Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Devision of Endocrinology, Department of Internal Medicine, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Diabetes Res Clin Pract. 2018 Oct;144:17-24. doi: 10.1016/j.diabres.2018.07.021. Epub 2018 Jul 21.
To investigate future diabetes in different abdominal obesity phenotypes during 12 years of follow-up.
For this population-based cohort, 7982 adults without diabetes including 3533 men and 4449 women, aged ≥20 years were selected from the Tehran Lipid and Glucose Study. Abdominal obesity was defined according to the national cutoffs for waist circumference (WC). Metabolic health was defined as having ≤1 metabolic abnormality based on Joint Interim Statement (JIS) criteria other than WC. Participants were classified into 4 groups of abdominal obesity phenotypes: Metabolically healthy non-abdominal obese (MHNAO), metabolically healthy abdominal obese (MHAO), metabolically unhealthy non-abdominal Obese (MUNAO), and metabolically unhealthy abdominal obese (MUAO).
In total, 1018 cases of incident diabetes occurred. Compared to the MHNAO phenotype, based on multivariate Cox regression models, diabetes risk was increased in all unhealthy phenotypes except the MUNAO phenotype in men. Regarding the association of the MHAO phenotype with incident diabetes, borderline statistical significance in men [HR 1.5 (95% CI: 1.0-2.36), p-value: 0.07] and statistical significance in women [HR 1.68 (95% CI: 1.08-2.6)] were detected.
In addition to unhealthy phenotypes except the MUNAO phenotype in men, the MHAO phenotype is also associated with incident diabetes, highlighting the importance of preventive strategies in this subgroup of abdominally obese subjects.
在 12 年的随访中，研究不同腹型肥胖表型的未来糖尿病发病情况。
本研究为基于人群的队列研究，共纳入 7982 名无糖尿病的成年人，包括 3533 名男性和 4449 名女性，年龄均≥20 岁，来自德黑兰血脂和血糖研究。腹型肥胖根据腰围（WC）的国家标准定义。代谢健康定义为根据联合临时声明（JIS）标准，除 WC 外，存在≤1 种代谢异常。根据腹部肥胖表型将参与者分为 4 组：代谢健康非腹型肥胖（MHNAO）、代谢健康腹型肥胖（MHAO）、代谢不健康非腹型肥胖（MUNAO）和代谢不健康腹型肥胖（MUAO）。
共发生 1018 例新发糖尿病。与 MHNAO 表型相比，基于多变量 Cox 回归模型，除男性 MUNAO 表型外，所有不健康表型的糖尿病发病风险均增加。关于 MHAO 表型与新发糖尿病的相关性，男性呈边缘统计学意义[HR 1.5（95% CI：1.0-2.36），p 值：0.07]，女性有统计学意义[HR 1.68（95% CI：1.08-2.6）]。
除男性 MUNAO 表型外，MHAO 表型也与新发糖尿病相关，这突出了针对这组腹型肥胖亚组的预防策略的重要性。
