Correlation between Different Obesity Metabolic Phenotypes and Atherosclerosis in a Young Population: Uric Acid as Its Potential Factor

doi:10.12114/j.issn.1007-9572.2023.0887

Abstract

Abstract:

Background

Obesity and metabolic abnormalities are associated with atherosclerosis, and different metabolic phenotypes of obesity have different risks of AS. The relationship between serum uric acid (SUA) levels and AS is unclear.

Objective

Using brachial-ankle pulse wave velocity (baPWV) as an early predictor of AS, we investigated the correlation between different metabolic phenotypes of obesity and the risk of AS, with a focus on metabolically healthy obese populations, and further explored whether uric acid serves as a potential influencing factor.

Methods

A total of 622 young medical check-ups at a street community health center from December 2021 to January 2022 were selected for questionnaire survey, physical examination, and laboratory tests. The study subjects were categorized into four groups based on BMI and metabolic status, metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO). Pearson's correlation was used to analyse the correlation between SUA and baPWV and various clinical indicators. Multiple linear regression models were used to analyze the correlation between SUA and baPWV and various clinical indicators, and scatter plots were drawn. Multifactorial Logistic regression models were used to analyze the correlation between different obesity metabolic phenotypes and high baPWV and hyperuricemia.

Results

After grouping according to different obesity metabolic phenotypes, the prevalence of high baPWV levels in the MHNO, MHO, MUNO and MUO groups gradually increased to 3.9%, 9.8%, 14.5% and 29.4%, respectively, with a statistically significant difference (χ² _trend=60.722, P<0.001); and the prevalence of hyperuricemia in the MHNO, MHO, MUNO and MUO groups. The prevalence rates were 3.6%, 8.9%, 10.1% and 26.9%, respectively, and the difference was statistically significant (χ² _trend=56.444, P<0.001). The results of multivariate linear regression analysis correcting for confounders showed SUA was an independent risk factor for atherosclerosis. The results of multifactorial Logistic regression modeling showed that after correcting for gender, age, current smoking, current alcohol consumption, and literacy, the risk of high baPWV was significantly higher in the four groups of MHNO, MHO, MUNO, and MUO in that order, and the risk of hyperuricemia was also significantly higher in that order.

Conclusion

In the young population, there is a significant correlation between different obesity metabolic phenotypes and atherosclerosis, and uric acid may be a potential influencing factor. In addition, we should pay attention to the young MHO population for early lifestyle intervention and health management.

Key words: Atherosclerosis, Pulse wave conduction velocity, Pulse wave analysis, Metabolic syndrome, Metabolically healthy obesity, Serum uric acid, Uric acid creatinine ratio, Young adult

摘要：

背景

肥胖和代谢异常与动脉硬化（AS）相关，不同肥胖代谢表型发生AS的风险不同。血清尿酸（SUA）水平与AS之间的关系尚不明确。

目的

以肱踝脉搏波传导速度（baPWV）作为AS的早期预测指标，研究肥胖代谢表型与AS发病风险之间的相关性，重点关注代谢健康型肥胖（MHO）人群，并进一步探讨SUA是否作为其潜在影响因素。

方法

选取2021年12月—2022年1月于安徽省宿州市埇桥区东关街道社区卫生服务中心接受健康体检的622名体检者为研究对象，对研究对象进行问卷调查、体格检查和实验室检测。根据BMI和代谢状况将研究对象分为四组，分别为代谢健康型非肥胖（MHNO）组、MHO组、代谢不健康型非肥胖（MUNO）组和代谢不健康型肥胖（MUO）组。采用Pearson相关性分析SUA与baPWV及各项临床指标之间的相关性，采用多元线性回归分析SUA对baPWV的影响、Logistic回归分析探讨不同肥胖代谢表型对高baPWV水平和高尿酸血症的影响。

结果

根据不同肥胖代谢表型分组后，MHNO、MHO、MUNO和MUO组高baPWV水平的患病率逐渐增高，分别为3.9%、9.8%、14.5%和29.4%，差异有统计学意义（χ²_趋势=60.722，P<0.001）；MHNO组、MHO组、MUNO组和MUO组高尿酸血症的患病率分别为3.6%、8.9%、10.1%和26.9%，差异有统计学意义（χ²_趋势=56.444，P<0.001）。校正混杂因素的多元线性回归分析结果显示，SUA是动脉硬化的独立危险因素（P<0.05）。多因素Logistic回归分析结果显示，在校正性别、年龄、当前吸烟、当前饮酒和文化程度后，MHNO、MHO、MUNO、MUO四组高baPWV的患病风险依次增高、高尿酸血症的患病风险也依次增高（P<0.05）。

结论

在青年人群中，肥胖代谢表型和AS间存在显著相关性，SUA可能是潜在影响因素。此外，应当关注青年MHO人群，尽早进行生活方式干预和健康管理。

关键词: 动脉硬化, 脉搏波传导速度, 脉搏波分析, 代谢综合征, 代谢健康型肥胖, 血清尿酸, 尿酸肌酐比值, 青年人

CLC Number:

R 543.5

GU Keyi,PAN Yaojia,HAN Zheng, et al. Correlation between Different Obesity Metabolic Phenotypes and Atherosclerosis in a Young Population: Uric Acid as Its Potential Factor[J]. Chinese General Practice, 2025, 28(07): 831-837. DOI: 10.12114/j.issn.1007-9572.2023.0887.
顾可羿,潘姚佳,韩正等. 青年人群不同肥胖代谢表型与动脉硬化的相关性研究：尿酸作为其潜在因素[J]. 中国全科医学, 2025, 28(07): 831-837. DOI: 10.12114/j.issn.1007-9572.2023.0887.

Figures/Tables 5

References 35

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组别	人数	性别（男/女）	当前吸烟[名（%）]	当前饮酒[名（%）]	大专及以上[名（%）]	年龄（±s，岁）	BMI （±s，kg/m²）	WC （±s，cm）	SBP （±s，mmHg）	DBP （±s，mmHg）
MHNO组	281	112/169	36（12.8）	28（10.0）	90（32.0）	30.2±8.8	21.88±1.74	75.48±11.48	120±12	77±9
MHO组	112	51/61	21（18.8）	19（17.0）	13（11.6）	31.9±7.9	27.71±2.66^a	86.55±13.73^a	126±15^a	82±11^a
MUNO组	69	43/26	15（21.7）	18（26.1）	7（10.1）	33.9±7.2^a	23.17±1.67^ab	84.72±18.17^a	131±13^a	87±8^ab
MUO组	160	112/48	43（26.9）	30（18.8）	21（13.1）	34.3±7.6^a	29.21±3.27^ab	93.02±10.90^ab	140±15^ab	92±11^ab
F（χ²）值		41.950^c	13.966^c	14.097^c	48.673^c	10.276	336.714	87.332	70.469	75.366
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
组别	baPWV （±s，cm/s）	TC （±s，mmol/L）	TG （±s，mmol/L）	HDL-C（±s，mmol/L）	LDL-C （±s，mmol/L）	FPG （±s，mmol/L）	Scr （±s，μmol/L）	SUA （±s，μmol/L）	SUA/Cr （±s）
MHNO组	1 110.03±149.29	4.29±0.70	0.96±0.43	1.46±0.29	2.58±0.63	5.00±0.39	62.28±12.33	277.56±77.63	4.47±0.95
MHO组	1 183.54±175.39^a	4.36±0.81	1.11±0.48	1.34±0.26^a	2.71±0.74^a	5.14±0.34	62.38±12.97	302.94±82.80^a	4.88±1.05^a
MUNO组	1 239.61±173.70^a	4.95±1.03^ab	2.04±1.28^ab	1.20±0.29^ab	3.06±0.91^ab	5.95±2.08^ab	66.03±13.11	320.8±76.85^a	4.91±1.03^a
MUO组	1 305.58±205.38^ab	4.93±0.96^ab	2.85±2.18^ab	1.07±0.22^ab	2.98±0.85^ab	6.21±2.06^ab	66.63±13.00^ab	358.31±93.41^ab	5.45±1.30^ab
F（χ²）值	41.996	24.083	54.272	87.817	13.180	24.959	5.137	29.806	24.490
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	0.002	<0.001	<0.001

组别	人数	性别（男/女）	当前吸烟[名（%）]	当前饮酒[名（%）]	大专及以上[名（%）]	年龄（±s，岁）	BMI （±s，kg/m²）	WC （±s，cm）	SBP （±s，mmHg）	DBP （±s，mmHg）
MHNO组	281	112/169	36（12.8）	28（10.0）	90（32.0）	30.2±8.8	21.88±1.74	75.48±11.48	120±12	77±9
MHO组	112	51/61	21（18.8）	19（17.0）	13（11.6）	31.9±7.9	27.71±2.66^a	86.55±13.73^a	126±15^a	82±11^a
MUNO组	69	43/26	15（21.7）	18（26.1）	7（10.1）	33.9±7.2^a	23.17±1.67^ab	84.72±18.17^a	131±13^a	87±8^ab
MUO组	160	112/48	43（26.9）	30（18.8）	21（13.1）	34.3±7.6^a	29.21±3.27^ab	93.02±10.90^ab	140±15^ab	92±11^ab
F（χ²）值		41.950^c	13.966^c	14.097^c	48.673^c	10.276	336.714	87.332	70.469	75.366
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
组别	baPWV （±s，cm/s）	TC （±s，mmol/L）	TG （±s，mmol/L）	HDL-C（±s，mmol/L）	LDL-C （±s，mmol/L）	FPG （±s，mmol/L）	Scr （±s，μmol/L）	SUA （±s，μmol/L）	SUA/Cr （±s）
MHNO组	1 110.03±149.29	4.29±0.70	0.96±0.43	1.46±0.29	2.58±0.63	5.00±0.39	62.28±12.33	277.56±77.63	4.47±0.95
MHO组	1 183.54±175.39^a	4.36±0.81	1.11±0.48	1.34±0.26^a	2.71±0.74^a	5.14±0.34	62.38±12.97	302.94±82.80^a	4.88±1.05^a
MUNO组	1 239.61±173.70^a	4.95±1.03^ab	2.04±1.28^ab	1.20±0.29^ab	3.06±0.91^ab	5.95±2.08^ab	66.03±13.11	320.8±76.85^a	4.91±1.03^a
MUO组	1 305.58±205.38^ab	4.93±0.96^ab	2.85±2.18^ab	1.07±0.22^ab	2.98±0.85^ab	6.21±2.06^ab	66.63±13.00^ab	358.31±93.41^ab	5.45±1.30^ab
F（χ²）值	41.996	24.083	54.272	87.817	13.180	24.959	5.137	29.806	24.490
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	0.002	<0.001	<0.001

变量	SUA		baPWV
变量	r值	P值	r值	P值
腰围	0.274	<0.001	0.280	<0.001
BMI	0.341	<0.001	0.339	<0.001
SBP	0.356	<0.001	0.576	<0.001
DBP	0.299	<0.001	0.619	<0.001
FPG	0.087	0.030	0.280	<0.001
HDL-C	-0.359	<0.001	-0.204	<0.001
LDL-C	0.214	<0.001	0.222	<0.001
TG	0.313	<0.001	0.270	<0.001
TC	0.226	<0.001	0.284	<0.001
SUA	—	—	0.189	<0.001
SUA/Cr	0.714	<0.001	0.088	0.029
baPWV	0.189	<0.001	—	—

变量	SUA		baPWV
变量	r值	P值	r值	P值
腰围	0.274	<0.001	0.280	<0.001
BMI	0.341	<0.001	0.339	<0.001
SBP	0.356	<0.001	0.576	<0.001
DBP	0.299	<0.001	0.619	<0.001
FPG	0.087	0.030	0.280	<0.001
HDL-C	-0.359	<0.001	-0.204	<0.001
LDL-C	0.214	<0.001	0.222	<0.001
TG	0.313	<0.001	0.270	<0.001
TC	0.226	<0.001	0.284	<0.001
SUA	—	—	0.189	<0.001
SUA/Cr	0.714	<0.001	0.088	0.029
baPWV	0.189	<0.001	—	—

因变量	MHO		MUNO		MUO
因变量	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
高baPWV
模型1	2.673（1.124~6.358）	0.026	4.160（1.689~10.248）	0.002	10.209（5.109~20.400）	<0.001
模型2	2.477（1.034~5.933）	0.042	3.325（1.327~8.334）	0.010	7.967（3.895~16.296）	<0.001
模型3	2.868（1.175~6.998）	0.021	3.859（1.500~9.923）	0.005	8.958（4.287~18.721）	<0.001
高尿酸血症
模型1	2.657（1.074~6.572）	0.034	3.060（1.121~8.355）	0.029	9.960（4.841~20.491）	<0.001
模型2	2.899（1.116~7.482）	0.029	3.036（1.048~8.797）	0.041	10.091（4.535~22.455）	<0.001
模型3	3.129（1.179~8.299）	0.022	3.301（1.107~9.849）	0.032	9.958（4.357~22.756）	<0.001