The Obesity-Diabetes Link: What’s New?

September 2, 2014

A healthy metabolic profile in the absence of diabetes risk factors does not protect young adult men from incident diabetes associated with overweight and obesity.

Here’s a brief synopsis of an article randomly culled from pubmed that we thought want to know about, but which you might easily miss.

Diabetes Risk Among Overweight and Obese Metabolically Healthy Young Adults.

The background: Does the incidence of diabetes increase over time among obese young adults without metabolic risk factors?

Researchers assessed nearly 34,000 young men, median age 31 years, who were followed for a median of 6 years for the development of diabetes. The men were stratified according to BMI and a number of metabolic abnormalities. Metabolically healthy obesity was defined as BMI ≥30 kg/m2 in the presence of normal blood sugar, normal blood pressure, and normal levels of fasting triglyceride and high-density lipoprotein (HDL)-cholesterol levels.

Key Findings: Some 734 new cases of diabetes were diagnosed during 210,282 person-years of follow-up.

  • The incidence rate of diabetes among participants with no metabolic risk factors was 1.15 per 1,000 person-years among lean men, 2.10 per 1,000 person-years for overweight men, and 4.34 per 1,000 person-years for obese men.
  • A multivariable model adjusted for age, country of origin, family history of diabetes, physical activity, fasting plasma glucose, triglyceride level, HDL-cholesterol, systolic blood pressure, and white blood cell count. Metabolically healthy overweight men had a higher diabetes risk (hazard ratio [HR] 1.89 [95% CI 1.25-2.86]; P < 0.001), as did metabolically healthy obese men (HR 3.88 [95% CI 1.94-7.77]; P < 0.001), compared with metabolically healthy normal weight men.
  • There was no interaction between BMI and the number of metabolic abnormalities at enrollment in predicting diabetes risk.

What Might It Mean? A healthy metabolic profile in the absence of diabetes risk factors does not protect young adult men from incident diabetes associated with overweight and obesity.

References:

  • Twig G, Afek A, Derazne E, et al. Diabetes risk among overweight and obese metabolically healthy young adults.  Diabetes Care. 2014 Aug 19. Epub ahead of print.