Haghighatdoost F, Amini M, Aminorroaya A, Abyar M, Feizi A. Different metabolic/obesity phenotypes are differentially associated with development of prediabetes in adults: Results from a 14-year cohort study. World J Diabetes 2019; 10(6): 350-361 [PMID: 31231458 DOI: 10.4239/wjd.v10.i6.350]
Corresponding Author of This Article
Awat Feizi, PhD, Professor, Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, P.O. Box 319, Hezar-Jerib Ave, Isfahan 81746-73461, Iran. awat_feiz@hlth.mui.ac.ir
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fahimeh Haghighatdoost, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Fahimeh Haghighatdoost, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Masoud Amini, Ashraf Aminorroaya, Majid Abyar, Awat Feizi, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Awat Feizi, Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Author contributions: Amini M and Aminorroaya A contributed to the concept, design, and data collection; Feizi A and Majid Abyar M analyzed data and interpreted results; Haghighatdoost F interpreted results and drafted the manuscript; Feizi A supervised the current study; All authors approved the final version of manuscript.
Institutional review board statement: This study was conducted at Isfahan Endocrine and Metabolism Research Center and approved by the ethics committee of Isfahan University of Medical Sciences.
Informed consent statement: All involved subjects gave their informed written consent prior to study inclusion.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Awat Feizi, PhD, Professor, Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, P.O. Box 319, Hezar-Jerib Ave, Isfahan 81746-73461, Iran. awat_feiz@hlth.mui.ac.ir
Telephone: +98-313-7923250 Fax: +98-313-7923232
Received: February 24, 2019 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
ARTICLE HIGHLIGHTS
Research background
The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated.
Research motivation
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.
Research objectives
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.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
