成人代谢健康型肥胖与炎症因子关系的Meta分析

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摘要目的系统评价成人代谢健康型肥胖(MHO)与各炎症因子的相关性,为肥胖炎症的早期血清学预警提供依据。方法检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library中有关MHO与炎症因子水平的横断面研究,设定发表时限由建库至 2024-08-03;运用美国医疗保健研究与质量局的偏倚风险评价表评价文献质量;运用 RevMan 5.4 进行 Meta 分析,并绘制漏斗图;依据肥胖及代谢综合征(MS)定义、地域、炎症因子的具体类型等方面进行亚组分析。结果共纳入12个国家的21项横断面研究,共23 308例研究对象,其中MHO者5 842例,代谢健康非肥胖(MHNO)者17 466例。Meta分析结果显示:白细胞计数(WBCC)(95%CI:0.02～0.18,P=0.01)、C反应蛋白(CRP)(95%CI:0.53～0.82,P<0.00001)、脂联素(APN)(95%CI:-1.43～-0.43,P=0.0003)、瘦素(LEP)(95%CI:1.39～0.43,P<0.00001)、白细胞介素(IL)-6(95%CI:0.13～1.29,P=0.02)均与成人MHO呈现相关性;各亚组分析提示,超敏C反应蛋白(hs-CRP)较CRP在两组人群中差异更显著(SMD=0.73,95%CI:0.59～0.88);在TNF-α与IL-6组中,BMI≥25 kg/m²较30 kg/m²作为肥胖诊断标准在两组人群差异更显著(SMD=1.14,95%CI:0.71～1.56)、(SMD=2.15,95%CI:1.65～2.64);北美洲的MHO较其他地域APN及LEP水平更高(SMD=-3.16,95%CI:-4.19～-2.13)、(SMD=8.46,95%CI:6.25,10.67)。本研究漏斗图分布对称性较好,提示无明显发表偏倚。结论成人MHO与炎症因子中的WBCC、CRP、APN、LEP、IL-6具有一定相关性,针对肥胖人群血清炎症因子的检测对于肥胖相关疾病的早期预警有重要意义。

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	吴梓敬
	李纪新
	邱林杰
	任燕
	邹姹姹
	李美洁
	栗文婕
	张晋

关键词 ：代谢健康型肥胖, 炎症因子, 早期预警, Meta分析

Abstract：Objective To systematically evaluate the association between adult metabolically healthy obesity (MHO) and various inflammatory factors, and to provide a basis for the early serological warning of obesity inflammation. Methods Cross-sectional studies on the association between MHO and inflammatory factors from CNKI, Wanfang, VIP, CBM , PubMed, Web of Science , Embase and Cochrane Library were retrieved, with the publication time limit set from inception to August 3, 2024. The quality of the literature was evaluated using the bias risk assessment form from AHRQ. Meta analysis was performed using RevMan 5.4 and a funnel plot was drawn. Subgroup analysis was conducted based on such aspects as the definitions of obesity and MS definitions (MS), regions and specific types of inflammatory factors. Results A total of 21 cross-sectional studies from 12 countries were included, involving 23308 research subjects, including 5842 MHO people and 17466 MHNO people. Meta-analysis results showed that white blood cell count (WBCC) (95%CI:0. 02~ 0. 18,P=0. 01), c-reactive protein (CRP) (95%CI:0. 53~0. 82,P<0. 00001), adiponectin (APN) (95%CI:-1 . 43 ~ -0. 43,P=0. 0003), leptin (LEP) ( 9 5%C I:1. 39 ~ 0 . 43, P< 0. 00001 ), and interleukin (IL) -6 (95%CI :0.1 3~1. 29,P=0. 02 ) were all correlated with adult metabolic health obesity. Analysis of each subgroup suggested that hypersensitive C-reactive protein (ha-CRP) showed a more significant difference than CRP in the two groups of people (SMD=0. 73, 95 %CI:0. 59 ~ 0. 88) . In the TNF-α and IL-6 groups, BMI≥25 kg/m² was more significant than 30 kg/m² as the diagnostic criterion for obesity between the two groups(SMD=1. 14,95%CI:0. 71~ 1. 56),(SMD = 2. 15,95 %C I:1. 6 5~ 2 . 64) . MHO people in North America had higher levels of APN and LEP than those in other regions( SMD =- 3. 16, 95%CI:-4.19~ -2. 13 ),( SMD = 8. 46 ,9 5% CI:6. 25 ,10. 67 ); The distribution symmetry of the funnel plot in this study was relatively good, indicating no significant publication bias. Conclusions Adult MHO is significantly correlated with inflammatory factors such as WBCC, CRP, APN, LEP, and IL-6. The detection of serum inflammatory factors in obese individuals is of great significance for early warning of obesity-related diseases.

Key words： metabolically healthy obesity inflammatory factor early warning meta analysis

收稿日期: 2025-01-01

ZTFLH:

R58

基金资助:中国中医科学院西苑医院具有知识产权的医疗机构制剂和中药新药的研究与转化专项(XYZX0301-16); 北京中医药薪火传承“3+3”工程项目(2023-SZ-A-5);中国中医科学院科技创新工程(CI2021A03005)

通讯作者: 张晋,E-mail:jin_zhang2000@hotmail.com

作者简介: 吴梓敬,硕士研究生。

引用本文:

吴梓敬, 李纪新, 邱林杰, 任燕, 邹姹姹, 李美洁, 栗文婕, 张晋. 成人代谢健康型肥胖与炎症因子关系的Meta分析[J]. 武警医学, 2025, 36(5): 426-434. WU Zijing, LI Jixin, QIU Linjie, REN Yan, ZOU Chacha , LI Meijie, LI Wenjie, ZHANG Jin. Meta-analysis on the association between adult metabolically healthy obesity and inflammatory factors. Med. J. Chin. Peop. Armed Poli. Forc., 2025, 36(5): 426-434.

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https://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 https://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2025/V36/I5/426

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