Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies

Summary The risk of type 2 diabetes among obese adults who are metabolically healthy has not been established. We systematically searched Medline (1946–August 2013) and Embase (1947–August 2013) for prospective studies of type 2 diabetes incidence (defined by blood glucose levels or self‐report) amo...

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Vydáno v:	Obesity reviews Ročník 15; číslo 6; s. 504 - 515
Hlavní autoři:	Bell, J. A., Kivimaki, M., Hamer, M.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Blackwell Publishing Ltd 01.06.2014 Wiley Subscription Services, Inc BlackWell Publishing Ltd
Témata:	adults Aging analysis blood blood glucose Blood Glucose - analysis Body Mass Index C-Reactive Protein C-Reactive Protein - analysis cholesterol Cholesterol, HDL Cholesterol, HDL - blood Cohort Studies complications confidence interval Diabetes Mellitus, Type 2 Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology epidemiology etiology Female Glycated Hemoglobin Glycated Hemoglobin - analysis glycemic control Heterogeneity Humans Hypertension Hypertension - epidemiology inflammation insulin lipoproteins Longitudinal Studies Male MEDLINE meta-analysis Metabolic health metabolism noninsulin-dependent diabetes mellitus Obesity Obesity - complications Obesity - metabolism Obesity Comorbidity Prospective Studies relative risk Risk Risk Factors risk profile triacylglycerols Triglycerides Triglycerides - blood type 2 diabetes Metabolic health obesity type 2 diabetes
ISSN:	1467-7881, 1467-789X, 1467-789X
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Shrnutí:	Summary The risk of type 2 diabetes among obese adults who are metabolically healthy has not been established. We systematically searched Medline (1946–August 2013) and Embase (1947–August 2013) for prospective studies of type 2 diabetes incidence (defined by blood glucose levels or self‐report) among metabolically healthy obese adults (defined by body mass index [BMI] and normal cardiometabolic clustering, insulin profile or risk score) aged ≥18 years at baseline. We supplemented the analysis with an original effect estimate from the English Longitudinal Study of Ageing (ELSA), with metabolically healthy obesity defined as BMI ≥ 30 kg m−2 and <2 of hypertension, impaired glycaemic control, systemic inflammation, adverse high‐density lipoprotein cholesterol and adverse triglycerides. Estimates from seven published studies and ELSA were pooled using random effects meta‐analyses (1,770 healthy obese participants; 98 type 2 diabetes cases). The pooled adjusted relative risk (RR) for incident type 2 diabetes was 4.03 (95% confidence interval = 2.66–6.09) in healthy obese adults and 8.93 (6.86–11.62) in unhealthy obese compared with healthy normal‐weight adults. Although there was between‐study heterogeneity in the size of effects (I2 = 49.8%; P = 0.03), RR for healthy obesity exceeded one in every study, indicating a consistently increased risk across study populations. Metabolically healthy obese adults show a substantially increased risk of developing type 2 diabetes compared with metabolically healthy normal‐weight adults. Prospective evidence does not indicate that healthy obesity is a harmless condition.
Bibliografie:	Academy of Finland istex:9F9820E53563265220488A04D8F49B2574574FA1 Medical Research Council - No. K013351 National Institute on Aging in the United States - No. 2RO1AG7644-01A1; No. 2RO1AG017644; No. AG034454 ark:/67375/WNG-QPT0M0W4-5 Economic and Social Research Council (ESRC) National Heart, Lung and Blood Institute - No. HL36310 an ESRC professorial fellowship British Heart Foundation - No. RE/10/005/28296 Appendix S1. Characteristics of the ELSA study population at baseline (n = 3,066)Appendix S2. Metabolically healthy obesity and risk of incident type 2 diabetes over 6 years follow-up in ELSA. Participants free from physician diagnosed diabetes at baseline (n = 3,066)Appendix S3. Metabolically healthy obesity and risk of incident diabetes over 6 years follow-up in ELSA. Participants free from physician diagnosed diabetes at baseline ArticleID:OBR12157 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	1467-7881 1467-789X 1467-789X
DOI:	10.1111/obr.12157