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Observational Study
. 2014 Mar 15;172(2):388-94.
doi: 10.1016/j.ijcard.2014.01.073. Epub 2014 Jan 25.

The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population: results of the REACTION study

Jieli Lu  1 , Yufang Bi  1 , Tiange Wang  1 , Weiqing Wang  1 , Yiming Mu  2 , Jiajun Zhao  3 , Chao Liu  4 , Lulu Chen  5 , Lixin Shi  6 , Qiang Li  7 , Qin Wan  8 , Shengli Wu  9 , Guijun Qin  10 , Tao Yang  11 , Li Yan  12 , Yan Liu  13 , Guixia Wang  13 , Zuojie Luo  14 , Xulei Tang  15 , Gang Chen  16 , Yanan Huo  17 , Zhengnan Gao  18 , Qing Su  19 , Zhen Ye  20 , Youming Wang  21 , Huacong Deng  22 , Xuefeng Yu  23 , Feixia Shen  24 , Li Chen  25 , Liebing Zhao  1 , Meng Dai  1 , Min Xu  1 , Yu Xu  1 , Yuhong Chen  1 , Shenghan Lai  26 , Guang Ning  27
Affiliations
Observational Study

The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population: results of the REACTION study

Jieli Lu et al. Int J Cardiol. .

Abstract

Objective: Obesity and insulin resistance are risk factors for cardiovascular diseases. Whether insulin-sensitive obese individuals are at higher risk for cardiovascular diseases is still debated. We aim to investigate whether insulin-sensitive obesity associates with prevalent cardiovascular diseases and 10-year coronary heart disease (CHD) risk.

Research design and methods: At the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, 211,641 participants aged 40 years or older were recruited from 25 communities across the China mainland, in 2011 to 2012. Participants were categorized by insulin-sensitive/resistant and general/abdominal obese status. Cardiovascular diseases included CHD, stroke, and myocardial infarction. Framingham risk score (FRS) was calculated according to National Cholesterol Education Program-Adult Treatment Panel III and FRS greater than 20% or cardiovascular diseases were identified as high risk for 10-year CHD.

Results: Controlling for potential confounders, compared with insulin-sensitive normal weight individuals, insulin-sensitive general obese individuals had increased risks for prevalent cardiovascular diseases (men: OR, 2.55, 95% CI, 2.04-3.18; women: 1.73, 1.45-2.06) and 10-year Framingham risk for CHD (men: 2.26, 1.86-2.76; women: 1.73, 1.46-2.06). Compared with insulin-sensitive normal waist subgroup, insulin-sensitive abdominal obesity was associated with higher risks for prevalent cardiovascular diseases (men: 1.32, 1.20-1.46; women: 1.36, 1.27-1.47) and 10-year Framingham risk for CHD (men, 1.34, 1.23-1.45; women, 1.37, 1.27-1.47).

Conclusion: Both general and abdominal obesity were associated with elevated prevalent cardiovascular diseases and 10-year CHD risk, regardless of the presence or absence of insulin resistance.

Keywords: Cardiovascular diseases; Epidemiology; Insulin resistance; Obesity.

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