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目的:探讨在40岁以上的中国社区人群中，代谢健康型肥胖与动脉粥样硬化患病风险的相关性。方法:来自上海嘉定社区共9 525名不伴有心血管疾病的居民(男性3 621名、女性5 904名)参与了本项研究。每位参与者均完成了调查问卷、体格检查[包括肱踝脉搏波传导速度(brachial-ankle pulse wave velocity, baPWV)和血压(blood pressure, BP)的测量]，以及实验室检查。根据体重指数(body mass index, BMI)和代谢水平，将参与者分为4组，分别是代谢健康型非肥胖(metabolically healthy non-obese, MHNO)、代谢不健康型非肥胖(metabolically unhealthy non-obese, MUNO)、代谢健康型肥胖(metabolically healthy obese, MHO)和代谢不健康型肥胖(metabolically unhealthy obese, MUO)。baPWV>1 400 mm/s被定义为高baPWV水平，脉压差(pulse pressure, PP)高于人群上四分位数被定义为高PP水平。利用多元n logistic回归分析模型探究MHO与高baPWV水平以及高PP水平之间的相关性。n 结果:多元n logistic回归分析显示，在校正性别、年龄、当前吸烟、当前饮酒及受教育程度之后，与MHNO组比较，MHO组人群与高baPWV水平(n OR＝1.18, 95%n CI 1.02～1.37)和高PP水平(n OR＝1.72, 95%n CI 1.43～2.08)有显著相关性。另外，MUNO和MUO组人群的高baPWV水平(MUNO为n OR＝3.02, 95%n CI 2.60～3.50; MUO为n OR＝3.26, 95%n CI 2.87～3.70)和高PP水平(MUNO为n OR＝2.56, 95%n CI 2.17～3.02; MUO为n OR＝3.49, 95%n CI 3.01～4.06)患病风险显著升高。n 结论:中国社区中老年人群中，MHO与动脉粥样硬化患病风险升高有显著相关性。“,”Objective:To investigate the association between metabolically healthy obesity(MHO) and atherosclerosis risk among Chinese community population aged 40 or older.Methods:A total of 9 525 participants without cardiovascular diseases (3 621 men and 5 904 women) from Jiading community in Shanghai were enrolled to complete questionnaires, undergo extensive physical examination including brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) assessment, and laboratory screening. According to body mass index (BMI) and metabolic status, these participants were categorized into 4 groups including metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), MHO, and metabolically unhealthy obese (MUO). High baPWV was defined as baPWV>1 400 mm/s, and high pulse pressure (PP) was defined as PP above fourth quartile of the population. Multivariaten logistic regression model was conducted to explore the relationship between MHO and high baPWV as well as high PP after adjusting for confounders.n Results:After multivariable adjustment, such as sex, age, current smoking, current drinking, and education, n logistic regression analysis showed that MHO was significantly correlated with high baPWV (n OR=1.18, 95%n CI 1.02-1.37) and high PP (n OR=1.72, 95%n CI 1.43-2.08) in comparison with MHNO. Otherwise, both MUNO and MUO subjects were at higher risk for suffering from high baPWV (MUNO: n OR=3.02, 95%n CI 2.60-3.50; MUO: n OR=3.26, 95%n CI 2.87-3.70) and high PP (MUNO: n OR=2.56, 95%n CI 2.17-3.02; MUO: n OR=3.49, 95%n CI 3.01-4.06).n Conclusion:On the basis of Chinese community population, there was a pronounced correlation between the MHO phenotype and the increased risk of developing atherosclerosis.