中国南方成年人群肥胖代谢表型与心肾代谢结局的关联

Associations between metabolic obesity phenotypes and cardiorenal metabolic outcomes in adults from Southern China

摘要

目的：评估中国南方地区成年人群不同肥胖代谢表型与高血压、慢性肾脏病（chronic kidney disease，CKD）及高尿酸血症风险之间的关联。方法：采用方便抽样方法，共纳入8 972例参与者，依据体质量指数与代谢健康状况分为4组：代谢健康非超重/肥胖组（MHNO组）、代谢不健康非超重/肥胖组（MUNO组）、代谢健康超重/肥胖组（MHO组）及代谢不健康超重/肥胖组（MUO组）。采用多因素logistic回归模型分析不同肥胖代谢表型与高血压、CKD和高尿酸血症的关联，并按性别进行分层分析以探讨其异质性。结果：与MHNO组相比，MUNO组和MUO组发生高血压的风险均显著增加（MUNO组： OR=2.47，95% CI：2.09～2.91；MUO组： OR=3.08，95% CI：2.62～3.63），其中MUO组风险最高。同时，与MHNO组相比，MUNO组和MUO组的CKD风险均显著增加（MUNO组： OR=2.81，95% CI：1.95～4.05；MUO组： OR=3.15，95% CI：2.20～4.51），且尿白蛋白/肌酐比值升高的风险也显著增加（MUNO组： OR=1.90，95% CI：1.39～2.61；MUO组： OR=2.37，95% CI：1.72～3.26）。高尿酸血症风险在MUNO组、MHO组及MUO组均增加，其中MUO组风险最高（OR=4.32，95% CI：3.47～5.37）。性别分层分析显示，上述关联在男性和女性中均保持一致。结论：代谢不健康状态与多种心肾代谢相关疾病风险显著相关，且在合并肥胖时其相关强度进一步增强。

Abstract

Objective: To assess the associations between different metabolic obesity phenotypes and the risks of hypertension, chronic kidney disease (CKD), and hyperuricemia among adults in Southern China. Methods: A total of 8,972 participants were recruited using convenience sampling in this study. According to body mass index (BMI) and metabolic health status, all participants were divided into four groups: the metabolically healthy non-overweight/obesity (MHNO) group, the metabolically unhealthy non-overweight/obesity (MUNO) group, the metabolically healthy overweight/obesity (MHO) group, and the metabolically unhealthy overweight/obesity (MUO) group. Multivariable logistic regression models were applied to analyze the associations of different metabolic obesity phenotypes with hypertension, CKD, and hyperuricemia. Stratified analyses were further conducted by gender to explore the heterogeneity. Results: Compared with the MHNO group, the risks of hypertension in both the MUNO and MUO groups (MUNO group: OR=2.47, 95% CI: 2.09-2.91; MUO group: OR=3.08, 95% CI: 2.62-3.63) were significantly increased, with the MUO group showing the highest risk. Meanwhile, compared with the MHNO group, both the MUNO and MUO groups had a significantly increased risk of CKD (MUNO group: OR=2.81, 95% CI: 1.95-4.05; MUO group: OR=3.15, 95% CI: 2.20-4.51), as well as a significantly increased risk of elevated urinary albumin-to-creatinine ratio (uACR) (MUNO group: OR=1.90, 95% CI: 1.39-2.61; MUO group: OR=2.37, 95% CI: 1.72-3.26). The risk of hyperuricemia was increased in the MUNO, MHO and MUO groups, with the MUO group exhibiting the highest risk (OR=4.32, 95% CI: 3.47-5.37). Gender-stratified analysis revealed that these associations were consistent across both males and females. Conclusion: Metabolically unhealthy status is significantly associated with the risk of multiple cardiometabolic and renal diseases, and this association is further strengthened when combined with obesity.

关键词

超重 / 肥胖症 / 代谢疾病 / 高血压 / 慢性肾脏病 / 高尿酸血症 / 心血管疾病 / 横断面研究

Key words

overweight / obesity / metabolic diseases / hypertension / chronic kidney disease / hyperuricemia / cardiovascular disease / cross-sectional studies

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基金资助

国家自然科学基金资助项目(82270806)

广西科技创新平台计划项目(桂科 LT2600640048)

广西重点研发计划项目(桂科 AB21196022)