Risk Of Type 2 Diabetes In Metabolically Healthy Obese Individuals In Southern China

Objective:To study the risk of type 2 diabetes in metabolically healthy obese(MHO)individual in Southern China after 4-year follow up,Compare the risk of type 2 diabetes in different groups of MHO,obesity with metabolic syndrome(MS)and metabolically unhealthy normal weight(MUNW).Methods:4067 individuals were evaluated for health examination in Hunan Provincial People’s Hospital from June 2006 to January 2010.1358 individuals were followed up,398 of which were examined every year for 4 years.Body height,body weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),serum alanine aminotransferase(ALT),peripheral white blood cell count(WBCC)and abdominal ultrasonography were collected.We used the criteria of American Cholesterol Education program(the National Cholesterol Education Programe,NCEP)in the third report(Adult Treatment Panel Ⅲ,ATP-Ⅲ)to define MS,MHO and other different metabolic status.MHO was defined as obesity without MS.MUNW was MS without obesity.We used metabolically healthy normal weight(MHNW)group as normal control and study the risk of type 2 diabetes in MHO,obesity with MS and MUNW.Results:1.The risk of impaired glucose metabolism in different groups:MHO had no significantly increased risk while obesity with MS,and MUNW had increase risks of impaired glucose metabolism(OR 13.750,13.430,P<0.05).2.The risks of type 2 diabetes in different groups:MHO,obesity with MS and MUNW all demonstrated increased risks of type 2 diabetes.MUNW owned the highest risk(OR=61.489),obesity with MS was with the moderate risk(OR=30.656)and MHO has the lowest risk of type 2 diabetes(OR=8.500)(P<0.05).3.MHO can be divided into MHO-0(without any abnormal MS component)and MHO-1(with 1 abnormal MS component).MHO-0 had not increased the risk of impaired glucose metabolism and type 2 diabetes,while MHO-1 significantly increased the risks(OR=4.231,12.143,P<0.05).4.In group MHO-1,obesity with hypertension showed increased risk of impaired glucose metabolism(OR=3.819,P<0.05)but not type 2 diabetes.Obesity with high serum TG did not show any increased risk both in impaired glucose metabolism and type 2 diabetes.5.Obesity with MS can be MSO-2(obesity with 2 abnormal MS components)or MSO-3(obesity with≥3 abnormal MS components).MSO-3 appeared higher risks of impaired glucose metabolism and type 2 diabetes than MSO-2(OR:27.792 vs 8.403,80.000 vs 11.591,P<0.05).Conclusions:1.After 4-year follow-up in Southern China,MHO was at increased risk of type 2 diabetes.This tendency was also found in MHO-1 but not in MHO-0.2.Obesity with MS showed higher risk of type 2 diabetes than MHO,but lower risk than MUNW.With elevation of the number of abnormal MS components from 2 to 3 and 4,the risk of type 2 diabetes increased rapidly.3.MUNW showed higher risk of type 2 diabetes than obesity with MS and MHO,which means that obesity in MS may play a protective role in the progression of type 2 diabetes.