| アブストラクト | OBJECTIVE: This study aimed to examine the impact of obesity, as defined by body mass index (BMI), and a metabolically unhealthy phenotype on the development of coronary artery disease (CAD) according to glucose tolerance status. METHODS: This population-based retrospective cohort study included 123,746 Japanese men aged 18-72years (normal glucose tolerance: 72,047; prediabetes: 39,633; diabetes: 12,066). Obesity was defined as a BMI>/=25kg/m(2). Metabolically unhealthy individuals were defined as those with one or more of the following conditions: hypertension, hypertriglyceridaemia and/or low HDL cholesterol. A Cox proportional hazards regression model identified variables related to CAD incidence. RESULTS: The prevalences of obese subjects with normal glucose tolerance, prediabetes and diabetes were 21%, 34% and 53%, whereas those for metabolically unhealthy people were 43%, 60% and 79%, respectively. Multivariate analysis showed that a metabolically unhealthy phenotype increases hazard ratios (HRs) for CAD compared with a metabolically healthy phenotype, regardless of glucose tolerance status (normal glucose tolerance: 1.98, 95% CI: 1.32-2.95; prediabetes: 2.91, 95% CI: 1.85-4.55; diabetes: 1.90, 95% CI: 1.18-3.06). HRs for CAD among metabolically unhealthy non-obese diabetes patients and obese diabetes patients with a metabolically unhealthy status were 6.14 (95% CI: 3.94-9.56) and 7.86 (95% CI: 5.21-11.9), respectively, compared with non-obese subjects with normal glucose tolerance and without a metabolically unhealthy status. CONCLUSION: A metabolically unhealthy state can associate with CAD independently of obesity across all glucose tolerance stages. Clinicians may need to consider those with at least one or more conditions indicating a metabolically unhealthy state as being at high risk for CAD regardless of glucose tolerance status. |
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| ジャーナル名 | Diabetes & metabolism |
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| 投稿日 | 2017/9/18 |
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| 投稿者 | Fujihara, K; Matsubayashi, Y; Yamamoto, M; Osawa, T; Ishizawa, M; Kaneko, M; Matsunaga, S; Kato, K; Seida, H; Yamanaka, N; Kodama, S; Sone, H |
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| 組織名 | Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757,;Asahimachi, 951-8510 Niigata, Japan.;Japan Medical Data Center Co., Ltd., 2-5-5, Shibadaimon, 105-0012 Tokyo, Japan.;Asahimachi, 951-8510 Niigata, Japan. Electronic address:;sone@med.niigata-u.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28918195/ |
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