Metabolically healthy obesity increased diabetes incidence in a middle‐aged and elderly Chinese population

Abstract

BackgroundWe examined the association between metabolically healthy obese (MHO) and diabetes incidence in a middle‐aged and elderly population and whether the association differed by the presence of nonalcoholic fatty liver disease (NAFLD).MethodsWe examined 17 801 participants without diabetes at study entry (7980 males and 9821 females with a mean age of 63.2 years) derived from the Dongfeng‐Tongji cohort study (median follow‐up: 4.6 years). Participants were divided into six groups based on BMI (normal weight, overweight, or obese) and metabolic health (healthy/unhealthy) defined by the Adult Treatment Panel III criteria. The MHO was defined as BMI greater than 28.0 kg/m2 with 0 or 1 of four metabolic abnormalities (elevated blood pressure, triglyceridaemia, hyperglycaemia, low HDL cholesterol). The hazard ratio (HR) and 95% confidence interval (CI) for incident diabetes were derived from the Cox proportional hazard regression model.ResultsDuring 79 843 person‐years of follow‐up, 1453 individuals developed diabetes. Compared with metabolically healthy normal weight (MH‐NW) individuals, the multivariable‐adjusted HRs (95% CI) were 1.74 (1.16‐2.59) for MHO and 2.15 (1.65‐2.81) for metabolically unhealthy obese subjects after adjusting for age, sex, smoking, alcohol drinking, physical activity, fruit and vegetable consumption, family history of diabetes, fasting glucose, waist circumference, and NAFLD. Among those without NAFLD, MHO individuals showed higher incidence of diabetes (multivariate‐adjusted HR = 2.71, 95% CI: 1.47‐5.00) than MH‐NW individuals.ConclusionsThe MHO phenotype was associated with increased incidence of diabetes in a middle‐aged and elderly population, and the association did not differ by the presence or absence of NAFLD.

Obesity, Even in the Metabolically Healthy, Increases the Risk of Poor Physical Performance: A Cross-Sectional Study of Older People in a Chinese Community

“…Although there is no universally accepted definition for metabolic health status, using ATP-III criteria is reasonable because the threshold for metabolic risk has been validated. 23,24 The prevalence rates of MHNO, MHO, MUHNO, and MUHO in our study were 49.75%, 3.58%, 37.63%, and 9.03%, respectively, similar to a relatively large sample size study in China. 23…”

“…23,24 The prevalence rates of MHNO, MHO, MUHNO, and MUHO in our study were 49.75%, 3.58%, 37.63%, and 9.03%, respectively, similar to a relatively large sample size study in China. 23…”

Obesity and impairment of pancreatic β‐cell function in early adulthood, independent of obesity age of onset: The Santiago Longitudinal Study

“…Our results suggest that the presence of obesity, whether it is recent‐ or long‐term, always carries a risk of major cardiometabolic complications. Interestingly, other cohort studies concluded that metabolically healthy obese subjects also have an increased risk of developing type‐2 diabetes compared to normal weight subjects 44‐46 . It seems that obesity never comes toll‐free; therefore, the only options are to overcome or avoid it.…”

Association Between Obesity Type and Common Vascular and Metabolic Diseases: A Cross-Sectional Study

“…Our study showed that both compound obesity and central obesity alone were associated with hypertension, dyslipidemia, and diabetes mellitus, a finding that suggested that measuring resident waist circumference and BMI may prevent obesityrelated diseases. Although there are different definitions of obesity based on BMI, an abnormal BMI has been shown to be an independent risk factor for hypertension, dyslipidemia, and diabetes mellitus (36)(37)(38). At present, the most commonly used way to prevent obesity-related diseases is to control excessive BMI.…”