ABSTRACT
Objective:To explore whether metabolically healthy obesity(MHO) is a healthy state by observing the incidence of metabolic syndrome(MS) including its components and cardiovascular disease(CVD) in this population.Methods:In 2011, a cohort of 10 140 residents aged 40-79 years old was selected with cluster sampling in the Guiyang urban area. Fasting plasma glucose(FPG), blood lipids, and blood pressure were examined to assess their metabolic status. Height and weight were also measured. Among them, 1 299 metabolically healthy subjects were divided into 3 groups according to body mass index, namely metabolically healthy normal weight(MHNW), metabolically healthy overweight(MHOW), and MHO. Three groups were reassembled in 2014, and finally a total of 966 subjects with baseline and complete follow-up data were included in the analysis. The relationship between MS and its components, and the incidence of CVD were compared among the three groups.Results:(1) After an average follow-up of 3 years, 47.77% of the MHO population transformed into a metabolically unhealthy state. There was no significant difference in the incidence of MS components among the three groups( P>0.05), but there was a significant difference in the incidence of MS( P<0.05); (2) There was no significant difference in the incidence of CVD among the three groups after 3 years of follow-up. Logistic regression was used to analyze the risk factors of CVD in the three groups. Taking the MHNW as the control group, after adjusting for age, gender, FPG, blood lipids, and blood pressure, the risk ratio of the MHOW group was 0.941(0.661-1.202), and MHO group was 0.974(0.702-1.291). Conclusions:After 3 years of follow-up, although the risk of CVD in the MHO population did not increase significantly, the incidences of MS, triglycerides, and FPG abnormality increased compared with the normal people, suggesting that the MHO is not a " stable" healthy state.
ABSTRACT
Objective:To discuss hypertension situations of 40-79 years old residents with different glucose metabolic status in Guiyang urban area under the new hypertension diagnostic criteria proposed by American College of Cardiology/American Heart Association (ACC/AHA) in 2017 and provide a clue for diagnostic criteria and treatment strategy of hypertension.Methods:10 140 residents in 40-79 years old in Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgitudinal (REACTION) Study Research Guiyang Sub-center were conducted retrospective analysis. According to medical history of diabetes and oral glucose tolerance test results, these residents were divided into normal glucose group, impaired fasting glucose(IFG) group, impaired glucose tolerance (IGT) group, IFG+ IGF group, previous diagnostic diabetes group and newly diagnosed diabetes group. Hypertension situation of residents with different glucose metabolic status under the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), and Hypertension Guide of ACC/AHA in 2017 were calculated.Results:Under JNC 7 criteria, hypertension′s standardized prevalence rate of normal blood glucose people, prediabetes patients, and diabetes patients in 40-79 years old respectively reached 8.19%, 9.57%, and 8.19%. Under ACC/AHA 2017 criteria, hypertension′s standardized prevalence rate respectively reached 20.27%, 16.35%, and 11.59%. By contrast, the most obvious increase of hypertension′s prevalence rate was in the normal blood glucose group and IGT group. Newly increased hypertension patients reached 1 739. Among them, 25.8% required antihypertensive drugs for treatment. According to the 6th demographic census data of Guizhou Province in 2010, it was estimated that newly increased hypertensive patients aged 40-79 years in prediabetes patients reached 123 000, among them, 20 000 required treatment. Newly increased hypertensive patients aged 40-79 years in diabetes patients reached 68 000, among them, 21 000 required treatment.Conclusions:ACC/AHA Hypertension Guide in 2017 will obviously increase hypertension′s prevalence rate of people with different glucose metabolic status in 40-49 years old. The treatment ratio of hypertension groups with diabetes and prediabetes is considerably high. As a result, social medical burdens is going to aggravate.