Stability and changes in metabolically healthy overweight or obesity and risk of future diabetes: Niigata wellness study

Abstract

Objective: Stability and changes in obesity and metabolic health status from a baseline period and longitudinally investigated their impact on predicting future diabetes were assessed. Methods: Studied were 27,478 Japanese individuals without diabetes. Metabolically healthy (MH) was indicated by having 1 among impaired fasting glucose, hypertension, hypertriglyceridemia and low HDL cholesterol concentration. Metabolically abnormal (MA) was indicated by having 2 of those metabolic abnormalities. A cut-off value of BMI 25.0 defined overweight or obesity (O) or normal weight (NW). Hazard ratio (HR) for diabetes for a 6-year period was investigated after changes in phenotypes were assessed during the previous 2 years. Conclusions: Examining the transitory nature of apparently benign or unhealthy obese phenotypes was effective for differentiating high-risk individuals for future diabetes.

“Metabolically Healthy” Obesity and Hyperuricemia Increase Risk for Hypertension and Diabetes: 5‐year Japanese Cohort Study

“…This result confirms other studies (7, 8, 9, 10) and suggests that “metabolically healthy” obesity is a misnomer as it is still associated with increased risk for hypertension and DM. Second, our study documented that hyperuricemia is an independent risk factor for developing hypertension and DM in the overall population.…”

“…While obesity is recognized as an independent risk factor for hypertension and diabetes mellitus (DM) (7, 8, 9, 10), the classical approach in obesity research is to control for the various metabolic risk factors, many of which may be causally linked to obesity. An alternative approach would be to perform longitudinal analyses in which subjects with obesity are stratified at baseline into those with or without metabolic syndrome.…”

Influence of the definition of “metabolically healthy obesity” on the progression of coronary artery calcification

“…MHO class II without any metabolic abnormality did not significantly increase the risk of CACS progression even after adjusting for possible confounders. By contrast, MHO class I, which has been frequently defined in previous studies [24–27,29,30], showed a 1.7-fold higher risk for CACS progression than non-obese metabolically healthy subjects. A stratified analysis of this MHO class I group according to the number of metabolic abnormality (that is, 0 or 1) showed that there was a significant difference in the risk of CACS progression between MHO subjects with no metabolic abnormality and one metabolic abnormality at the baseline.…”

“…Briefly, obese participants who met ≤ 1 of the following National Cholesterol Education Program–Adult Treatment Panel III (NCEP–ATP III) criteria for metabolic syndrome [28] were considered to have MHO class I: (a) TG level ≥ 1.7 mmol/L (150 mg/dL); (b) HDL cholesterol level < 1.0 mmol/L (40 mg/dL) in men and < 1.3 mmol/L (50 mg/dL) in women; (c) blood pressure ≥ 130/85 mmHg or intake of antihypertensive medication; and (d) fasting glucose level ≥ 5.6 mmol/L (100 mg/dL) or intake of anti-diabetic medication. The WC criterion was not used in the definition of metabolic health as in the previous studies [24–27,29,30], because of collinearity with BMI. Additionally, we defined MHO using stricter criteria following the Healthy Obese Project, which was a population-based cohort study conducted in 7 European countries (MHO class II) [31]: MHO class II was established when subjects with obesity had none of the metabolic syndrome components.…”

Lower serum zinc levels are associated with unhealthy metabolic status in normal-weight adults: The 2010 Korea National Health and Nutrition Examination Survey

“…This was a cross-sectional study, so it was not possible to determine the cause-effect relationship between serum zinc level and metabolic health status. Furthermore, metabolic health profiles such as MONW and MHO are dynamic conditions, and changes in BMI and metabolic condition result in different metabolic outcomes [40]. Further longitudinal follow-up studies of the relationship between serum zinc and changes in metabolic health status are now needed.…”