陕西省城市成年人群肥胖代谢表型异质性流行病学特征分析

景慧; 滕雨芯; SamuelSteven Chacha; 石国帅; 李晶; 杜玉娇; 颜虹; 党少农

doi:10.11847/zgggws1136326

陕西省城市成年人群肥胖代谢表型异质性流行病学特征分析

Epidemiological characteristics of metabolic phenotypic heterogeneity in adults with obesity in Shaanxi province

摘要

摘要:
目的了解陕西省城市成年人群肥胖代谢表型异质性的流行特征，为肥胖代谢表型的个体分层化识别和分类管理提供可靠依据。
方法收集2017 — 2019年中国西北区域自然人群队列研究陕西城市队列基线调查中13072名20 ～ 89岁无重大疾病城市成年人群的相关数据，以肥胖和代谢异常状况区分人群的肥胖代谢亚型为代谢健康型非肥胖（MHNO）、代谢不健康型非肥胖（MUNO）、代谢健康型肥胖（MHO）和代谢不健康型肥胖（MUO），对比分析不同肥胖代谢表型人群的异质性及流行病学特征。
结果陕西省13072名城市成年人群中，MHNO者8700人（66.55 %），MUNO者2949人（22.56 %），MHO者535人（4.09 %），MUO者888人（6.79 %）。在男性人群中，MHNO、MUNO、MHO和MUO者比例分别为55.8 %、27.9 %、6.1 %和10.2 %，肥胖代谢表型随年龄的增加而变化（χ²_趋势 = 9.143，P_趋势 = 0.002）；MUNO的比例随年龄的增加而上升（χ²_趋势 = 217.096，P_趋势 < 0.001），NHNO和MHO的比例均随年龄的增加而下降（均P_趋势 < 0.001）。在女性人群中，MHNO、MUNO、MHO和MUO者比例分别为55.8 %、27.9 %、4.09 %和6.79 %，肥胖代谢表型随年龄的增加而变化（χ²_趋势 = 486.235，P_趋势 < 0.001）；MUNO、MHO和MUO的比例均随年龄的增加而上升（均P_趋势 < 0.05），NHNO的比例随年龄的增加而下降（χ²_趋势 = 738.600，P_趋势 < 0.001）。当肥胖标准从BMI ≥ 28变为BMI ≥ 25时，MHO的比例从4.09 %增加至16.06 %；当代谢异常标准从 ≥ 2项指标异常变为 ≥ 0项指标异常时，MHO的比例从4.09 %降低至1.02 %。
结论陕西省城市成年人群肥胖代谢异质性明显，存在肥胖且代谢正常的人群但比例较低，而肥胖人群的代谢异常问题较为突出。

Abstract:
Objective To examine epidemic characteristics of obesity metabolic phenotype heterogeneity among urban adults in Shaanxi province, and to provide evidences for individualy stratified identification and classification management of obesity metabolic phenotype.
Methods Data on 13 072 urban adults aged 20 – 89 years without major diseases were collected from Shaanxi Urban Cohort Baseline Survey of Natural Population Cohort Study in Northwest China conducted from 2017 to 2019. According to the status of obesity and metabolic abnormality, the adults were further divided into four subgroups of metabolic healthy non-obesity (MHNO), metabolic unhealthy non-obesity (MUNO), metabolic healthy obesity (MHO) and metabolic unhealthy obesity (MUO), and the heterogeneity and epidemiological characteristics of different obesity metabolic phenotype groups were analyzed.
Results Of all the adults, the majority (66.55%, 8 700) were with MHNO, followed by those with MUNO (22.56%, 2 949), MHO (4.09%, 535) and MUO (6.79%, 888). For the male adults, the proportion of MHNO, MUNO, MHO and MUO population was 55.8%, 27.9%, 6.1% and 10.2%, respectively; the metabolic phenotype of obesity changed with age (χ²_trend = 9.143, P_trend = 0.002), with the proportion of MUNO increasing with the increase of age (χ²_trend = 217.096, P_trend < 0.001) and the proportions of NHNO and MHO decreasing with the increase of age (both P_trend < 0.001). For the female adults, the proportion of MHNO, MUNO, MHO and MUO were 55.8%, 27.9%, 4.09% and 6.79%, and the proportion also changed with age (χ²_trend = 486.235, P_trend < 0.001); the proportion of MUNO, MHO and MUO increased with the increase of age (P_trend < 0.05 all) but the proportion of MHNO decreased with the increase of age (χ²_trend = 738.600, P_trend < 0.001). When the obesity standard changed from body mass index (BMI) ≥ 28.0 to BMI ≥ 25.0, the proportion of MHO increased from 4.09% to 16.06%; when the metabolic abnormality criterion changed from ≥ 2 to ≥ 0, the proportion of MHO decreased from 4.09% to 1.02%.
Conclusion The metabolic heterogeneity of obesity exists obviously among urban adults in Shaanxi province; the proportion of the adults with obesity but normal metabolism is low, while the metabolic abnormality is prominent in obese adults.

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