]In all subjects,55%were females(M/F=1509/1840).The prevalence of MONW was 16.09%(0.04%for male,16.05%for female,P<0.001).The prevalence increased significantly with increasing age in both genders(P<0.001).The binary logistic regression analysis shows that among the risk factors with MONW,age,BMI,gender,systolic pressure,hypertension[Male:ORs=2.56,95%CI(1.23,5.32);Female:ORs=2.88,95%CI(1.76,4.71)]and hypertriglyceridemia[Male:ORs=3.23,95%CI(1.67,6.19);Female:ORs=2.57,95%CI(1.64,4.03)]were found to be statistically significant.The level of ALT in MONW group was(27.88±15.85)in male and(24.33±15.75)in female,which were significantly higher than those in the non-MetS group.[Conclusions]The prevalence of MONW was pretty high.We considered MONW be significantly associated with the increase of ALT.Female gender,advanced age,and elevated ALT were independent risk factors for MONW.It was high time that the government should raise the public attention toward metabolic function in normal weight population.Effective prevention and treatment strategies for MONW and its risk factors should be developed targeting different ages and genders.
文摘Background Not only the obese, but also the non-obese adults have the high prevalence of metabolic syndrome in the upper normal weight. The aim of this study was to assess the prevalence rates of metabolic syndrome and its individual components in non-obese adult Taiwan Residents （body mass index （BMI） ≤ 26.9 kg/m^2）. Methods A cross-sectional study was conducted from January 2006 to December 2007. One thousand six hundred and fifty-nine subjects （aged 47.5±12.4 years）, 60.8% of which were men, were enrolled. The prevalence and odds ratios of metabolic syndrome, defined by the American Heart Association/National Heart, Lung and Blood Institute （2005）, were analyzed in the BMI category according to 2.0 unit increments, in individuals seeking a health examination. Results The higher the BMI categories, the more prevalent the metabolic syndrome was in women and in men （P 〈0.001）. Compared with those women with a BMI ≤20.9 kg/m^2, the odds ratios for metabolic syndrome in women were 1.3 （95% CI： 0.5-3.2） with BMI 21.0-22.9 kg/m^2, 3.0 （1.3-7.1） with BMI 23.0-24.9 kg/m^2, and 8.6 （3.6-20.8） for women with BMI 25.0-26.9 kg/m^2, after controlling for age, smoking status, alcohol consumption, betel nut chewing, blood routine, biochemical data, hepatitis B virus surface antigen and anti-hepatitis C virus. The corresponding odds ratios in men were 1.6 （0.6-4.2）, 3.7 （1.6-8.8）, and 9.9 （4.2-23.2）. Conclusions Individuals in the upper normal weight and slightly overweight BMI range have relatively high prevalence and increased risk of having metabolic syndrome. Therefore, physicians should screen metabolic syndrome in not only obese but also non-obese individuals for the prevention of cardiovascular disease.
文摘Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.
文摘目的分析体重正常代谢性肥胖(MONW)人群的血糖、血脂、氧化应激反应指标水平变化情况。方法将本院体检的25名体重正常代谢正常人群及同期收治的26例MONW患者、25例超重/肥胖代谢正常患者、25例超重/肥胖伴代谢异常患者、25例单纯2型糖尿病(T2DM)患者分别设为MHNW组、MONW组、MHO组、MAO组、T2DM组。比较五组的血糖、血脂、氧化应激反应指标水平。结果MONW组的FBG、2 h PG水平及HbA1c、HOMA-IR高于MHNW组和MHO组,但低于MAO组和T2DM组(P<0.05);MAO组、MONW组和MHO组的腰臀比比较,差异不显著(P>0.05),但该三组的腰臀比均大于其余两组(P<0.05)。MONW组的TC、TG水平均高于MHNW组、MHO组和T2DM组,但低于MAO组;HDL-C水平低于MHNW组、MHO组和T2DM组,但高于MAO组(P<0.05)。MONW组的MDA水平高于MHNW组和MHO组,但低于MAO组和T2DM组;SOD、T-AOC水平低于MHNW组和MHO组,但高于MAO组和T2DM组(P<0.05)。结论相较于MHNW人群,MONW人群具有较高的血糖、血脂水平,且氧化应激反应严重,代谢紊乱明显,糖尿病患病风险高,临床应重视MONW人群的早诊断及治疗。
基金supported by the Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)the Science and Technology Commission of Shanghai Municipality(16JC1400500).
文摘A metabolically healthy status,whether obese or not,is a transient stage with the potential to develop into metabolic disor-ders during the course of life.We investigated the incidence of metabolic disorders in 1078 metabolically healthy Chinese adults from the Shanghai Changfeng Study and looked for metabolites that discriminated the participants who would develop metabolic disorders in the future.Participants were divided into metabolically healthy overweight/obesity(MHO)and meta-bolically healthy normal weight(MHNW)groups according to their body mass index(BMI)and metabolic status.Their serum metabolomic profile was measured using a ^(1)H nuclear magnetic resonance spectrometer(^(1)H-NMR).The prevalence of diabetes,hypertriglyceridemia,hypercholesterolemia and metabolic syndrome was similar between the MHNW and MHO participants at baseline.After a median of 4.2 years of follow-up,more MHO participants became metabolically unhealthy than MHNW participants.However,a subgroup of MHO participants who remained metabolically healthy(MHO→MHO)had a similar prevalence of metabolic disorders as the MHNW participants at the follow-up examination,despite a signifi-cant reduction in their serum concentrations of high-density lipoprotein(HDL)and an elevation in valine,leucine,alanine and tyrosine.Further correlation analysis indicated that serum intermediate-density lipoprotein(IDL)and very low-density lipoprotein cholesterol(VLDL-CH)might be involved in the transition from metabolically healthy to unhealthy status and could be valuable to identify the MHNW and MHO with increased metabolic risks.
文摘The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic.The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view,in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver,elicits inflammation,and changes its adipokines profile promoting insulin resistance and the metabolic syndrome.Up to 40%of nonalcoholic fatty liver disease(NAFLD)patients are not obese and up to 20%are actually lean.Furthermore roughly 10%of lean subjects have NAFLD.In fact,adiposopathy can occur in patients with normal weight,and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance.This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction.Overweight/obese persons have higher probability of exceeding that threshold,explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese.In this article,the epidemiology,pathogenesis,and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals.
文摘目的:探讨心率变异性(HRV)、心率减速力(DC)与正常体重肥胖(NWO)儿童青少年心血管代谢性疾病(CMD)的关系。方法:回顾性病例对照研究。纳入2022年12月至2023年6月在成都市妇女儿童中心医院正常体检的6~17岁儿童青少年200例,根据体重指数(BMI)和体脂比例(BF%)分为正常体重肥胖(NWO)组50例、正常体型(NWL)组51例、超重肥胖(OW-OB)组99例。均行24 h动态心电图记录,自动计算正常窦性N-N间期标准差(SDNN)、全部记录中每5 min N-N间期平均值的标准差(SDANN)、相邻N-N间期标准差的平均值(SDNNindex)、相邻N-N间期差值的均方根值(rMSSD)、相邻N-N间期差值>50 ms的心搏数占心搏总数的百分比(pNN50)等HRV指标和DC;测量血压,检测血糖和血脂,累计积分得出心血管代谢性疾病风险评分(CRS)。采用方差分析比较3组一般资料、SDNN、SDANN、SDNNindex、rMSSD、pNN50、DC和CRS指标,采用Spearman相关性分析和多元Logistic回归分析影响CRS的危险因素。结果:3组年龄、性别等一般资料比较差异均无统计学意义(均P>0.05)。NWO组、NWL组和OW-OB组的SDNN[(120.88±16.36)ms比(129.07±16.36)ms比(109.29±16.38)ms,F=26.231,P<0.001]、SDANN[(64.44±11.61)ms比(66.25±8.34)ms比(61.70±6.85)ms,F=5.048,P=0.007]、rMSSD[(27.02±3.87)ms比(27.51±5.92)ms比(25.12±6.78)ms,F=3.328,P=0.038]、pNN50[(12.62±4.04)%比(13.39±2.26)%比(11.22±2.93)%,F=9.099,P<0.001]、DC[(4.83±0.20)ms比(4.94±0.33)ms比(4.63±0.28)ms,F=23.496,P<0.001],CRS(0.94±0.87比0.69±0.19比1.57±1.07)比较差异均有统计学意义。Spearman相关性分析显示,BMI(r=0.211,P=0.003)、BF%(r=0.558,P<0.001)与CRS呈正相关,SDNN(r=-0.258,P<0.001)、DC(r=-0.499,P<0.001)与CRS呈负相关。多元Logistic回归分析显示,BF%(95%CI:0.098~0.265,P<0.001)和DC(95%CI:-3.962~-1.391,P<0.001)是预测CMD的独立危险因素。结论:BF%升高与DC下降是CMD的独立危险因素。对儿童青少年进行体成分和HRV分析有助于更准确地识别潜在高风险人群,早期干预,降低CMD患病风险。
