Association of metabolic phenotypes with cardiovascular events in patients aged 18-45 with acute coronary syndrome.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-02-10 DOI:10.1007/s12020-025-04169-z

Rongdi Xu, Chen Wang, Hongliang Cong, Le Wang

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Abstract

Background: Obesity and metabolic syndrome are related to cardiovascular events. However, the association different metabolic phenotypes and obesity with cardiovascular events among young adults aged 18-45 with acute coronary syndrome (ACS) remains unclear. The study aimed to investigate the prognosis of patients aged 18-45 years with ACS based on their metabolic phenotype.

Methods: This study included 1787 patients with ACS ≤ 45 years of age who underwent coronary angiography. Patients were divided into four groups according to metabolic phenotype: metabolically healthy non-obesity (MHN); MHO; metabolically unhealthy non-obesity (MUN); and metabolically unhealthy obesity (MUO). The primary outcome was major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, stroke, or unplanned revascularization.

Results: Among 1787 patients with ACS, the median age was 41.6 years, 1675 (93.7%) were men, 1111 (62.2%) had obesity, and 659 (36.9%) were classified as MHO. During a median 65 months follow-up, 404 MACE occurred. Multivariate analysis showed that MHO was correlated with a decreased risk of MACE, while MUN significantly increased the risk compared to MHN (MHO: HR 0.69, 95%CI 0.52-0.92, P = 0.011; MUN: HR 1.47, 95%CI 1.07-2.02 P = 0.018). Moreover, restricted cubic spline analysis revealed a linear relationship between body mass index (BMI) and the incidence of MACE (P_nonlinear= 0.304, P_overall < 0.001).

Conclusions: MHO was correlated with a decreased risk of MACE, while MUN significantly increased the risk compared to MHN. Moreover, there was a linear relationship between BMI and the incidence of MACE.

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18-45岁急性冠脉综合征患者代谢表型与心血管事件的关系

背景：肥胖和代谢综合征与心血管事件有关。然而，在18-45岁的急性冠脉综合征（ACS）年轻人中，不同代谢表型和肥胖与心血管事件的关系尚不清楚。本研究旨在探讨18-45岁ACS患者代谢表型的预后。方法：本研究纳入1787例年龄≤45岁的ACS患者行冠状动脉造影。根据代谢表型将患者分为四组：代谢健康非肥胖组（MHN）；姆欧;代谢不健康的非肥胖（MUN）；以及代谢不健康的肥胖（MUO）。主要结局是主要不良心血管事件（MACE），包括全因死亡、心肌梗死、中风或计划外血运重建术。结果：1787例ACS患者中位年龄为41.6岁，男性1675例（93.7%），肥胖1111例（62.2%），MHO 659例（36.9%）。在中位65个月的随访期间，发生404例MACE。多因素分析显示，MHO与MACE风险降低相关，而MUN与MHN相比显著增加MHO风险(MHO: HR 0.69, 95%CI 0.52 ~ 0.92, P = 0.011；男性：hr 1.47, 95%ci 1.07-2.02 p = 0.018)。此外，限制性三次样条分析显示身体质量指数（BMI）与MACE发生率之间存在线性关系（p非线性= 0.304），总体结论：MHO与MACE风险降低相关，而MUN与MHN相比显著增加MACE风险。此外，BMI与MACE发生率之间存在线性关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.