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Obesity, weight fluctuation increased type 2 diabetes risk among Koreans
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In a young to middle-aged Korean population, metabolic health, obesity and weight fluctuation appeared to be independently correlated with an increased incidence of diabetes, according to study findings published in Obesity.
Previous research shows that Asian patients with diabetes are expected to account for 60% of the global total in the near future, according to the study. Researchers constructed a large cohort study of Korean men and women to examine risks for type 2 diabetes that may be unique to Asians.
Data from the study showed that weight change in obese individuals was associated with increased diabetes risk independent of metabolic health status.
Researchers enrolled 34,999 Korean employees of a large company and their spouses. All study participants underwent extensive health examinations at the Kangbuk Samsung Hospital in Seoul, South Korea, from 2005 to 2006.
The study participants were aged 30 to 59 years and were free of diabetes at baseline. All participants were seen for follow-up visits annually or biennially through 2011. At each follow-up examination, investigators took medical histories, physical measurements, including BMI, and blood biochemical measurements. Fasting serum samples were tested for glucose, insulin, high-sensitivity C-reactive protein, total cholesterol, triglycerides and HDL cholesterol. An automated chemistry analyzer was used to directly assess serum LDL cholesterol. The researchers also determined HbA1c using the Cobas Integra 800 (Roche Diagnostics). Metabolic health was defined as not having any aspect of metabolic syndrome.
The investigators found that during 176,878.6 person-years of follow-up, diabetes developed in 889 participants, for an incidence rate of 5/1,000 person-years. Metabolically unhealthy obese participants had adjusted HRs for diabetes of 13.7 (95% CI, 9.8-19) vs. metabolically healthy normal-weight participants; metabolically healthy obese participants had HRs of 2.7 (95% CI, 1.7-4.3) vs. normal-weight participants. Compared with a reference weight change of –0.9 kg to 0.4 kg, weight changes of less than –0.9 kg had an adjusted HR of 0.8 (95% CI, 0.66-0.97), weight change of 0.5 kg to 2 kg had an adjusted HR of 0.99 (95% CI, 0.82-1.2), and weight change of at least 2.1 kg had an adjusted HR of 1.24 (95% CI, 1.02-1.49; P for trend<.001).
According to the researchers, it is noteworthy that diabetes risk was elevated in obese individuals, regardless of metabolic health status.
“Compared to previous studies, we have used a more stringent definition of metabolically healthy status, and found that metabolically healthy obese individuals, defined as participants with no metabolic abnormalities, were still at higher risk for diabetes compared to normal
weight-metabolically healthy individuals,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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