Utility of obesity and metabolic dyslipidemia (a non‐insulin based determinate of the metabolic syndrome and insulin resistance) in predicting arterial stiffness

Aroor, Annayya R.; Whaley‐Connell, Adam; Sowers, James R.

doi:10.1111/jch.13615

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…We confirmed the two hypotheses that metabolic health and obesity phenotypes was associated with the development of arterial stiffness, and unhealthy individuals with either obesity or nonobesity status had a significantly higher risk of arterial stiffness than individuals with the MUNO phenotype, which did not exist in those with the MHO phenotype. The increase in the PWV with age in adulthood was reported to be not only due to the decrease in elasticity caused by the degeneration of the arterial wall but also the consequence of many metabolic abnormalities such as obesity and CAs [30]. Recent studies have demonstrated that the baPWV is associated with metabolic syndrome and increases with increasing numbers of metabolic syndrome components [23,31] .…”

Section: Discussionmentioning

confidence: 99%

Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Yuan

Chu

et al. 2020

Nutr Metab (Lond)

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Background: Metabolically healthy obesity (MHO) has been reported to be associated with the development of vascular damage by the carotid intima-media thickness, but the relationship between metabolic health and obesity phenotypes and arterial stiffness is still unknown. Our hypothesized that different metabolic health and obesity phenotypes might be associated with the development of arterial stiffness, and that subjects in MHO phenotype might not have increased risks of arterial stiffness compared with those in metabolically healthy nonobesity phenotype (MHNO), while metabolic unhealthy individuals might have increased risks of arterial stiffness. Methods: A prospective cohort of 2076 participants (aged 36-48 years) who were enrolled in the Hanzhong Adolescent Hypertension Cohort Study in 2017 was analyzed in a cross-sectional analysis. A subgroup of 202 participants from 2005 to 2017 was selected by an isometric sampling method and was included in the final longitudinal analysis. Results: We identified four metabolic health and obesity phenotypes for both the cross-sectional and longitudinal analyses as follows: MHNO, metabolically unhealthy nonobesity (MUNO), MHO, and metabolically unhealthy obesity (MUO). In the cross-sectional analysis, individuals with the MHO phenotype had the lowest brachial-ankle pulse wave velocity (baPWV) levels of the four phenotypes (P < 0.001), and participants with the MHO phenotype had a similar risk of arterial stiffness after fully adjustment [odds ratio (OR) = 0.99 (0.61-1.60)] as the MUNO subjects. Subjects with metabolically unhealthy status had a significantly higher risk of arterial stiffness than the MHNO individuals, particularly females (P < 0.005). In the longitudinal analysis, subjects with the MUNO and MUO phenotypes had a significantly higher risk of arterial stiffness than the MHNO individuals after adjustment for age and sex [OR = 5.21 (2.26-12.02), OR = 3.32 (1.18-9.32), respectively]. Conclusions: The MHO phenotype did not significantly increase the progression of arterial stiffness. Metabolically unhealthy individuals (MUNO, MUO), regardless of obesity status, showed a worse effect for the development of arterial stiffness, particularly females. Trial registration: NCT02734472. Registered 12 April 2016-Retrospectively registered, http:www.clinicaltrials.gov.

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Section: Discussionmentioning

confidence: 99%

Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Yuan

Chu

et al. 2020

Nutr Metab (Lond)

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“…In addition to plasma triglyceride and HDL‐C that are related to insulin‐mediated glucose disposal, the inclusion of BMI as a surrogate for visceral adiposity takes into account the causal relationship between adipose tissue inflammation and the development of IR and ultimately T2DM [ 37 - 39 ]. The nonlinear relationship we observed between baseline METS-IR and new-onset T2DM might be partly explained by the multifactorial interactions among adiposity, dysglycemia, and inflammation in metabolic pathways and vascular biologic processes [ 13 , 39 - 42 ]. Our findings echo previous literature on the nonlinear relationship between FPG and T2DM in the European population [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care

Cheng,

Jia,

et al. 2024

JMIR Public Health Surveill

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Background The metabolic score for insulin resistance (METS-IR) has emerged as a noninsulin-based index for the approximation of insulin resistance (IR), yet longitudinal evidence supporting the utility of METS-IR in the primary prevention of type 2 diabetes mellitus (T2DM) remains limited. Objective We aimed to investigate the longitudinal association between METS-IR, which combines fasting plasma glucose (FPG), lipid profiles, and anthropometrics that can be routinely obtained in resource-limited primary care settings, and the incidence of new-onset T2DM. Methods We conducted a closed-cohort analysis of a nationwide, prospective cohort of 7583 Chinese middle-aged and older adults who were free of T2DM at baseline, sampled from 28 out of 31 provinces in China. We examined the characteristics of participants stratified by elevated blood pressure (BP) at baseline and new-onset T2DM at follow-up. We performed Cox proportional hazard regression analysis to explore associations of baseline METS-IR with incident T2DM in participants overall and in participants stratified by baseline BP. We also applied net reclassification improvement and integrated discrimination improvement to examine the incremental value of METS-IR. Results During a mean follow-up period of 6.3 years, T2DM occurred in 527 participants, among which two-thirds (332/527, 62.9%; 95% CI 58.7%-67.1%) had baseline FPG<110 mg/dL. A SD unit increase in baseline METS-IR was associated with the first incidence of T2DM (adjusted hazard ratio [aHR] 1.33, 95% CI 1.22-1.45; P<.001) in all participants. We obtained similar results in participants with normal baseline BP (aHR 1.41, 95% CI 1.22-1.62; P<.001) and elevated baseline BP (aHR 1.29, 95% CI 1.16-1.44; P<.001). The predictive capability for incident T2DM was improved by adding METS-IR to FPG. In study participants with new-onset T2DM whose baseline FPG was <126 mg/dL and <110 mg/dL, 62.9% (332/527; 95% CI 60%-65.9%) and 58.1% (193/332; 95% CI 54.3%-61.9%) of participants had baseline METS-IR above the cutoff values, respectively. Conclusions METS-IR was significantly associated with new-onset T2DM, regardless of baseline BP level. Regular monitoring of METS-IR on top of routine blood glucose in clinical practice may add to the ability to enhance the early identification of primary care populations at risk for T2DM.

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“…In addition to plasma triglyceride and HDL-C that are related to insulin-mediated glucose disposal, the inclusion of BMI as a surrogate for visceral adiposity takes into account the causal relationship between adipose tissue inflammation and the development of IR and ultimately T2DM [37][38][39]. The nonlinear relationship we observed between baseline METS-IR and new-onset T2DM might be partly explained by the multifactorial interactions among adiposity, dysglycemia, and inflammation in metabolic pathways and vascular biologic processes [13,[39][40][41][42]. Our findings echo previous literature on the nonlinear relationship between FPG and T2DM in the European population [43].…”

Section: Relationship With Other Studiesmentioning

confidence: 96%

Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care (Preprint)

Cheng,

Jia,

et al. 2023

Preprint

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BACKGROUND The metabolic score for insulin resistance (METS-IR) has emerged as a noninsulin-based index for the approximation of insulin resistance (IR), yet longitudinal evidence supporting the utility of METS-IR in the primary prevention of type 2 diabetes mellitus (T2DM) remains limited. OBJECTIVE We aimed to investigate the longitudinal association between METS-IR, which combines fasting plasma glucose (FPG), lipid profiles, and anthropometrics that can be routinely obtained in resource-limited primary care settings, and the incidence of new-onset T2DM. METHODS We conducted a closed-cohort analysis of a nationwide, prospective cohort of 7583 Chinese middle-aged and older adults who were free of T2DM at baseline, sampled from 28 out of 31 provinces in China. We examined the characteristics of participants stratified by elevated blood pressure (BP) at baseline and new-onset T2DM at follow-up. We performed Cox proportional hazard regression analysis to explore associations of baseline METS-IR with incident T2DM in participants overall and in participants stratified by baseline BP. We also applied net reclassification improvement and integrated discrimination improvement to examine the incremental value of METS-IR. RESULTS During a mean follow-up period of 6.3 years, T2DM occurred in 527 participants, among which two-thirds (332/527, 62.9%; 95% CI 58.7%-67.1%) had baseline FPG<110 mg/dL. A SD unit increase in baseline METS-IR was associated with the first incidence of T2DM (adjusted hazard ratio [aHR] 1.33, 95% CI 1.22-1.45; P<.001) in all participants. We obtained similar results in participants with normal baseline BP (aHR 1.41, 95% CI 1.22-1.62; P<.001) and elevated baseline BP (aHR 1.29, 95% CI 1.16-1.44; P<.001). The predictive capability for incident T2DM was improved by adding METS-IR to FPG. In study participants with new-onset T2DM whose baseline FPG was <126 mg/dL and <110 mg/dL, 62.9% (332/527; 95% CI 60%-65.9%) and 58.1% (193/332; 95% CI 54.3%-61.9%) of participants had baseline METS-IR above the cutoff values, respectively. CONCLUSIONS METS-IR was significantly associated with new-onset T2DM, regardless of baseline BP level. Regular monitoring of METS-IR on top of routine blood glucose in clinical practice may add to the ability to enhance the early identification of primary care populations at risk for T2DM.

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Utility of obesity and metabolic dyslipidemia (a non‐insulin based determinate of the metabolic syndrome and insulin resistance) in predicting arterial stiffness

Cited by 8 publications

References 25 publications

Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study

Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care

Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care (Preprint)

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