Distribution of metabolic/obese phenotypes and association with diabetes: 5 years’ cohort based on 22,276 elderly
- 25 Downloads
To describe the distribution and changes of different metabolic/obese phenotypes among more than 22,000 male elderly in China, and also explore the association with diabetes incidence.
A cohort study based on 22,276 male elderly was conducted in Beijing, from 2009 to 2013. Multiple Cox model was used to calculate the relative risk.
There were only 53.8% of total participants who kept the same phenotype for the 5 years. On the whole, participants with metabolically unhealthy phenotypes had higher relative risks (RRs) than those with metabolically healthy phenotypes. RRs for diabetes showed an increasing trend along with metabolic abnormalities (p < 0.001). However, no statistically significant difference was found across different obese status with the same number of metabolic abnormalities. Changes of metabolic/obese status also showed the same trend. Those who had kept metabolic unhealthy had the highest RRs for diabetes incidence, which was higher than those who kept obesity.
Both metabolically healthy obesity and metabolically unhealthy normal weight phenotypes had an increased risk for diabetes incidence, and metabolic abnormalities might have more influence on diabetes than obesity itself. Changes of metabolic/obese status also had an important impact on diabetes incidence.
KeywordsMetabolically healthy obesity Metabolically unhealthy normal weight Diabetes Cohort study Elderly
Body mass index
Diastolic blood pressure
Fasting blood glucose
High-density lipoprotein cholesterol
Low-density lipoprotein cholesterol
Metabolically healthy normal weight
Metabolically healthy obesity
Metabolically healthy overweight
Metabolically unhealthy normal weight
Metabolically unhealthy obesity
Metabolically unhealthy overweight
Systolic blood pressure
Two hours plasma glucose
This study is supported by research grants from Beijing Nova Program (Z181100006218085), Opening Foundation of State Key Laboratory of Kidney Diseases (KF-01-115), Opening Foundation of National Clinical Research Center of Geriatrics (NCRCG-PLAGH-2017017), National Natural Science Foundation of China (81703285), Beijing Natural Science Foundation (7174350), Beijing Municipal Science and Technology Commission (Z161100005016021), Military Fund (15BJZ41, 17BJZ51). The views and opinions expressed in this paper are those of the authors and do not necessarily reflect the official position of the study sponsors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. And this study protocol had been approved by the Ethics Committees of Chinese PLA General Hospital (EC0411-2001).
Informed consent was obtained from all individual participants included in the study.
- 2.S.L. Hardoon, R.W. Morris, M.C. Thomas, S.G. Wannamethee, L.T. Lennon, P.H. Whincup, Is the recent rise in type 2 diabetes incidence from 1984 to 2007 explained by the trend in increasing BMI?: evidence from a prospective study of British men. Diabetes Care 33, 1494–1496 (2010)CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Y. Chang, S. Ryu, Y. Choi, Y. Zhang, J. Cho, M.J. Kwon, Y.Y. Hyun, K.B. Lee, H. Kim, H.S. Jung, K.E. Yun, J. Ahn, S. Rampal, D. Zhao, B.S. Suh, E.C. Chung, H. Shin, R. Pastor-Barriuso, E. Guallar, Metabolically healthy obesity and development of chronic kidney disease: a cohort study. Ann. Intern. Med. 164, 305–312 (2016)CrossRefPubMedGoogle Scholar
- 9.A. Goday, E. Calvo, L.A. Vázquez, E. Caveda, T. Margallo, C. Catalina-Romero, J. Reviriego, Prevalence and clinical characteristics of metabolically healthy obese individuals and other obese/non-obese metabolic phenotypes in a working population: results from the Icaria study. BMC Public Health 16, 248 (2016)CrossRefPubMedPubMedCentralGoogle Scholar
- 10.H.K. Nan, A.S. Ji, H. Cho, J.H. Seo, J.H. Yu, H.J. Yoo, S.G. Kim, K.M. Choi, S.H. Baik, D.S. Choi, C. Shin, N.H. Cho, Risk of the development of diabetes and cardiovascular disease in metabolically healthy obese people: the Korean genome and epidemiology study. Medicine 95, e3384 (2016)CrossRefGoogle Scholar
- 12.K.G. Alberti, R.H. Eckel, S.M. Grundy, P.Z. Zimmet, J.I. Cleeman, K.A. Donato, J.C. Fruchart, W.P. James, C.M. Loria, S.C. Smith Jr; International Diabetes Federation Task Force on Epidemiology and Prevention; Hational Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity, Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International. Circulation 120, 1640 (2009)CrossRefPubMedGoogle Scholar
- 13.G. Calori, G. Lattuada, L. Piemonti, M.P. Garancini, F. Ragogna, M. Villa, S. Mannino, P. Crosignani, E. Bosi, L. Luzi, G. Ruotolo, G. Perseghin, Prevalence, metabolic features, and prognosis of metabolically healthy obese Italian individuals: the Cremona Study. Diabetes Care 34, 210 (2011)CrossRefPubMedGoogle Scholar
- 14.E.J. Rhee, M.K. Lee, J.D. Kim, W.S. Jeon, J.C. Bae, S.E. Park, C.Y. Park, K.W. Oh, S.W. Park, W.Y. Lee, Metabolic health is a more important determinant for diabetes development than simple obesity: a 4-year retrospective longitudinal study. PLoS ONE 9, e98369 (2014)CrossRefPubMedPubMedCentralGoogle Scholar
- 20.L.L. Roberson, E.C. Aneni, W. Maziak, A. Agatston, T. Feldman, M. Rouseff, T. Tran, M. Blaha, R. Santos, A. Sposito, M. Al-Mallah, R. Blankstein, M. Budoff, K. Nasir, Beyond BMI: the “metabolically healthy obese” phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality—a systematic review. BMC Public Health 14, 14 (2014)CrossRefPubMedPubMedCentralGoogle Scholar