Diabetes, Metabolic Syndrome and Obesity (Aug 2021)

Effect of Metabolic Health and Obesity Phenotype on Risk of Diabetes Mellitus: A Population-Based Longitudinal Study

  • Zhu X,
  • Hu J,
  • Guo H,
  • Ji D,
  • Yuan D,
  • Li M,
  • Yan T,
  • Xue C,
  • Ma H,
  • Zhou X,
  • Liu Y,
  • Li Y,
  • Sun K,
  • Liu Y,
  • Sun Z,
  • Wang B

Journal volume & issue
Vol. Volume 14
pp. 3485 – 3498

Abstract

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Xiaoyue Zhu,1 Jingyao Hu,1 Haijian Guo,2 Dakang Ji,1 Defu Yuan,1 Mingma Li,1 Tao Yan,1 Chenghao Xue,1 Haonan Ma,1 Xu Zhou,1 Yuxiang Liu,1 You Li,1 Kaicheng Sun,3 Yu Liu,4 Zilin Sun,5 Bei Wang1 1Key Laboratory of Environment Medicine Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China; 2Integrated Business Management Office, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, Jiangsu Province, People’s Republic of China; 3Yandu Centre for Disease Control and Prevention, Yancheng, Jiangsu Province, People’s Republic of China; 4Jurong Centre for Disease Control and Prevention, Jurong, Jiangsu Province, People’s Republic of China; 5Department of Endocrinology, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu Province, People’s Republic of ChinaCorrespondence: Bei WangKey Laboratory of Environment Medicine Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, People’s Republic of ChinaTel +86 25 83272569Email [email protected]: Epidemiologic evidence on body mass index (BMI)-metabolic status phenotypes and diabetes risk remains controversial, especially for metabolically healthy obesity (MHO). We aimed to examine the effect of metabolic health and obesity phenotype on diabetes risk in the Chinese population.Methods: A population-based cohort study was carried out. The baseline survey was conducted in 2017, with two follow-up visits in 2018 and 2020. Diabetes was defined based on the criteria of the World Health Organization. Robust generalized estimating equation models with a binary distribution using a log link and exchange structure were applied for the pooled analysis sample.Results: A total sample of 9623 observations was pooled for the longitudinal data analysis. The average follow-up time was 1.64 years per person and the overall incidence density of diabetes was 6.94% person-years. Decreased diabetes risk was found in metabolically healthy overweight phenotype (RR = 0.65; 95% CI = 0.47– 0.90) and no significant associations were detected for the MHO individuals (RR = 0.99; 95% CI = 0.63– 1.53) compared with those of metabolically healthy normal weight, in contrast to metabolically unhealthy normal weight (MU-NW) (RR = 1.81; 95% CI = 1.28– 2.55), metabolically unhealthy overweight (MU-OW) (RR = 2.02; 95% CI = 1.57– 2.61) and metabolically unhealthy obesity (MUO) (RR = 2.48; 95% CI = 1.89– 3.26) phenotypes. Significant associations between BMI-metabolic status phenotypes and diabetes were found in both males and females.Conclusion: The MUO phenotype needs to be accorded much more importance. MU-NW and MU-OW are also important component for targeted prevention. Our findings can be targeted for optimizing preventive strategies to mitigate the obviously increased prevalence of diabetes.Keywords: diabetes, metabolic health, obesity phenotype, prevention

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