The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus

Han, Seung Jin; Boyko, Edward J.

doi:10.4093/dmj.2018.0055

Cited by 80 publications

(87 citation statements)

References 52 publications

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“…This finding may be justified with the paradox of obesity which was recently reported in some studies. 37,38 In older adults, overweight may particularly be accompanied by a lower risk of all-cause and cardiovascular motility. 37 Furthermore, among type 2 diabetic patients, the U-shaped association of BMI with all-cause mortality with adjusted age, sex, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, smoking, and diabetes duration has been observed which showed that overweight participants had a significantly lower hazard ratio of mortality than other BMI groups.…”

Section: Discussionmentioning

confidence: 99%

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Aliyari¹,

Hajizadeh²,

Aminorroaya³

et al. 2020

DMSO

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Background: Increase in the prevalence of type 2 diabetic mellitus (T2DM) as a complex disease, its complications, and spread has become a dominant global health threat in recent decades. Objective: The aim of the current study was to investigate the impact of risk factors and transition probability on the development and progression of the late complications of T2DM. Methods: This study was an open cohort one which was conducted at Isfahan Endocrine and Metabolism Research Center (IEMRC). The data were collected from 1993 to 2018. The sample size consisted of 2519 adults diagnosed with type 2 diabetes. We applied the homogeneous multistate models including no complication, retinopathy alone, coronary artery disease (CAD), microalbuminuria, retinopathy and CAD, and the final absorbing mortality states. Results: Based on our results, time-varying hypertension strongly intensified the hazard of transition to mortality in CAD, no complication, CAD and retinopathy, and retinopathy patients by 4.99, 4.09, 3.42, and 2.65 times, respectively. Hypertension seemed to be a potential factor for the transition of microalbuminuria to no complication in diabetic patients. One-unit increase in LDL increased the hazard ratio of transition from CAD, and retinopathy and CAD to mortality by 1.8% and 2.4%, respectively. Moreover, one level increase in time-varying HbA1c increased the hazard ratio of transition to retinopathy and mortality among no complication diabetic patients by 30% and 67%, respectively. One level increase in time-varying HbA1c also intensified the hazard ratio of transition from retinopathy to mortality by 45%. The same level of increase in time-varying HbA1c also intensified the hazard ratio of transition from CAD alone to CAD and retinopathy, and microalbuminuria to retinopathy by 26% and 50%, respectively. Conclusion: In addition to glycemic control, our study indicates that controlling hypertension and hyperlipidemia is more effective in reducing mortality and the diabetic macro-and microvascular complications.

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Section: Discussionmentioning

confidence: 99%

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Aliyari¹,

Hajizadeh²,

Aminorroaya³

et al. 2020

DMSO

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“…Body mass index (BMI) is widely used to assess health status based on weight and height. In general, higher BMI (overweight and/or obesity) is an indicator of increased risk of developing a range of conditions, including metabolic disorders, such as type 2 diabetes mellitus (T2DM) (Bays, Chapman & Grandy, 2007;Han & Boyko, 2018). Weight fluctuation is commonly associated with dietary consumption, and increasing food intake overtime, can lead to gaining weight.…”

Section: Introductionmentioning

confidence: 99%

Gut microbiota of obese and diabetic Thai subjects and interplay with dietary habits and blood profiles

Gruneck

Kullawong

Kespechara³

et al. 2020

PeerJ

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Obesity and type 2 diabetes mellitus (T2DM) have become major public health issues globally. Recent research indicates that intestinal microbiota play roles in metabolic disorders. Though there are numerous studies focusing on gut microbiota of health and obesity states, those are primarily focused on Western countries. Comparatively, only a few investigations exist on gut microbiota of people from Asian countries. In this study, the fecal microbiota of 30 adult volunteers living in Chiang Rai Province, Thailand were examined using next-generation sequencing (NGS) in association with blood profiles and dietary habits. Subjects were categorized by body mass index (BMI) and health status as follows; lean (L) = 8, overweight (OV) = 8, obese (OB) = 7 and diagnosed T2DM = 7. Members of T2DM group showed differences in dietary consumption and fasting glucose level compared to BMI groups. A low level of high-density cholesterol (HDL) was observed in the OB group. Principal coordinate analysis (PCoA) revealed that microbial communities of T2DM subjects were clearly distinct from those of OB. An analogous pattern was additionally illustrated by multiple factor analysis (MFA) based on dietary habits, blood profiles, and fecal gut microbiota in BMI and T2DM groups. In all four groups, Bacteroidetes and Firmicutes were the predominant phyla. Abundance of Faecalibacterium prausnitzii, a butyrate-producing bacterium, was significantly higher in OB than that in other groups. This study is the first to examine the gut microbiota of adult Thais in association with dietary intake and blood profiles and will provide the platform for future investigations.

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“…The incidence of thyroid cancer has been increasing throughout the world during the last few decades [30][31][32][33]. During the same time period, the prevalence of obesity has dramatically increased and has become a major public health issue worldwide [34,35]. In addition to the widespread use of high-resolution imaging tools, changes in lifestyle and environmental factors are considered contributing factors to an increase in the incidence of thyroid cancer [33,36].…”

Section: Discussionmentioning

confidence: 99%

Serum Adiponectin and Progranulin Level in Patients with Benign Thyroid Nodule or Papillary Thyroid Cancer

et al. 2020

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Background: Obesity is associated with thyroid cancer risk. Adiponectin has insulin-sensitizing and anti-inflammatory effects, while progranulin is associated with inflammation and tumorigenesis. We investigated serum adiponectin and progranulin levels in patients with benign thyroid nodule (benign group) and papillary thyroid cancer (PTC; PTC group). The associations between these levels and the clinicopathological features of PTC were evaluated. Methods: We included 157 patients who underwent thyroid surgery (17% of benign and 83% of PTC group). Clinicopathological features including size, lymph node metastasis, extrathyroidal extension (ETE), multifocality, American Thyroid Association risk stratification were evaluated. Results: The age was 42.0 years, and 69% were female. Serum adiponectin and progranulin levels were 6.3 µg/mL and 101.5 ng/mL in the benign group and 5.4 µg/mL and 106.1 ng/mL in the PTC group, respectively (P=0.6 and P=0.4, respectively). Serum adiponectin levels showed no significant differences according to clinicopathological features of PTC. The proportions of patients with primary tumor size >1 cm were 3%, 5%, 8%, and 8% according to serum progranulin level quartiles, respectively (P=0.03). The proportions of patients with microscopic/gross ETE were 8%/0%, 9%/1%, 11%/1%, and 11%/2% according to serum progranulin level quartiles, respectively. Median serum progranulin level was significantly higher in patients with PTC >1 cm than in patients with papillary thyroid microcarcinoma (P=0.04, 115.3 ng/mL and 104.7 ng/mL, respectively). Conclusion: Serum adiponectin and progranulin levels showed no significant difference between benign and PTC groups. Increased serum progranulin levels were significantly associated with PTC >1 cm and microscopic and gross ETE.

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The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus

Cited by 80 publications

References 52 publications

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Gut microbiota of obese and diabetic Thai subjects and interplay with dietary habits and blood profiles

Serum Adiponectin and Progranulin Level in Patients with Benign Thyroid Nodule or Papillary Thyroid Cancer

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