TY - JOUR
T1 - BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults
T2 - A cohort study
AU - Xu, Renying
AU - Shen, Peixiao
AU - Wu, Chunhua
AU - Wan, Yanping
AU - Fan, Zhuping
AU - Gao, Xiang
N1 - Funding Information:
Acknowledgements: None. Financial support: The study was supported by the grant from Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition (no. 17DZ2272000). Conflict of interest: There are no conflicts of interest. Authorship: R.X. researched data, performed the analyses and drafted and reviewed the manuscript; P.S., C.W. and Z.F. researched the data; Y.W. and X.G. reviewed/edited the manuscript. All the authors have read and approved the final submitted manuscript. Ethics of human subject participation: The study protocol was approved by the Ethical Committee of Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University. As a de-identified secondary data analysis, patients’ consent was waived by the Ethical Committee.
Publisher Copyright:
© 2021 Cambridge University Press. All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Objective: We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. Design: Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. Results: Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. Conclusion: BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.
AB - Objective: We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. Design: Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. Results: Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. Conclusion: BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.
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U2 - 10.1017/S136898002000289X
DO - 10.1017/S136898002000289X
M3 - Article
C2 - 32840191
AN - SCOPUS:85092347253
SN - 1368-9800
VL - 24
SP - 4124
EP - 4131
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 13
ER -
