Diabetes, Metabolic Syndrome and Obesity (Jun 2021)

Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults

  • Min J,
  • Hu X,
  • Zhang J,
  • Zeng T,
  • Wang Y,
  • Tian S,
  • Liu G,
  • Zhong X,
  • Qiu K,
  • Peng M,
  • Chen L

Journal volume & issue
Vol. Volume 14
pp. 2561 – 2571

Abstract

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Jie Min, Xiang Hu, Jiaoyue Zhang, Tianshu Zeng, Ying Wang, Shenghua Tian, Geng Liu, Xueyu Zhong, Kangli Qiu, Miaomiao Peng, Lulu Chen Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Lulu ChenDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, People’s Republic of ChinaTel +86 27 8572 6082Fax +86 27 8535 6365Email [email protected]: Changes in transition from metabolically healthy overweight/obesity (MHO) to metabolically unhealthy overweight/obesity (MUO) are associated with the risk for cardiometabolic complications. This study aims to investigate the effects of short-term dynamic changes in body mass index (BMI) and metabolic status on the risk of type 2 diabetes (T2D) and to identify biological predictors for the MHO-to-MUO transition.Patients and Methods: A total of 4604 subjects from the REACTION study were included for a 3-year follow-up. Subjects were categorized based on their BMI and metabolic syndrome status. Overweight/obesity was defined as BMI ≥ 24 kg/m2. Metabolically healthy was defined as having two or fewer of the metabolic syndrome components proposed by the Chinese Diabetes Society. Thus, subjects were divided into four groups: metabolically healthy normal weight (MHNW), MHO, metabolically unhealthy normal weight (MUNW), and MUO.Results: Compared with MHNW, MHO was not predisposed to an increased risk for T2D (OR 1.08, 95% CI 0.64– 1.83, P = 0.762). However, a 3-year transition probability of 20.6% was identified for subjects who shifted from MHO to MUO; this conversion increased the risk of T2D by 3-fold (OR 3.04, 95% CI 1.21– 7.68, P = 0.018). The fatty liver index independently predicted the MHO-to-MUO transition with an OR 3.14 (95% CI 1.56– 7.46, P = 0.002) when comparing the fourth quartile to the first quartile.Conclusion: This study reveals that metabolic changes affect the short-term susceptibility to T2D in the overweight/obese Chinese population, and the fatty liver index is an efficient clinical parameter for identifying those with a metabolic deterioration risk.Keywords: overweight, obesity, metabolic syndrome, type 2 diabetes

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