Basic Discipline of Chinese and Western Integrative, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China.
Front Endocrinol (Lausanne). 2021 Nov 3;12:724873. doi: 10.3389/fendo.2021.724873. eCollection 2021.
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.
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.
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.
MANW subjects had a higher risk of T2DM. MANW subjects should be given more attention in the prevention and control of common chronic diseases.
肥胖症在体重指数（BMI）和代谢状态方面存在异质性。本研究旨在探讨中国代谢异常但体重正常（MANW）人群患 2 型糖尿病（T2DM）的风险。
共纳入浙江代谢综合征队列的 17238 名参与者进行前瞻性队列研究。根据中国肥胖工作组的标准，定义为普通肥胖。代谢异常定义为两个或两个以上异常成分（升高的甘油三酯（TG）、低高密度脂蛋白胆固醇（HDL-C）、升高的收缩压（SBP）或舒张压（DBP）或使用抗高血压治疗、空腹血糖升高或使用降糖治疗）。使用多回归模型，调整潜在混杂因素后，计算危险比（HR）及其 95%置信区间。
与代谢正常且体重正常（MNNW）受试者相比，代谢异常且肥胖/超重（MAO）受试者的 T2DM 发病风险最高，HR 为 4.67（95%CI：3.23-6.76），其次是 MANW 受试者（HR=2.61，95%CI：1.74-3.92）和代谢正常但肥胖/超重（MNO）受试者（HR=2.09，95%CI：1.29-3.38），调整年龄、性别、吸烟、饮酒、体力活动和糖尿病家族史后。与 MNNW 受试者相比，MANW 受试者的 HR 明显高于 MNO 受试者。在体重正常的受试者中，T2DM 的 HR 与代谢异常成分的数量呈显著正相关。
MANW 受试者患 T2DM 的风险较高。在普通人群中，MANW 受试者应在常见慢性病的防治中得到更多关注。
