E xcess adiposity has long been associated with metabolic dysfunction. However, epidemiological investigations have demonstrated that not all overweight and obese individuals exhibit poor metabolic function (1). Approximately a decade ago, the concept of metabolically benign obesity, a state in which an individual has a high body mass index (BMI) that is not associated with metabolic disturbance was proposed and characterized. Stefan et al. (2) found that obese adults could have insulin sensitivity and intima-media thickness comparable to normal weight individuals. However, it was not known at that time whether the state of metabolic health could persist under circumstances of excess adiposity or whether rates of clinical outcomes such as cardiovascular disease events (CVD) or deaths were similar in metabolically healthy overweight (MHOW) (BMI $25 kg/m) or metabolically healthy obese (MHO) (BMI $30 kg/m) individuals compared with others. Recently, studies have consistently placed MHO individuals between metabolically healthy lean (MHL) and metabolically unhealthy obesity (MUHO) individuals in terms of CVD risk (3), occult cardiac

中文翻译：

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通过了解复杂表型进行更适当的心血管风险筛查

长期以来，过度肥胖与代谢功能障碍有关。然而，流行病学调查表明，并非所有超重和肥胖的个体都表现出较差的代谢功能 (1)。大约十年前，提出并表征了代谢良性肥胖的概念，即个体具有与代谢紊乱无关的高体重指数 (BMI) 的状态。斯蒂芬等人。(2) 发现肥胖成人的胰岛素敏感性和内中膜厚度与正常体重的人相当。然而，当时尚不清楚代谢健康状态是否可以在过度肥胖的情况下持续存在，或者心血管疾病事件 (CVD) 或死亡等临床结果的发生率是否与代谢健康超重 (MHOW)（BMI $25 kg/ m) 或代谢健康肥胖 (MHO) (BMI $30 kg/m) 的个体与其他人相比。最近，研究一直将 MHO 个体在 CVD 风险 (3)、隐匿性心脏病方面置于代谢健康的瘦 (MHL) 和代谢不健康的肥胖 (MUHO) 个体之间