"Body size, insulin sensitivity, metabolic health and risk of cardiovascular disease in Chinese adults: Insights from the China Cardiometabolic Disease and Cancer Cohort (4C) study"
作者全名："Hu, Chunyan; Wang, Shuangyuan; Lin, Hong; Wan, Qin; Zheng, Ruizhi; Zhu, Yuanyue; Li, Mian; Xu, Yu; Xu, Min; Zheng, Jie; Chen, Lulu; Zeng, Tianshu; Hu, Ruying; Ye, Zhen; Shi, Lixin; Su, Qing; Chen, Yuhong; Yu, Xuefeng; Yan, Li; Wang, Tiange; Zhao, Zhiyun; Qin, Guijun; Chen, Gang; Dai, Meng; Zhang, Di; Tang, Xulei; Gao, Zhengnan; Shen, Feixia; Gu, Xuejiang; Luo, Zuojie; Qin, Yingfen; Chen, Li; Hou, Xinguo; Huo, Yanan; Li, Qiang; Wang, Guixia; Zhang, Yinfei; Liu, Chao; Wang, Youmin; Wu, Shengli; Yang, Tao; Deng, Huacong; Zhao, Jiajun; Mu, Yiming; Lai, Shenghan; Li, Donghui; Ning, Guang; Wang, Weiqing; Hu, Weiguo; Bi, Yufang; Lu, Jieli"
作者地址："[Hu, Chunyan; Wang, Shuangyuan; Lin, Hong; Zheng, Ruizhi; Zhu, Yuanyue; Li, Mian; Xu, Yu; Xu, Min; Zheng, Jie; Chen, Yuhong; Wang, Tiange; Zhao, Zhiyun; Dai, Meng; Zhang, Di; Ning, Guang; Wang, Weiqing; Bi, Yufang; Lu, Jieli] Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Sch Med, Shanghai, Peoples R China; [Hu, Chunyan; Wang, Shuangyuan; Lin, Hong; Zheng, Ruizhi; Zhu, Yuanyue; Li, Mian; Xu, Yu; Xu, Min; Zheng, Jie; Chen, Yuhong; Wang, Tiange; Zhao, Zhiyun; Dai, Meng; Zhang, Di; Ning, Guang; Wang, Weiqing; Bi, Yufang; Lu, Jieli] Shanghai Jiao Tong Univ, Shanghai Natl Ctr Translat Med, Shanghai Natl Clin Res Ctr Endocrine & Metab Dis, Key Lab Endocrine & Metabo Dis,Natl Hlth Commiss P, Shanghai, Peoples R China; [Wan, Qin] Southwest Med Univ, Affiliated Hosp, Luzhou, Peoples R China; [Chen, Lulu; Zeng, Tianshu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Hu, Ruying; Ye, Zhen] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Peoples R China; [Shi, Lixin] Guiyang Med Coll, Affiliated Hosp, Guiyang, Peoples R China; [Su, Qing] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Shanghai, Peoples R China; [Yu, Xuefeng] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Yan, Li] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China; [Qin, Guijun] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China; [Chen, Gang] Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China; [Tang, Xulei] Lanzhou Univ, Hosp 1, Lanzhou 730000, Peoples R China; [Gao, Zhengnan] Dalian Municipal Cent Hosp, Dalian, Peoples R China; [Shen, Feixia; Gu, Xuejiang] Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China; [Luo, Zuojie; Qin, Yingfen] Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China; [Chen, Li; Hou, Xinguo] Shandong Univ, Qilu Hosp, Jinan, Peoples R China; [Huo, Yanan] Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Peoples R China; [Li, Qiang] Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China; [Wang, Guixia] Jilin Univ, Hosp 1, Changchun, Peoples R China; [Zhang, Yinfei] Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China; [Liu, Chao] Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Peoples R China; [Wang, Youmin] Anhui Med Univ, Affiliated Hosp 1, Hefei, Peoples R China; [Wu, Shengli] Karamay Municipal Peoples Hosp, Karamay, Xinjiang, Peoples R China; [Yang, Tao] Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Peoples R China; [Deng, Huacong] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhao, Jiajun] Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China; [Mu, Yiming] Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China; [Lai, Shenghan] Univ Maryland, Sch Med, Dept Epidemiol & Publ Hlth, Baltimore, MD USA; [Li, Donghui] Univ Texas MD Anderson Canc Ctr, Dept Gastrointestinal Med Oncol, Houston, TX USA; [Lu, Jieli] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Geriatr, Ruijin Hosp,Sch Med,Med Ctr Aging, Shanghai, Peoples R China; [Wang, Weiqing; Bi, Yufang; Lu, Jieli] Shanghai Jiao Tong Univ, RuiJin Hosp, Natl Clin Res Ctr Metab Dis, Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China; [Hu, Weiguo] Shanghai Jiao Tong Univ, Ruijin Hosp, Med Ctr Aging, Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China"
通信作者："Wang, WQ; Bi, YF; Lu, JL (通讯作者)，Shanghai Jiao Tong Univ, RuiJin Hosp, Natl Clin Res Ctr Metab Dis, Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China.; Hu, WG (通讯作者)，Shanghai Jiao Tong Univ, Ruijin Hosp, Med Ctr Aging, Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China."
来源：DIABETES OBESITY & METABOLISM
ESI学科分类：CLINICAL MEDICINE
WOS号：WOS:001178613100001
JCR分区：Q1
影响因子：5.8
年份：2024
卷号：
期号：
开始页：
结束页：
文献类型：Article; Early Access
关键词：body size; cardiovascular disease; insulin sensitivity; metabolic status; metabolically healthy obesity; obesity
摘要："AimsTo assess the excess risk of cardiovascular disease (CVD) associated with different criteria for metabolic health, and the interplay of body size, insulin sensitivity and metabolic health with CVD risk.Materials and MethodsWe conducted a prospective study involving 115 638 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Metabolic health was defined using three different definitions: (1) insulin sensitivity defined by homeostatic model assessment of insulin resistance index; (2) absence of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria; and (3) simultaneous absence of metabolic abnormalities (diabetes, hypertension, dyslipidaemia). The primary endpoint was a composite of incident CVD events comprising the first occurrence of myocardial infarction, stroke, heart failure, or cardiovascular death.ResultsDuring a mean 3.61-year follow-up period, obese individuals with insulin sensitivity (multivariable-adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.37-2.08), or without metabolic syndrome (HR 1.46, 95% CI 1.13-1.89) still exhibited increased CVD risks, when compared to their normal-weight counterparts. Otherwise, those with obesity but simultaneous absence of metabolic abnormalities demonstrated similar CVD risk compared to normal-weight individuals (HR 0.91, 95% CI 0.53-1.59). CVD risk increased with the number of abnormalities across body mass index categories, regardless of insulin sensitivity.ConclusionsThis study emphasizes the need for refined definitions of metabolic health and advocates for meticulous screening for metabolic abnormalities to reduce cardiovascular risks, even in individuals with normal weight and insulin sensitivity."
基金机构：Ministry of Science and Technology of China
基金资助正文：The investigators are grateful to all participants for their cooperation in this study.
