National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China.
J Clin Endocrinol Metab. 2023 Aug 18;108(9):2240-2247. doi: 10.1210/clinem/dgad152.
Diabetes is a major health problem and metabolically unhealthy is an important risk factor.
To conduct the first nationally representative study on epidemiological data of metabolically unhealthy normal weight (MUNW) focused only on nondiabetic subjects and determine the predictive effect on diabetes in China.
A longitudinal study was conducted using data from the Rich Healthcare Group in China. Metabolic status was determined by the revised National Cholesterol Education Program Adult Treatment Panel III criteria, and individuals with 2 or more criteria were categorized as MUNW and diagnosed with metabolic syndrome (MetS) if they met 3 or more.
Of a total of 63 830 nondiabetic normal-weight individuals, 8935 (14.0%) were classified as MUNW and 1916 (3.00%) were diagnosed with MetS. After adjusting for potential confounders, individuals with MUNW had a greater diabetes risk (4.234, 95% CI 3.089-5.803) than those without MUNW during an average of 3.10 years of follow-up. Also, the multivariable-adjusted hazard ratios for developing diabetes were 3.069 (95% CI 1.790-5.263), 7.990 (95% CI 4.668-13.677), and 11.950 (95% CI 6.618-21.579) for participants with 1, 2, and 3 or more components, respectively, compared with those without any components. Further analyses suggested that the number of MetS components present is associated with the risk of diabetes, especially in metabolically unhealthy normal-weight young male adults. Multivariable-adjusted hazard ratios (95% CI) for incident diabetes among individuals with 1, 2, and at least 3 components were 4.45 (1.45-13.72), 9.82 (3.05-31.64), and 15.13 (3.70-61.84) for participants aged ≤44 years, and 3.55 (1.81-6.97), 8.52 (4.34-16.73), and 13.69 (6.51-28.77) for male participants, respectively.
The prevalence of MUNW is 14% in Chinese normal-weight nondiabetic individuals, and active intervention is necessary for this category of people. The presence of MUNW significantly increases the risk of diabetes, and the risk of diabetes is associated with the number of MetS components present in the patient.
糖尿病是一个主要的健康问题，代谢不健康是一个重要的危险因素。
对仅针对非糖尿病患者的代谢不健康正常体重（MUNW）进行首次全国代表性研究，以确定其在中国发生糖尿病的预测效果。
使用中国瑞驰医疗集团的数据进行一项纵向研究。代谢状态根据修订后的国家胆固醇教育计划成人治疗小组 III 标准确定，如果满足 3 项或更多项标准，则将有 2 项或更多项标准的个体归类为 MUNW 并诊断为代谢综合征（MetS）。
在总共 63830 名非糖尿病正常体重个体中，8935 名（14.0%）被归类为 MUNW，1916 名（3.00%）被诊断为 MetS。在调整潜在混杂因素后，MUNW 个体的糖尿病风险更高（4.234，95%CI 3.089-5.803），在平均 3.10 年的随访期间，MUNW 个体发生糖尿病的风险比没有 MUNW 的个体更高。此外，患有 1、2 和 3 个或更多个成分的参与者发生糖尿病的多变量调整后的危险比分别为 3.069（95%CI 1.790-5.263）、7.990（95%CI 4.668-13.677）和 11.950（95%CI 6.618-21.579），而没有任何成分的参与者。进一步的分析表明，MetS 成分的数量与糖尿病的风险相关，尤其是在代谢不健康的年轻男性正常体重成年人中。年龄≤44 岁的参与者中，患有 1、2 和至少 3 个成分的个体中，发生糖尿病的多变量调整后的危险比（95%CI）分别为 4.45（1.45-13.72）、9.82（3.05-31.64）和 15.13（3.70-61.84）；而男性参与者中，患有 1、2 和至少 3 个成分的个体中，发生糖尿病的多变量调整后的危险比（95%CI）分别为 3.55（1.81-6.97）、8.52（4.34-16.73）和 13.69（6.51-28.77）。
中国非糖尿病正常体重个体中 MUNW 的患病率为 14%，需要对这一人群进行积极干预。MUNW 的存在显著增加了糖尿病的风险，并且糖尿病的风险与患者中存在的 MetS 成分数量相关。
