代谢健康的肥胖亚裔美国人（18-44岁）心血管结局：来自全国住院患者样本的见解

Obesity Pillars Pub Date : 2025-01-10 DOI:10.1016/j.obpill.2025.100158

Rupak Desai , Avilash Mondal , Boney Lapsiwala , Venkata Balaji Chenna , Pratik Rajpopat , Vaidehi Mendpara , Athri Kodali , Amritha R. Nair , Ayodya Perera , Subramanian Gnanaguruparan

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引用次数: 0

摘要

肥胖通常与高血压、糖尿病和高脂血症等心脏代谢危险因素相关，是住院患者主要心脑血管不良事件（MACCE）的预测因子。然而，对年轻、代谢健康（MHO）的亚洲肥胖患者的住院结果尚未进行研究。方法本研究是一项回顾性队列研究，利用2019年国家住院患者样本（NIS）数据库，确定代谢健康的年轻（18-44岁）亚裔美国人/太平洋岛民（AA/API）的住院情况。采用1:1倾向匹配，比较代谢健康的亚洲肥胖（MHO+）和亚洲无肥胖（MHO-）患者的合并症和住院结果。采用多变量logistic回归分析确定MHO+组MACCE的预测因素。结果在327,065例青少年AA/API住院患者中，7.8% （n=25,470）为肥胖。其中，14315人在排除伴随的心脏代谢危险因素后代谢健康。匹配队列（MHO+和MHO-， N = 14,200，中位年龄32岁，>； 84%女性）显示，MHO+组有更高的抑郁、焦虑、烟草使用障碍、慢性肺部疾病和甲状腺功能减退的发生率，而MHO-组有更高的癌症和大麻使用障碍的发生率。MACCE的发生率（aOR 0.98, 95%CI 0.70 ~ 1.37, p = 0.886）和全因死亡的发生率（aOR 1.26, 95%CI % 0.4 ~ 3.99, p = 0.690）均无统计学意义。男性（aOR 10.18, 95%Cl 3.39 ~ 30.53）、吸毒者（aOR 2.87, 95%Cl 1.05 ~ 7.86）、癌症患者（aOR 9.70, 95%Cl 2.14 ~ 44.01）、先天性循环系统异常患者（aOR 21.77, 95%Cl 4.07 ~ 116.60）发生MACCE的几率显著高于男性（aOR 10.18, 95%Cl 3.39 ~ 30.53）。抑郁（aOR 3.09, 95%Cl 0.86-11.08）、择期入院（aOR 3.71, 95%Cl 0.74-18.58）和吸烟（aOR 0.81, 95%Cl 0.26-2.60）是无统计学意义的预测因素。结论：亚裔美国男性、吸毒者和癌症患者尽管BMI较低，但心血管风险较高，而与代谢健康的肥胖人群相比，住院心血管事件发生率的总体几率无统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample

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Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample

Objective

Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored.

Methods

This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18–44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group.

Results

Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, >84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70–1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4–3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39–30.53), drug users (aOR 2.87, 95%Cl 1.05–7.86), cancer patients (aOR 9.70, 95%Cl 2.14–44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07–116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86–11.08), elective admission (aOR 3.71, 95%Cl 0.74–18.58), and tobacco use (aOR 0.81, 95%Cl 0.26–2.60) were not statistically significant predictors.

Conclusion

Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.

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Obesity Pillars

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