Published online Jun 15, 2019. doi: 10.4239/wjd.v10.i6.350
Peer-review started: February 26, 2019
First decision: March 11, 2019
Revised: May 10, 2019
Accepted: May 14, 2019
Article in press: May 14, 2019
Published online: June 15, 2019
Processing time: 111 Days and 2 Hours
The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated.
Due to the potential association between various metabolic/obesity phenotypes and the risk of prediabetes incidence, developing appropriate guidelines to care for various metabolic/obesity phenotypes to reduce prediabetes occurrence is necessary.
This study aimed to (1) estimate the prevalence of different metabolic/obesity phenotypes in an Iranian population and (2) determine the association of baseline metabolic/obesity phenotypes and their interchanges during follow-up with the risk of prediabetes development in a pros-pective cohort study.
In a population-based cohort study, 1741 adults (aged > 19 years) with normal blood glucose were followed for 14 years. According to body mass index and metabolic health status, participants were categorized into four groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy obese (MUO). Multivariable Cox regression analysis was used to measure the risk of prediabetes according to the baseline metabolic/obesity phenotype and their changes during the follow-up.
In the whole population, all three MUNW, MHO, MUO groups were at higher risk for developing prediabetes compared to MHNW. The MUNW group was at the greatest risk for developing prediabetes (HR: 3.84). In stratified analysis by sex, no significant association was found in men, while women in the MUNW group were at the greatest risk for prediabetes (HR: 6.74). Transforming from each phenotype to MHNW or MHO was not related to the risk of prediabetes development, whereas transforming from each phenotype to MUO was associated with an increased risk of prediabetes.
Our findings indicate that MHO is not a high risk unless it progresses to MUO. However, individuals in the MUNW group have the greatest risk for developing prediabetes, and therefore need to be screened and treated.
Given that various metabolic/obesity phenotypes can boost the risk of prediabetes incidence, clinical trials need to be developed with appropriate guidelines to care for various metabolic/ obesity phenotypes to reduce prediabetes occurrence.