Impact of the Dynamic Change of Metabolic Health Status on the Incident Type 2 Diabetes: A Nationwide Population-Based Cohort Study
10.3803/EnM.2019.34.4.406
- Author:
Jung A KIM
1
;
Da Hye KIM
;
Seon Mee KIM
;
Yong Gyu PARK
;
Nan Hee KIM
;
Sei Hyun BAIK
;
Kyung Mook CHOI
;
Kyungdo HAN
;
Hye Jin YOO
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. deisy21@naver.com
- Publication Type:Original Article
- Keywords:
Obesity;
Metabolic syndrome;
Diabetes mellitus, type 2
- MeSH:
Body Mass Index;
Cohort Studies;
Diabetes Mellitus, Type 2;
Female;
Follow-Up Studies;
Healthy Volunteers;
Humans;
Incidence;
Mass Screening;
Obesity;
Phenotype;
Weight Gain
- From:Endocrinology and Metabolism
2019;34(4):406-414
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.METHODS: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.RESULTS: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.CONCLUSION: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.
