The Risk of Incident Type 2 Diabetes in a Korean Metabolically Healthy Obese Population: The Role of Systemic Inflammation

Jung, Chang Hee; Lee, Min Jung; Kang, Yu Mi; Jang, Jung Eun; Leem, Jaechan; Hwang, Jenie Yoonoo; Kim, Eun Hee; Park, Joong‐Yeol; Kim, Hong‐Kyu; Lee, Woo Je

doi:10.1210/jc.2014-3885

Cited by 73 publications

(88 citation statements)

References 35 publications

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“…Compared to a European population, Americans had a higher prevalence of MHO, and this was consistent with a meta-analysis [42] focusing on the prevalence of MHO in adults. Studies in Korea showed that the prevalence of MHO varied from 5.7 to 25.8% and the prevalence of MUO from 13.6 to 25.9%, and most studies used ATPIII to define metabolic abnormality [22, 29, 43-45]. Our study revealed that the MHO prevalence was 4.2–11.4% and MUO prevalence was 12.9–20.1% when we adopted ATPIII, CDS, Wildman, and Karelis criteria to define metabolic status.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

et al. 2019

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Objective: Obesity-related disease risks may vary depending on whether the subject has metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). At least 5 definitions/criteria of obesity and metabolic disorders have been documented in the literature, yielding uncertainties in a reliable international comparison of obesity phenotype prevalence. This report aims to compare differences in MHO and MUO prevalence according to the 5 most frequently used definitions. Methods: A random sample of 4,757 adults aged 35 years and older (male 51.1%) was enrolled. Obesity was defined either according to body mass index or waist circumference, and the definitions of metabolic abnormalities were derived from 5 different criteria. Results: In MHO, the highest prevalence was obtained when using the homeostasis model assessment (HOMA) criteria (13.6%), followed by the Chinese Diabetes Society (11.4%), Adult Treatment Panel III (10.3%), Wildman (5.2%), and Karelis (4.2%) criteria; however, the MUO prevalence had an opposite trend to MHO prevalence. The magnitude of differences in the age-specific prevalence of MHO and MUO varied greatly and ranked in different orders. The proportion of insulin resistance for MHO and MUO individuals differed significantly regardless of which metabolic criterion was used. Conclusion: The prevalence of MHO and MUO in the Chinese population varies according to different definitions of obesity and metabolic disorders.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

et al. 2019

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“…6 In brief, the study subjects were recruited from among those aged 420 years who visited the Health Screening and Promotion Center of Asan Medical Center (Seoul, Republic of Korea) between March 2007 and December 2013 for routine medical examinations. During this period, a total of 151,759 subjects participated in this examination.…”

Section: Materials and Methods Study Populationmentioning

confidence: 99%

“…Drinking habits were categorized as frequency per week (that is, ⩽ 1 time/week and ⩾ 2 times/week (moderate drinker)); smoking habits were categorized as noncurrent or current; and exercise habits were categorized as frequency per week (that is, ⩽ 2 times/week and ⩾ 3 times/week (physically active)). 6,51 History of cardiovascular disease was based on each subject's history of angina, myocardial infarction, and/or cerebrovascular accidents, all of which were diagnosed by a physician. Subjects with diabetes were defined as those with a FPG level ⩾ 7.0 mmol/l and/or hemoglobin A1c level ⩾ 6.5%.…”

Section: Kidney Internationalmentioning

confidence: 99%

“…[3][4][5] However, the prognostic value of MHO has been the subject of much debate and faces a considerable challenge. [6][7][8][9] In addition, it may depend on the health outcome being examined. 7 Beyond the effect of obesity on the development of type 2 diabetes and cardiovascular disease, the rapidly increasing prevalence of obesity worldwide is also linked to chronic kidney disease (CKD), and obesity is known to be a risk factor for progressive renal function loss.…”

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confidence: 99%

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The risk of chronic kidney disease in a metabolically healthy obese population

Jung

Lee

Kang

et al. 2015

Kidney International

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Obesity has become an important risk factor for chronic kidney disease (CKD). The metabolically healthy obese (MHO) phenotype refers to obese individuals with a favorable metabolic profile. However, its prognostic value remains controversial and may depend on the health outcome being investigated. To assess this, we examined the risk of MHO phenotype with incident CKD in a Korean population of 41,194 people without CKD. Individuals were stratified by body mass index (cutoff value, 25.0 kg/m(2)) and metabolic health state (assessed using Adult Treatment Panel-III criteria). Incident CKD was defined as a glomerular filtration rate of <60 ml/min per 1.73 m(2) calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Over the median follow-up period of 38.7 months, 356 of the individuals developed incident CKD. Compared with the metabolically healthy nonobese (MHNO) group, the MHO group showed increased risk of incident CKD with a multivariate-adjusted hazard ratio of 1.38 (95% CI, 1.01-1.87). Nonobese but metabolically unhealthy individuals were at an increased risk of incident CKD (multivariate-adjusted hazard ratio, 1.37 (95% CI, 1.02-1.93)) than the MHNO group. Metabolically unhealthy obese individuals were at the highest risk of incident CKD. Thus, a healthy metabolic profile does not protect obese adults from incident CKD. Hence, it is important to consider metabolic health along with obesity when evaluating CKD risk.

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“…The magnitude and consistency of excess risk for type 2 diabetes among healthy obese adults fits with what is known about progressions from healthy to unhealthy obesity, given strong links with future insulin resistance (57) which subsequently induces hyperglycaemia. Since this meta-analysis, at least 6 additional studies have examined type 2 diabetes risk among healthy obese versus healthy normal-weight adults, all of which report excess risk of a similar magnitude (65)(66)(67)(68)(69)(70).…”

Section: Is Healthy Obesity Harmless?mentioning

confidence: 99%

Healthy obesity as an intermediate state of risk: a critical review

Bell

Hamer

2016

Expert Review of Endocrinology & Metabolism

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Introduction: Obesity is a top public health priority but interventions to reverse the condition have had limited success. About 1-in-3 obese adults are free of metabolic risk factor clustering and are considered 'healthy', and much attention has focused on the implications of this state for obesity management. Areas covered:We searched for individual studies, systematic reviews, and meta-analyses which examined correlates and outcomes of metabolically healthy obesity. We discuss the key roles of fat distribution and physical activity in determining healthy vs. unhealthy obesity and report a greatly increased risk of incident type 2 diabetes associated with healthy obesity vs. healthy normal-weight, among other outcomes. We argue that despite inconsistencies in the definition, patterns across studies clearly show that healthy obesity is a state of intermediate disease risk. Expert commentary:Given the current state of population-level evidence, we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health. We recommend that weight loss through energy restriction be a stand-alone target in addition to increased physical activity for minimising risk of future disease.

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The Risk of Incident Type 2 Diabetes in a Korean Metabolically Healthy Obese Population: The Role of Systemic Inflammation

Abstract: MHO subjects show a substantially higher risk of incident type 2 diabetes than MHNO subjects. The level of systemic inflammation partially explains this increased risk.

Cited by 73 publications

References 35 publications

The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

The risk of chronic kidney disease in a metabolically healthy obese population

Healthy obesity as an intermediate state of risk: a critical review

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