中文摘要：

目的了解代谢正常肥胖（MHO）患者的代谢异常发生风险,并探讨其影响因素。方法于2011年4—8月,采用简单随机抽样法在泸州市抽取3个社区,在该3个社区的社区卫生服务中心中采用发放宣传册的方式招募自愿参加本研究的代谢正常居民1374例。根据腹围,将纳入居民分为MHO组（n=286）和代谢正常非肥胖（MHNO）组（n=1088）。采用标准化问卷收集居民的基本情况,并进行体格检查和实验室检测,随访3年,记录两组的代谢异常发生情况。结果 MHO组和MHNO组的代谢异常发病率分别为38.8%（111/286）、25.1%（273/1088）,MHO组高于MHNO组,差异有统计学意义〔OR（95%CI）=1.891（1.437,2.489）,P〈0.05〕。按性别分层,MHO组男性、女性代谢异常发病率均高于MHNO组,差异有统计学意义（P〈0.05）。按年龄分层,MHO组40-55岁、56-70岁代谢异常发病率高于MHNO组,差异有统计学意义（P〈0.05）;而两组71-93岁代谢异常发病率比较,差异无统计学意义（P〉0.05）。MHO组是否发生代谢异常患者性别、平均年龄、职业、吸烟、饮酒、腰围、臀围、收缩压、舒张压、谷氨酰转肽酶（GGT）、糖化血红蛋白（Hb A1c）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）比较,差异无统计学意义（P〉0.05）;MHO组发生代谢异常患者BMI、空腹血糖（FPG）、葡萄糖耐量试验（OGTT）2 h血糖、三酰甘油（TG）高于未发生者,高密度脂蛋白胆固醇（HDL-C）低于未发生者（P〈0.05）。多因素Logistic回归分析结果显示,TG、HDL-C是MHO患者发生代谢异常的影响因素（P〈0.05）。结论 MHO并非一种持续良好状态,其代谢异常发生风险高于MHNO,高TG和低HDL-C水平是MHO转归代谢异常的危险因素。

英文摘要：

Objective To study the incidence and risk factors of metabolic disorders in metabolically healthy obese（ MHO） patients.Methods From April to August 2011,we selected 3 communities from Luzhou using simple random sampling method.And by issuing recruitment brochures at the community health service centers of the 3 communities,we recruited 1 374 residents who had normal metabolism and volunteered to participate in this study.In accordance with the abdominal circumference,the included residents were divided into MHO group（ n = 286） and metabolically healthy non-obese（ MHNO） group（ n= 1 088）.We used standardized questionnaires to collect the general data of the residents,and gave them physical examination and laboratory tests.The incidences of metabolic disorders of both groups were recorded at 3-year follow-up.Results The incidence of metabolic disorders was higher in the MHO group than that in the MHNO group 〔38.8%（ 111 /286） vs.25.1%（ 273 /1 088）,OR（ 95% CI） = 1.891（ 1.437,2.489）,P〈0.05〕.As stratified by gender,when compared with MHNO group,higher incidences of metabolic disorders were observed in both males and females in the MHO group（ P〈0.05）.As stratified by age,higher incidences of metabolic disorders were noted in both aged 40 to 55 years and aged 56 to 70 years in MHO group compared with the MHNO group（ P〈0.05）.However,the incidence of metabolic disorders in residents aged 71 to 93 years in the MHO group was not significantly different from that in the MHNO group（ P〉0.05）.There were no statistically significant difference in terms of sex,mean age,occupation,history of smoking,history of drinking,waist circumference,hip circumference,levels of systolic pressure,diastolic pressure,glutamyltranspetidase（ GGT）,glycosylated hemoglobin（ Hb A1c）,total cholesterol（ TC） and low-density lipoprotein cholesterol（ LDL-C） between the pateints with metabolic disorders and those without in the MHO group（ P〉0.05）.In the MHO group,the pateints with m