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. 2021 Nov 3:12:724873.
doi: 10.3389/fendo.2021.724873. eCollection 2021.

Metabolically Abnormal But Normal-Weight Individuals Had a Higher Risk of Type 2 Diabetes Mellitus in a Cohort Study of a Chinese Population

Qiannan Chen  1 , Yaohan Zhou  2 , Chen Dai  3 , Gang Zhao  4 , Yimin Zhu  2   5 , Xuhui Zhang  6
Affiliations

Metabolically Abnormal But Normal-Weight Individuals Had a Higher Risk of Type 2 Diabetes Mellitus in a Cohort Study of a Chinese Population

Qiannan Chen et al. Front Endocrinol (Lausanne). .

Abstract

Aims: Obesity is a heterogeneous disease in terms of body mass index (BMI) and metabolic status. The purpose of this study was to investigate the risk of type 2 diabetes mellitus (T2DM) in subjects with metabolically abnormal but normal weight (MANW) in China.

Materials and methods: A prospective cohort with a total of 17,238 participants of the Zhejiang metabolic syndrome cohort was recruited. According to the standard of the Working Group on Obesity in China, general obesity is defined. Metabolic abnormality was defined as two or more abnormal components (elevated triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), elevated systolic blood pressure (SBP) or diastolic blood pressure (DBP) or use of antihypertensive therapy, and elevated fasting plasma glucose or antidiabetic treatment). The hazard ratio (HR) and its 95% CI were calculated using a multiple regression model, adjusted for the potential confounding factors.

Results: Compared with metabolically normal and normal weight (MNNW) subjects, the metabolically abnormal and obesity/overweight (MAO) subjects had the highest risk of T2DM disease, with an HR of 4.67 (95% CI: 3.23-6.76), followed by MANW subjects (HR = 2.61, 95% CI: 1.74-3.92) and metabolically normal but obesity/overweight (MNO) subjects (HR = 2.09, 95% CI: 1.29-3.38) after adjusting for age, sex, smoking, drinking, physical activity, and family history of diabetes. Compared with that in the MNNW subjects, the HR in MANW subjects was significantly higher than that in MNO subjects. In normal-weight subjects, the HR of T2DM was significantly positively correlated with the number of components with metabolic abnormalities.

Conclusions: MANW subjects had a higher risk of T2DM. MANW subjects should be given more attention in the prevention and control of common chronic diseases.

Keywords: heterogeneity; metabolically abnormal but normal weight (MANW); metabolically normal but obesity/overweight (MNO); obesity; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The overall trends of the cumulative incidence of T2DM in the subjects with different phenotypes of obesity after follow-up in the Zhejiang cohort. The subjects with MAO (red and solid line) had the highest incidence of T2DM, followed by MANW (blue and dotted line) and MNO (green and dashed line). MNNW (black and dashed-dotted line) had a lower risk. T2DM, type 2 diabetes mellitus; MAO, metabolically abnormal and obesity/overweight; MANW, metabolically abnormal but normal weight; MNO, metabolically normal but obesity/overweight; MNNW, metabolically normal and normal weight.
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