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Future risk of diabetes among Indians with metabolic and phenotypic obesity: Results from the 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES–158)

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Abstract

Aim

To investigate the risk of type 2 diabetes (T2DM) among the combinations of BMI categories and metabolic syndrome in Asian Indians.

Materials and methods

Individuals from the Chennai Urban Rural Epidemiology Study cohort (n = 1,368), free of diabetes at baseline were stratified by BMI and metabolic health as metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically obese non-obese (MONO) and metabolically obese obese (MOO). Phenotypic obesity was defined as BMI ≥ 25 kg/m2 and metabolic obesity as presence of any two of the metabolic abnormalities: hyperglycemia, high blood pressure, high triglyceridemia or low HDL cholesterol. Hazard ratios for progression to diabetes were estimated using Cox proportional hazard regression.

Results

During median 9.1 years of follow-up, incident cases of diabetes were highest among MOO–45.1%, followed by MONO–41.3%, MHO–27.1% and MHNO–15.9%. Incidence rates of diabetes among MOO, MONO, MHO and MHNO were 57.8, 50.9, 30.4 and 18.1 per 1000 person years, respectively. Hazard ratio for diabetes development were 1.71 in MHO, 2.87 in MONO, and 3.39 in MOO compared with MHNO.

Conclusions

Increased BMI and metabolic risk factor clustering independently contribute to the increased risk of T2DM in obese individuals. Screening for metabolic abnormalities should be performed routinely in clinic to identify high-risk individuals and institute appropriate preventive measures.

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Abbreviations

BMI:

Body Mass Index

T2DM:

Type 2 diabetes

CURES:

Chennai Urban Rural Epidemiology Study

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Acknowledgments

The authors thank the staff of Dr. Mohan’s Diabetes Specialities Centre, Chennai and the epidemiology team of the Madras Diabetes Research Foundation for the fieldwork and all the participants who took part in the study. Future risk of diabetes among Indians with metabolic and phenotypic obesity—Results from the ten-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES–158)

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No funding was received for this work.

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Authors and Affiliations

  1. Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India

    Hariharasudan Natarajan, Coimbatore Subramanian Shanthi Rani, Dharman Krishna Kumar, Ranjit Mohan Anjana, Unnikrishnan Ranjit, Ulagamathesan Venkatesan, Ganesan Uma Sankari, Rajendra Pradeepa, Viswanathan Mohan & Mohan Deepa

Authors
  1. Hariharasudan Natarajan
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  2. Coimbatore Subramanian Shanthi Rani
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  4. Ranjit Mohan Anjana
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  5. Unnikrishnan Ranjit
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  9. Viswanathan Mohan
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Contributions

VM conceived the study and involved in execution of the fieldwork, wrote parts of the manuscript and revised all drafts of the article. HN wrote the draft of the manuscript. CSSR and MD were involved in the execution of the fieldwork and wrote the parts of the manuscript. RMA provided scientific inputs and revised the drafts of the manuscript. RU and RGP gave valuable comments and suggestions for the writing of the article. GU helped in the fieldwork to collect data. UV and KK did all the statistical analyses of the data. VM, RMA and CSSR are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Viswanathan Mohan.

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Conflict of interests

None of the authors has any potential conflicts of interest relevant to the article.

Ethics approval

The study protocol was approved by the Institutional Ethical committee.

Informed consent

Participants provided written informed consent before inclusion in the study.

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Communicated by Massimo Federici .

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Natarajan, H., Shanthi Rani, C., Krishna Kumar, D. et al. Future risk of diabetes among Indians with metabolic and phenotypic obesity: Results from the 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES–158). Acta Diabetol 58, 1051–1058 (2021). https://doi.org/10.1007/s00592-021-01698-7

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  • DOI: https://doi.org/10.1007/s00592-021-01698-7

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