代谢综合征的中心环节是肥胖和胰岛素抵抗,但也有部分体重正常人群存在体内的糖脂代谢紊乱,包括高血压、高 血脂、高血糖、亚临床炎症等,这部分人群被称为体重正常的代谢异常者。 由于目前对代谢综合征及肥胖的诊断标准不统 一,因此体重正常的代谢异常人群在不同的研究中定义也并不一致。 近年来的研究发现其面临的健康危害主要有心血管疾 病、肿瘤、肾脏损伤等风险增加,还可能与胆石症、低睾酮血症及甲状腺功能减退风险增加有关。 体重正常人群的代谢异常可 能受体重、身体成分、膳食模式、肠道菌群、年龄等影响,具体的机制尚不明确。 相比较肥胖患者,体重正常的代谢异常人群容 易被忽视或者漏诊,也缺乏大样本人群干预研究。 本文对体重正常的代谢异常人群的分布、面临的健康风险及可能的影响因 素进行阐述,旨在提高对这部分患者的关注。

Obesity and insulin resistance are central part of metabolic syndrome . However some people with normal weight also exist glucose and lipid metabolism disorder including hypertension hyperlipidemia hyperglycemia subclinical inflammation etc. These people are called metabolically unhealthy normal weight. As the current diagnostic criteria for metabolic syndrome and obesity are inconsistent the definition of metabolically unhealthy normal weight is also inconsistent in different studies. Health hazards of metabolically normal weight including increased risk of cardiovascular disease tumor kidney damage cholelithiasis and low testosterone were found in recent studies. Metabolic unhealthy normal weight may be related to body weight body composition intestinal flora dietary patterns and age but the specific mechanism remains unclear. Compared with obese patients the metabolically abnormalities in these people are easy to be ignored or missed. And intervention studies of large sample population in metabolic unhealthy normal weight are lacking. We reviewed the population distribution risks and possible influencing factors of metabolic unhealthy in patients with normal weight aiming to improve the attention to these patients.