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; Yaohan Zhou; Chen Dai; Gang Zhao; Yimin Zhu; Xuhui Zhang

doi:10.3389/fendo.2021.724873

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

Front Endocrinol (Lausanne). 2021 Nov 3:12:724873. doi: 10.3389/fendo.2021.724873. eCollection 2021.

Authors

Qiannan Chen¹, Yaohan Zhou², Chen Dai³, Gang Zhao⁴, Yimin Zhu^{2

5}, Xuhui Zhang⁶

Affiliations

¹ Basic Discipline of Chinese and Western Integrative, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
² Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China.
³ Department of Endocrinology and Institute of Cardiovascular Diseases, Putuo District People's Hospital , Zhoushan, China.
⁴ Department of office Hangzhou Center of Disease Control and Prevention, Hangzhou, China.
⁵ Department of Respiratory Diseases, Sir Run Run Shaw Hospital Affiliated to the School of Medicine, Zhejiang University, Hangzhou, China.
⁶ Affiliated Hangzhou Center of Disease Control and Prevention, Zhejiang University School of Public Health, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Body Mass Index
China / epidemiology
Cohort Studies
Diabetes Mellitus, Type 2 / epidemiology
Diabetes Mellitus, Type 2 / etiology*
Female
Follow-Up Studies
Humans
Ideal Body Weight*
Male
Metabolic Syndrome / complications*
Metabolic Syndrome / epidemiology
Middle Aged
Risk Factors