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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Subclinical Risk Markers for Cardiovascular Disease (CVD) in Metabolically Healthy Obese (MHO) Subjects
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Subclinical Risk Markers for Cardiovascular Disease (CVD) in Metabolically Healthy Obese (MHO) Subjects

机译：代谢健康肥胖（MHO）受试者中心血管疾病（CVD）的亚临床风险标志物

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Metabolically Healthy Obesity/Metabolic Healthy Obesity (MHO) is an enigma in scientific medical literature. Debate is still on regarding the safety status of MHO phenotype. The general consensus states that it is a condition with obesity but lacking metabolic abnormalities such as dyslipidemia, impaired glucose tolerance, or Metabolic Syndrome (MS). MHO population has less visceral adipose tissue, and a decreased inflammatory profile as compared to MS.Aim: To assess subclinical cardiovascular risk markers like Carotid Intima-Media Thickness (CIMT), Non Alcoholic Fatty Liver Disease (NAFLD) and high sensitivity C-reactive Protein (hs-CRP) level in MHO subjects.Materials and Methods: This cross-sectional study was done in a tertiary care hospital conducted for a period of three years from January 2016 to January 2019. After obtaining institutional ethical clearance, this cross-sectional study was conducted on 222 MHO subjects, 65 MS and 81 Metabolic Healthy Non Obese (MHNO) subjects. Anthropometric data was obtained. Metabolic parameters like hs-CRP, CIMT and NAFLD status were estimated and compared with MS and MHNO group. The data was analysed using appropriate statistical significance tests.Results: In one way Analysis of Variance (ANOVA), anthropometric determinants and metabolic variables differed significantly across the groups (p<0.0001). The mean hs-CRP in MHO was; 4.01±1.68 versus control group; 2.16±0.56 (p<0.0001). Using Pearson?s correlation coefficient, significant positive correlation was found between the sub clinical CVD risk markers with other anthropometric and metabolic parameters. In multiple regression analysis body mass index Waist Circumference (WC), NAFLD and abnormal CIMT were significantly associated with elevated hs-CRP. The mean CIMT in MHO was; 0.74±0.17 versus control group; 0.65±0.14 (p<0.0001). In multiple regression analysis NAFLD and hs-CRP were significantly associated with CIMT values. Prevalence of NAFLD in MHO was 59.01%. In multiple regression analysis WC, CIMT and hsCRP were significantly associated with NAFLD. Adjusted Odd?s Ratio (AOR) for high hs-CRP, NAFLD, and abnormal CIMT in MHO as compared to MHNO was 1.98, 1.81, 1.61 respectively.Conclusion: MHO phenotype is associated with higher prevalence of fatty liver, increased hs-CRP levels and abnormal CIMT as compared to MHNO phenotype. This indicates that obesity even if associated with a healthy metabolic profile, still harbour subclinical inflammation. So subjects with MHO should be targeted for appropriate preventive strategies in form of health education, life style modifications to avoid future cardiovascular morbidities. MHO phenotype with evidence of subclinical vascu.
机译：代谢性健康肥胖/代谢性健康肥胖（MHO）是科学医学文献中的一个谜。关于MHO表型的安全性状况仍在争论中。普遍共识指出，这是一种肥胖症，但缺乏代谢异常，例如血脂异常，葡萄糖耐量降低或代谢综合征（MS）。与MS相比，MHO人群的内脏脂肪组织更少，并且炎症分布减少。目标：评估亚临床的心血管疾病危险指标，如颈动脉内膜中层厚度（CIMT），非酒精性脂肪肝病（NAFLD）和高敏感性MHO受试者中C反应蛋白（hs-CRP）水平。材料与方法：这项横断面研究是在2016年1月至2019年1月的三年期间在一家三级医院进行的。从伦理上讲，这项横断面研究是针对222名MHO受试者，65名MS和81名代谢健康非肥胖（MHNO）受试者进行的。获得人体测量数据。估计了诸如hs-CRP，CIMT和NAFLD状态的代谢参数，并与MS和MHNO组进行了比较。使用适当的统计显着性检验对数据进行分析。结果：在一种方差分析（ANOVA）中，各组的人体测量学决定因素和代谢变量差异显着（p <0.0001）。 MHO中的hs-CRP平均为对照组4.01±1.68; 2.16±0.56（p <0.0001）。使用皮尔森相关系数，发现亚临床CVD风险标志物与其他人体测量学和代谢参数之间存在显着正相关。在多元回归分析中，体重指数腰围（WC），NAFLD和异常CIMT与hs-CRP升高显着相关。 MHO的平均CIMT为;对照组为0.74±0.17; 0.65±0.14（p <0.0001）。在多元回归分析中，NAFLD和hs-CRP与CIMT值显着相关。 MHO中NAFLD的患病率为59.01％。在多元回归分析中，WC，CIMT和hsCRP与NAFLD显着相关。与MHNO相比，MHO中高hs-CRP，NAFLD和CIMT异常的调整后奇数比（AOR）分别为1.98、1.81、1.61。与MHNO表型相比，hs-CRP水平和CIMT异常。这表明，即使与健康的代谢状况有关，肥胖症仍具有亚临床炎症。因此，应该以健康教育，生活方式改变的形式，针对患有MHO的受试者采取适当的预防策略，以避免将来发生心血管疾病。具有亚临床血管的证据的MHO表型。

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