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Endocrine

pp 1–9 | Cite as

Distribution of metabolic/obese phenotypes and association with diabetes: 5 years’ cohort based on 22,276 elderly

  • Miao Liu
  • Ru Tang
  • Jianhua Wang
  • Yao He
Original Article
  • 25 Downloads

Abstract

Aims

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Metabolically healthy obesity Metabolically unhealthy normal weight Diabetes Cohort study Elderly 

Abbreviations

BMI

Body mass index

CI

Confidence interval

DBP

Diastolic blood pressure

FBG

Fasting blood glucose

HDL-C

High-density lipoprotein cholesterol

LDL-C

Low-density lipoprotein cholesterol

MHNW

Metabolically healthy normal weight

MHO

Metabolically healthy obesity

MHOW

Metabolically healthy overweight

MUNW

Metabolically unhealthy normal weight

MUO

Metabolically unhealthy obesity

MUOW

Metabolically unhealthy overweight

RR

Relative risk

SBP

Systolic blood pressure

TC

Total cholesterol

TG

Triglyceride

2hPG

Two hours plasma glucose

Notes

Funding

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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

Supplementary material

12020_2018_1672_MOESM1_ESM.doc (78 kb)
Appendix Tables
12020_2018_1672_MOESM2_ESM.jpg (49 kb)
Appendix Figure 1Flow Chart of Inclusion of Participants
12020_2018_1672_MOESM3_ESM.jpg (524 kb)
Appendix Figure 2 Diabetes-free survival curve according to six phenotypes
12020_2018_1672_MOESM4_ESM.doc (33 kb)
Appendix Figure 3 RRs of diabetes according to changes of combination of metabolic status and BMI

References

  1. 1.
    R. Viner, B. White, D. Christie, Type 2 diabetes in adolescents: a severe phenotype posing major clinical challenges and public health burden. Lancet 389, 2252–2260 (2017)CrossRefPubMedGoogle Scholar
  2. 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
  3. 3.
    A. Abdullah, A. Peeters, M.D. Courten, J. Stoelwinder, The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Res. Clin. Pract. 89, 309–319 (2010)CrossRefPubMedGoogle Scholar
  4. 4.
    L.C. Hwang, C.H. Bai, C.A. Sun, C.J. Chen, Prevalence of metabolically healthy obesity and its impacts on incidences of hypertension, diabetes and the metabolic syndrome in Taiwan. Asia Pac. J. Clin. Nutr. 21, 227–233 (2012)PubMedGoogle Scholar
  5. 5.
    A.D. Karelis, D.H. St-Pierre, F. Conus, R. Rabasa-Lhoret, E.T. Poehlman, Metabolic and body composition factors in subgroups of obesity: what do we know? J. Clin. Endocrinol. Metab. 89, 2569–2575 (2004)CrossRefPubMedGoogle Scholar
  6. 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
  7. 7.
    Y. Chang, B.K. Kim, K.E. Yun, J. Cho, Y. Zhang, S. Rampal, D. Zhao, H.S. Jung, Y. Choi, J. Ahn, J.A. Lima, H. Shin, E. Guallar, S. Ryu, Metabolically-healthy obesity and coronary artery calcification. J. Am. Coll. Cardiol. 63, 2679–2686 (2014)CrossRefPubMedGoogle Scholar
  8. 8.
    N. Eckel, K. Mühlenbruch, K. Meidtner, H. Boeing, N. Stefan, M.B. Schulze, Characterization of metabolically unhealthy normal-weight individuals: risk factors and their associations with type 2 diabetes. Metab. Clin. Exp. 64, 862–871 (2015)CrossRefPubMedGoogle Scholar
  9. 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. 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
  11. 11.
    M. Liu, J. Wang, J. Zeng, X. Cao, Y. He, Association of NAFLD with diabetes and the impact of BMI changes: a 5 years’ cohort study based on 18507 elderly. J. Clin. Endocrinol. Metab. 102, 1309 (2017)CrossRefPubMedGoogle Scholar
  12. 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. 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. 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
  15. 15.
    S.L. Appleton, C.J. Seaborn, R. Visvanathan, C.L. Hill, T.K. Gill, A.W. Taylor, R.J. Adams, North West Adelaide Health Study Team. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype. Diabetes Care 36, 2388 (2013)CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    G.M. Hinnouho, S. Czernichow, A. Dugravot, H. Nabi, E.J. Brunner, M. Kivimaki, A. Singh-Manoux, Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. Eur. Heart J. 36, 551–559 (2015)CrossRefPubMedGoogle Scholar
  17. 17.
    Y. Heianza, K. Kato, S. Kodama, A. Suzuki, S. Tanaka, O. Hanyu, K. Sato, H. Sone, Stability and changes in metabolically healthy overweight or obesity and risk of future diabetes: Niigata wellness study. Obesity 22, 2420–2425 (2014)CrossRefPubMedGoogle Scholar
  18. 18.
    K. Aung, C. Lorenzo, M.A. Hinojosa, S.M. Haffner, Risk of developing diabetes and cardiovascular disease in metabolically unhealthy normal-weight and metabolically healthy obese individuals. J. Clin. Endocrinol. Metab. 99, 462–468 (2014)CrossRefPubMedGoogle Scholar
  19. 19.
    C.K. Kramer, B. Zinman, R. Retnakaran, Are metabolically healthy overweight and obesity benign conditions?: a systematic review and meta-analysis. Ann. Intern. Med. 159, 758–769 (2013)CrossRefPubMedGoogle Scholar
  20. 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
  21. 21.
    F. Badoud, M. Perreault, M.A. Zulyniak, D.M. Mutch, Molecular insights into the role of white adipose tissue in metabolically unhealthy normal weight and metabolically healthy obese individuals. FASEB J. 29, 748–758 (2015)CrossRefPubMedGoogle Scholar
  22. 22.
    N. Freemantle, J. Holmes, A. Hockey, S. Kumar, How strong is the association between abdominal obesity and the incidence of type 2 diabetes?. Int. J. Clin. 62, 1391–1396 (2008)CrossRefGoogle Scholar
  23. 23.
    M.J. Mcneely, J.B. Shofer, D.L. Leonetti, W.Y. Fujimoto, E.J. Boyko, Associations among visceral fat, all-cause mortality, and obesity-related mortality in Japanese Americans. Diabetes Care 35(2), 296–298 (2012)CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of Geriatrics, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics DiseaseChinese PLA General HospitalBeijingChina
  2. 2.Clinical Department of NanlouChinese PLA General HospitalBeijingChina

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