Journal of Diagnostics Concepts & Practice ›› 2017, Vol. 16 ›› Issue (04): 419-424.doi: 10.16150/j.1671-2870.2017.04.015

• Original article • Previous Articles     Next Articles

Association of metabolically healthy obesity, insulin resistance with risk of diabetes: a prospective study

NI Hengru1, LIN Lin2, PENG Kui2, HAO Mingli2, WANG Tiange2, GAO Jinli1   

  1. 1. Songnan Community Health Service Center, Baoshan District, Shanghai 200441, China;
    2. Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2017-02-09 Online:2017-08-25 Published:2017-08-25

Abstract: Objective: To investigate the association between metabolically healthy obesity (MHO) and risk of diabetes in population in Shanghai and to assess the role of insulin resistance in their relationship. Methods: A prospective study was performed among 1 967 participants aged 40 years or older in Baoshan community, Shanghai. The participants were categorized into four groups according to obesity and metabolic status: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese(MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Questionnaire interview, anthropometric measurements, and biochemical measurements were obtained in the participants. Metabolic profiles and rate of incident diabetes were compared between the groups. Results: After a median follow-up period of 4 years, the rate of incident diabetes in group MHNO, group MUNO, group MHO, and group MUO were 3.4%, 16.4%, 7.7%, and 17.5%, respectively. Multivariate logistic analysis revealed that patients in group MHO had an increased risk of incident diabetes [odds ratio (OR)=2.25, 95% confidence interval (CI) 1.31-3.85] when compared with subjects in MHNO. Compared with patients in group MHNO, patients resistant to insulin [homeostasis model assessment of insulin resistance(HOMA-IR≥2.5)] in group MHO had an increased OR for incident diabetes (OR=5.20, 95% CI 2.56-10.56). Conclusions: The 4-year follow-up revealed that patients of MHO have a high incidence of diabetes in which insulin resistance might play a role.

Key words: Obesity, Metabolic healthy, Diabetes, Insulin resistance

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