Different metabolic/obesity phenotypes are differentially associated with development of prediabetes in adults: Results from a 14-year cohort study

Table 1 General characteristics of study population at baseline¹

	Metabolically healthy and normal weight	Metabolically healthy and overweight or obese	Metabolically unhealthy and normal weight	Metabolically unhealthy and overweight or obese	P value2
Number (%)	274 (15.7)	843 (48.4)	71 (4.1)	553 (31.8)
Age in yr	41.05 ± 0.42	42.33 ± 0.22	43.38 ± 0.76	43.31 ± 0.27	< 0.0001
Weight in kg	59.22 ± 0.46	74.77 ± 0.38	61.64 ± 0.99	77.92 ± 0.50	< 0.0001
BMI in kg/m2	22.75 ± 0.11	29.47 ± 0.12	23.61 ± 0.16	30.35 ± 0.16	< 0.0001
WC in cm	76.79 ± 0.42	88.67 ± 0.29	81.19 ± 0.80	92.62 ± 0.38	< 0.0001
HC in cm	97.39 ± 0.30	108.71 ± 0.27	98.22 ± 0.57	109.51 ± 0.35	< 0.0001
WHR	0.79 ± 0.004	0.82 ± 0.002	0.83 ± 0.008	0.85 ± 0.003	< 0.0001
FBS in mg/dL	88.04 ± 0.42	88.33 ± 0.24	87.13 ± 1.12	88.54 ± 0.34	0.446
Blood sugar 30 min in mg/dL	124.91 ± 1.53	129.96 ± 0.94	132.30 ± 3.32	133.48 ± 1.13	< 0.0001
Blood sugar 60 min in mg/dL	118.09 ± 1.94	125.60 ± 1.12	127.76 ± 4.49	135.30 ± 1.38	< 0.0001
Blood sugar 120 min in mg/dL	95.74 ± 1.31	101.32 ± 0.74	102.16 ± 2.30	101.35 ± 0.95	0.001
HbA1c as %	4.92 ± 0.04	4.98 ± 0.03	4.84 ± 0.08	5.04 ± 0.04	0.070
Triglyceride, mg/dL	110.16 ± 3.14	124.47 ± 2.39	190.99 ± 7.46	218.15 ± 4.59	< 0.0001
Total cholesterol, mg/dL	182.54 ± 2.17	194.29 ± 1.39	192.34 ± 3.30	198.68 ± 1.69	< 0.0001
LDL-C, mg/dL	110.17 ± 1.92	120.04 ± 1.30	115.51 ± 3.28	118.31 ± 1.58	0.001
HDL-C, mg/dL	49.89 ± 0.83	49.93 ± 0.44	38.97 ± 1.0	39.03 ± 0.35	< 0.0001
Systolic blood pressure, mmHg	100.50 ± 0.08	110.01 ± 0.05	110.82 ± 0.17	120.22 ± 0.07	< 0.0001
Diastolic blood pressure in mmHg	60.79 ± 0.06	70.15 ± 0.04	70.96 ± 0.12	80.03 ± 0.05	< 0.0001
Physical activity , MET-hr/wk	19.73 ± 4.25	16.61 ± 3.03	26.63 ± 11.83	19.10 ± 3.11	0.742
Male as %	33.6	19.7	33.8	28.4	< 0.0001
Educational level as %					0.006
Illiterate	2.6	3.4	5.6	5.5
< 12 yr	38.4	48.1	42.3	50.3
= 12 yr	36.6	32.9	39.4	29.7
> 12 yr	22.4	15.6	12.7	14.5
Current smoker as %	16.8	6.9	13.0	11.2	0.073

¹Values are mean ± SE unless otherwise indicated.

²By ANOVA or χ² test. BMI: Body mass index; WC: Waist circumference; HC: Hip circumference; WHR: Waist to hip ratio; FBS: Fasting blood sugar; LDL: Low density lipoprotein; HDL: High density lipoprotein; MET-h/Wk: Metabolic equivalent-hr/wk.

Table 2 Multivariable-adjusted hazard ratios and 95% confidence intervals for prediabetes in the whole population and stratified by sex

	Metabolically healthy and normal weight	Metabolically healthy and overweight or obese	Metabolically unhealthy and normal weight	Metabolically unhealthy and overweight or obese	P value1
Whole population
Crude	1	1.38 (0.92, 2.05)	2.05 (1.05, 4.02)	1.67 (1.10, 2.52)	0.058
Model 1	1	1.43 (0.69, 2.94)	3.84 (1.20, 12.27)	2.50 (1.19, 5.25)	0.022
Male
Crude	1	1.06 (0.54, 2.08)	0.95 (0.30, 3.00)	1.39 (0.71, 2.73)	0.715
Model 1	1	0.94 (0.27, 3.27)	0.69 (0.08, 6.25)	1.10 (0.32, 3.75)	0.976
Female
Crude	1	1.74 (1.04, 2.93)	3.25 (1.39, 7.58)	2.0 (1.16, 3.44)	0.026
Model 1	1	1.67 (0.63, 4.49)	6.74 (1.53, 29.66)	3.45 (1.23, 9.68)	0.014

¹By the Mantel–Haenszel extension χ² test. Model 1: Adjusted for age, sex, physical activity and smoking.

Table 3 Multivariable-adjusted hazard ratios and 95% confidence intervals for prediabetes incidence based on changes in metabolic/obesity phenotype at follow-up

Baseline metabolic/obesity phenotype	Last metabolic/obesity phenotype	HR (95%CI)
MHNW	MHNW	1 (reference)
	MHO	1.04 (0.40, 2.69)
	MUNW	2.67 (0.96, 7.40)
	MUO	5.87 (1.75, 19.66)
MHO	MHNW	1.25 (0.40, 3.97)
	MHO	1.10 (0.62, 1.95)
	MUNW	1.63 (0.14, 19.00)
	MUO	6.68 (3.56, 12.54)
MUNW	MHNW	2.17 (0.55, 8.52)
	MHO	0.65 (0.13, 3.24)
	MUNW	5.22 (1.53, 17.86)
	MUO	5.71 (1.51, 21.63)
MUO	MHNW	1.63 (0.28, 9.61)
	MHO	0.82 (0.41, 1.63)
	MUNW	0.00 (0.0, 0.0)
	MUO	3.98 (2.21, 7.15)

MHNW: Metabolically healthy normal weight; MHO: Metabolically obese; MUNW: Metabolically unhealthy normal weight; MUO: Metabolically unhealthy obese.