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Estimation of risk for diabetes according to the metabolically healthy status stratified by degree of obesity in Korean men

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Abstract

Although obesity is clearly identified as a risk factor for diabetes, the relationship between diabetes and metabolically healthy status of obesity is less clear. This study was aimed to evaluate the incidental risk of diabetes according to metabolically healthy status of obesity. 31,834 Korean men without diabetes categorized into six groups according to their metabolically healthy status stratified by degree of obesity were followed up for 5 years: metabolically healthy normal weight (MH-NW), metabolically healthy overweight (MH-OW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MU-NW), metabolically unhealthy overweight (MU-OW), and metabolically unhealthy obese (MUO). Cox proportional hazards analysis was used to measure the risk for diabetes according to their categories. While overall incidence was 9.0 %, incidence of diabetes was in proportion to the degree of obesity and metabolically healthy status (MH-NW: 6.3 %, MH-OW: 7.5 %, MHO: 9.2 %, MU-NW: 11.8 %, MU-OW: 14.9 %, MUO: 20.1 %). When MH-NW was set as reference, the adjusted HRs (95 % CI) for diabetes of the MH-OW, MHO, MU-NW, MU-OW, MUO compared to MH-NW were 1.18 (1.06–1.32), 1.58 (1.03–2.41), 1.81 (1.61–2.04), 2.36 (2.11–2.63), and 3.47 (2.84–4.24), respectively. In conclusion, risk for diabetes was in proportion to the degree of obesity in both metabolically healthy and unhealthy group. Metabolically healthy status was more significant determinant for incident diabetes than obesity itself.

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Abbreviations

MH-NW:

Metabolically healthy normal weight (MH-NW)

MH-OW:

Metabolically healthy overweight (MH-OW)

MHO:

Metabolically healthy obese (MHO)

MU-NW:

Metabolically unhealthy normal weight (MU-NW)

MU-OW:

Metabolically unhealthy overweight

MUO:

Metabolically unhealthy obese

BP:

Blood pressure

LDL:

Low-density lipoprotein

HDL:

High-density lipoprotein

BMI:

Body mass index

HOMA-IR:

Homeostasis model assessment of insulin resistance

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

GGT:

γ-Glutamyltransferase

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Acknowledgments

This study was based on medical data collected and arranged by Kangbuk Samsung Cohort Study (KSCS). Their efforts and contribution enabled us to conduct this study. We thank Ha Won Park (Bangok middle school, Wonju, Korea) for her faithful technical and statistical assistance.

Conflict of interest

The authors declared that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea

    Jae-Hong Ryoo, Sung Keun Park & Joong-Myung Choi

  2. Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 78 Saemunan-gil, Jongro-Gu, Seoul, 110-746, Republic of Korea

    Sung Keun Park & Sun Yong Kim

  3. Health Promotion Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Sungmin Ye

  4. Korea Central Cancer Registry, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea

    Chang-Mo Oh

  5. Korea Institute of Drug Safety and Risk Management, Seoul, Republic of Korea

    Ju-Young Shin

  6. Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jai Hyung Park

  7. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Hyun Pyo Hong

  8. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea

    Taeg Su Ko

Authors
  1. Jae-Hong Ryoo
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  2. Sung Keun Park
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  3. Sungmin Ye
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  5. Chang-Mo Oh
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  6. Sun Yong Kim
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  7. Ju-Young Shin
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  8. Jai Hyung Park
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Correspondence to Sung Keun Park.

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Ryoo, JH., Park, S.K., Ye, S. et al. Estimation of risk for diabetes according to the metabolically healthy status stratified by degree of obesity in Korean men. Endocrine 50, 650–658 (2015). https://doi.org/10.1007/s12020-015-0635-5

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  • DOI: https://doi.org/10.1007/s12020-015-0635-5

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