Metabolically healthy obese people had a higher risk for type 2 diabetes than metabolically healthy nonobese people in a Korean population, according to a study published in the Journal of Clinical Endocrinology & Metabolism.
The risk for developing type 2 diabetes varied among the metabolically healthy obese people based on their degree of systemic inflammation, reported Chang Hee Jung of the University of Ulsan College of Medicine in Seoul, and colleagues.
The study included 36,135 Koreans without type 2 diabetes. Participants were separated into groups based on their BMI and metabolic health state. They were also separated into low and high systemic inflammation groups based on high-sensitive C-reactive protein (CRP).
After a median follow-up period of 36.5 months, 635 participants developed type 2 diabetes. Those in the metabolically healthy obese group had a significantly higher risk compared with the metabolically healthy nonobese group. But within the metabolically healthy obese group, the risk differed based on systemic inflammation.
The risk for type 2 diabetes did not significantly differ between the metabolically healthy obese/low systemic inflammation and the metabolically healthy nonobese/low systemic inflammation groups. The metabolically healthy obese/high systemic inflammation did, however, show a significantly increased risk.
These results indicate that metabolically healthy obese people have an increased risk for type 2 diabetes compared with their metabolically healthy nonobese counterparts, and levels of systemic inflammation account for part of this increased risk.
Design and methods: The study population comprised 36,135 Koreans without type 2 diabetes. Participants were stratified by BMI (cutoff value, 25.0 kg/m2) and metabolic health state (assessed using Adult Treatment Panel-III criteria). High-sensitive C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation. Subjects were classified into low (i.e., hsCRP< 0.5 mg/L) and high (i.e., hsCRP ≥ 0.5 mg/L) systemic inflammation groups.
Conclusions: MHO subjects show a substantially higher risk of incident type 2 diabetes than MHNO subjects. The level of systemic inflammation partially explains this increased risk.