"肥胖,代谢异常和轻度炎症:与亚临床动脉样硬化的差异关联"
Sergio González1, Máximo Schiavone2, Federico Piñero3
1Cardiometabolic Centre, Cardiology Department, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.
Frontiers in cardiovascular medicine
|October 1, 2025
概括
代谢健康的肥胖个体没有增加动脉样硬化风险. 代谢异常和炎症,而不是肥胖本身,是初级保健患者动脉样硬化发展的关键驱动因素.
科学领域:
- 心脏病学 心脏病学
- 代谢健康 代谢健康
- 公共卫生 公共卫生
背景情况:
- 肥胖是动脉样硬化的一个已知的危险因素,但最近的证据提出了相互矛盾的发现.
- 肥胖,代谢异常 (MAs) 和动脉样硬化发展中的低级炎症之间的相互作用需要进一步调查.
研究的目的:
- 确定肥胖或与MA和炎症的关联是否与动脉样硬化有更显著的联系.
- 在初级保健环境中评估动脉样硬化在不同肥胖和代谢健康现象型中的患病率.
主要方法:
- 一项横截面研究分析了心脏代谢风险因子注册表 (CARFARE) 的6735名参与者的数据.
- 参与者被分为代谢健康的非肥胖 (MHNO),代谢健康的肥胖 (MHO),代谢不健康的非肥胖 (MUNO) 和代谢不健康的肥胖 (MUO) 组.
- 动脉样硬化患病率使用单变量和多变量逻辑回归进行评估,考虑MA和中性粒细胞 (NEU) 炎症计数.
主要成果:
- 在单变量分析中,动脉样硬化在肥胖个体 (57.1%) 和非肥胖个体 (52.0%) 中更为普遍.
- 然而,MUNO和MUO组的动脉样硬化率 (60.4%,59.5%) 与MHNO和MHO组 (33.1%,34.4%) 相比显著更高.
- 多变量分析显示,MAS和NEU数量独立地与动脉样硬化相关,而仅仅肥胖并非如此. 与MHNO相比,MHO组在动脉样硬化方面没有差异.
结论:
- 在这种初级保健人群中,代谢健康的肥胖表型与动脉样硬化增加无关.
- 代谢异常和炎症是动脉样硬化比肥胖本身更重要的独立预测因素.
- 建议进行进一步的纵向研究,以阐明肥胖,代谢健康和动脉样硬化进展之间的复杂相互作用.
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