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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

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收录情况： ◇ SCIE

作者：
Hu Chunyan[1,2] * ; Wang Shuangyuan[1,2] * ; Lin Hong[1,2] * ; Wan Qin[3] * ; Zheng Ruizhi[1,2] ; Zhu Yuanyue[1,2] ; Li Mian[1,2] ; Xu Yu[1,2] ; Xu Min[1,2] ; Zheng Jie[1,2] ; Chen Lulu[4] ; Zeng Tianshu[4] ; Hu Ruying[5] ; Ye Zhen[5] ; Shi Lixin[6] ; Su Qing[7] ; Chen Yuhong[1,2] ; Yu Xuefeng[8] ; Yan Li[9] ; Wang Tiange[1,2] ; Zhao Zhiyun[1,2] ; Qin Guijun[10] ; Chen Gang[11] ; Dai Meng[1,2] ; Zhang Di[1,2] ; Tang Xulei[12] ; Gao Zhengnan[13] ; Shen Feixia[14] ; Gu Xuejiang[14] ; Luo Zuojie[15] ; Qin Yingfen[15] ; Chen Li[16] ; Hou Xinguo[16] ; Huo Yanan[17] ; Li Qiang[18] ; Wang Guixia[19] ; Zhang Yinfei[20] ; Liu Chao[21] ; Wang Youmin[22] ; Wu Shengli[23] ; Yang Tao[24] ; Deng Huacong[25] ; Zhao Jiajun[26] ; Mu Yiming[27] ; Lai Shenghan[28] ; Li Donghui[29] ; Ning Guang[1,2] ; Wang Weiqing[1,2,*1] ; Hu Weiguo[30,*2] ; Bi Yufang[1,2,*1] ; Lu Jieli[1,2,*1] ;
单位： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [2]Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. [3]The Affiliated Hospital of Southwest Medical University, Luzhou, China. [4]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [5]Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China. [6]Affiliated Hospital of Guiyang Medical College, Guiyang, China. [7]Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. [8]Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [9]Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. [10]The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. [11]Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China. [12]The First Hospital of Lanzhou University, Lanzhou, China. [13]Dalian Municipal Central Hospital, Dalian, China. [14]The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. [15]The First Affiliated Hospital of Guangxi Medical University, Nanning, China. [16]Qilu Hospital of Shandong University, Jinan, China. [17]Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China. [18]The Second Affiliated Hospital of Harbin Medical University, Harbin, China. [19]The First Hospital of Jilin University, Changchun, China. [20]Central Hospital of Shanghai Jiading District, Shanghai, China. [21]Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. [22]The First Affiliated Hospital of Anhui Medical University, Hefei, China. [23]Karamay Municipal People's Hospital, Xinjiang, China. [24]The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. [25]The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. [26]Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. [27]Chinese People's Liberation Army General Hospital, Beijing, China. [28]Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA. [29]Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. [30]Department of Geriatrics, Medical Center on Aging, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出处：
DOI： 10.1111/dom.15525
ISSN：

关键词： body size cardiovascular disease insulin sensitivity metabolic status metabolically healthy obesity obesity

摘要：
To 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.We 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.During 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.This 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.© 2024 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

基金：
Ministry of Science and Technology of China, Grant/Award Numbers: 2022YFC2505202, 2023YFC2506704; Clinical Research Project of Shanghai Municipal Health Commission, Grant/Award Number: 20224Y0087; Innovative research team of high-level local universities in Shanghai; Science and Technology Commission of Shanghai Municipality, Grant/Award Numbers: 23JS1400900, 23Y11908400; National Natural Science Foundation of China, Grant/Award Numbers: 82370810, 82088102, 81930021, 81970728, 81970691, 82170819, 82372347, 82200998; Clinical Research Project of Shanghai Municipal Health Commission, Grant/Award Numbers: 20224Y0087, 20214Y0002
语种：
外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2023]版：
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢
JCR分区：
出版当年[2022]版：
Q1 ENDOCRINOLOGY & METABOLISM
最新[2023]版：
Q1 ENDOCRINOLOGY & METABOLISM

影响因子： 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者：
第一作者单位： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [2]Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [2]Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. [30]Department of Geriatrics, Medical Center on Aging, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [*1]National Clinical Research Center for Metabolic Diseases, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai 200025, China. [*2]Department of Geriatrics, Medical Center on Aging, Ruijin hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai 200025, China
推荐引用方式(GB/T 7714)：
Hu Chunyan,Wang Shuangyuan,Lin Hong,et al.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[J].DIABETES OBESITY & METABOLISM.2024,doi:10.1111/dom.15525.
APA：
Hu Chunyan,Wang Shuangyuan,Lin Hong,Wan Qin,Zheng Ruizhi...&Lu Jieli.(2024).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.DIABETES OBESITY & METABOLISM,,
MLA：
Hu Chunyan,et al."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".DIABETES OBESITY & METABOLISM .(2024)

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