Prevalence of Metabolically Healthy Obesity and Its Impacts on Incidences of Hypertension, Diabetes and the Metabolic Syndrome in Taiwan

正常代謝水準之肥胖狀態在臺灣之盛行率及其對於高血壓、糖尿病和代謝症候群發生率的影響

Lee-Ching Hwang ； Chyi-Huey Bai ； Chien-An Sun ； Chien-Jen Chen

《Asia Pacific Journal of Clinical Nutrition》 21卷2期 (2012/06) Pp. 227-233

https://doi.org/10.6133/apjcn.2012.21.2.09

摘要

肥胖是與代謝疾病和心臟血管疾病罹病率及死亡率密切相關之流行性健康問題。然而，對於具有正常代謝水準之肥胖狀態，其罹患代謝疾病和心臟血管疾病的危險性所知有限。本研究是以具有全國代表性之研究世代為研究個案，探討具有正常代謝水準之肥胖狀態盛行率及其對於代謝疾病和心臟血管疾病發生率的影響。納入分析之研究個案數為1,547人（年齡介於18-59歲）。這些納入分析的研究個案在基礎收案時，除了腰圍一項外，並未具有代謝症候群之其他危險因子。研究結果發現，在此一研究世代族群中，具有正常代謝水準而肥胖之盛行率為8.2%；而在肥胖族群中具有正常代謝水準之比率為28.5%。在平均5.4年的追蹤過程中，研究世代之高血壓、第二型糖尿病及代謝症候群之累積發生率分別為7.8%、1.2%及5.6%。罹患代謝症候群之相對危險性隨著身體質量指數的增加而顯著的增加：相對於身體質量指數為18.5-22.9 kg/m^2，身體質量指數為23.0-24.9 kg/m^2者之相對危險性為4.68（95%信賴區間為2.22-9.86）；身體質量指數為25.0-26.9 kg/m^2者之相對危險性為8.82（95%信賴區間：4.01-19.4）；身體質量指數≧27.0 kg/m^2者之相對危險性為24.4 （95%信賴區間：12.3-48.4）。同時，身體質量指數每增加1 kg/m^2，罹患高血壓的危險性提高了18%，而罹患代謝症候群之危險性增加26%。本研究結果顯示，具正常代謝水準之肥胖狀態仍有罹患高血壓、第二型糖尿病及代謝症候群的高危險性。本研究結果並不支持具有正常代謝水準之肥胖狀態為一無健康危害狀態的論點。

關鍵字

正常代謝水準的肥胖 ； 第二型糖尿病 ； 高血壓 ； 代謝症候群 ； 發生率

並列摘要

Obesity is an epidemic health problem related to morbidity and mortality of metabolic and cardiovascular diseases. However, little is known regarding the development of cardiometabolic diseases in an obese subgroup with a healthy metabolic risk profile. This study examined the prevalence of baseline metabolically healthy obese subjects and its impacts on the incidences of cardiometabolic diseases using a nation-wide population cohort. Metabolically healthy obese were prevalent in 8.2% of the baseline population and 28.5% of the obese subjects. Subjects included were 1,547 men and women (age range, 18-59 years), who were free of components of the metabolic syndrome except waist criteria. During an average 5.4-year follow-up, the cumulative incidences of hypertension, type 2 diabetes and the metabolic syndrome were 7.8%, 1.2% and 5.6%, respectively. The hazard ratios (95% CIs) for the metabolic syndrome incidence were significantly higher at BMI levels of ≥23.0 kg/m^2 [4.68 (2.22-9.86)] for BMI of 23-24.9 kg/m^2; 8.82 (4.01-19.4) for BMI of 25-26.9 kg/m^2; and 24.4 (12.3-48.4) for BMI of ≥27 kg/m^2). The hazard ratios for diabetes or hypertension incidence were significantly higher at BMI levels of ≥25.0 kg/m^2. Each kg/m^2 of BMI gained was associated with an 18% increase in the risk of developing hypertension and a 26% increase in risk for the metabolic syndrome. We conclude that metabolically healthy obese individuals are at higher risk to develop hypertension, type 2 diabetes and the metabolic syndrome than their non-obese counterparts. Our data provide further evidence that opposes the notion of metabolically healthy obese as harmless conditions.

並列關鍵字

metabolically healthy obesity ； type 2 diabetes mellitus ； hypertension ； the metabolic syndrome ； incidence