Risk of diabetes according to the metabolic health status and degree of obesity

Abstract

Aim: To determine the progression rates from metabolically healthy or unhealthy normal weight, overweight and obese phenotype to type 2 diabetes (T2D) in a non-diabetic high risk population in Isfahan, Iran.

Methods: T2D incidence during a mean (SD) follow-up of 10.1 (2.3) years was examined among 1,982 non-diabetic first-degree relatives (FDR) of patients with T2D 30-70 years old. Participants were divided into 6 groups based on body mass index and metabolic syndrome component, except waist circumference, at baseline: metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), metabolically unhealthy overweight (MUOW) and metabolically unhealthy obese (MUO).

Results: The MHO, MUOW, and MUO individuals at baseline were associated with incidence of T2D, independently of age and gender. MHO were 3 times (OR 2.96; 95% CI 1.07, 8.24) and MUOW were 2.75 times (95% CI 1.17, 6.45) more likely to develop T2D than those with MHNW. There was excess risk in MUO than MHO (OR 3.86; 95% CI 1.64, 9.11).

Conclusions: Obesity was a risk factor for T2D, even in the absence of any metabolic abnormalities. Metabolic abnormalities were a stronger predictor of incident T2D than obesity.

Keywords: First-degree relatives; Incidence; Metabolic syndrome; Metabolically healthy obese; Obesity; Risk factor; Type 2 diabetes.