Abstract

Aim of the study was to investigate the risk of developing type 2 diabetes mellitus (T2DM) in individuals with metabolically healthy and unhealthy obesity phenotypes (MHO and MUO) and evaluate the contribution of metabolic syndrome (MS) components to the 12-year risk of developing T2DM according to a prospective study.Material and methods. The study included 1958 people with a BMI ≥30 kg/m² and no T2DM, from among those examined at the baseline screening in 2003– 2005 of the HAPPIE project. New cases of T2DM were diagnosed between 2003 and 2018 according to the register of diabetes mellitus and repeated screenings. The median follow-up period was 12.1 years. Were used to define MHO: criteria of the NCEPATP III, 2001 and IDF, 2005.Results. The incidence of T2DM in the MHO group according to all studied criteria is on 1,5 times lower than in persons with MUO, p<0,001. According to the results of Cox regression multivariate analysis, the risk of developing T2DM in individuals with MHO is 2.3 times lower according to the IDF criteria, 2005 and 2,2 times lower according to the NCEP ATP III, 2001 criteria, compared with persons with MUO. The risk of developing T2DM increases in direct proportion to the number of MS components: 3 components—OR = 3,1 (95% CI: 1.0; 9.9), p = 0.048, 4 components—OR = 4.4 (95% CI: 1.4; 14.0), p = 0.011. However, the presence of obesity in a person with one risk factor does not lead to the development of T2DM within 12 years, p>0.05. When analyzing obese individuals who had abdominal obesity (AO), the risk of developing T2DM is 2 times higher compared to individuals with normal waist circumference (WC), and people without AO demonstrate no risk of developing T2DM, with an increase in the number of MS components, p> 0.05.Conclusions. The incidence of first-­onset T2DM during 12 years in the MHO group by any used criteria is on 1.5 times lower than in the MUO group. In individuals with obesity, regardless of its phenotype, the most significant independent predictors of the risk of incident T2DM are AO and fasting hyperglycaemia. In individuals without AO, the risk of developing T2DM does not increase, even with an increase in the number of MS components. In the presence of AO, the risk of developing T2DM increases 2 times already with the appearance of any other component.

Highlights

  • Цель исследования — изучить риск развития сахарного диабета 2 типа (СД2) у лиц с метабо‐ лически здоровым (МЗФО) и нездоровым фенотипом ожирения (МНЗФО) и оценить вклад компонентов метаболического синдрома (МС) в 12-летний риск развития СД2 по данным проспективного исследования

  • Однако лица с МЗФО демонстрируют благоприят‐ ные уровни биологических факторов, влияющих на развитие СД2

  • Aim of the study was to investigate the risk of developing type 2 diabetes mellitus (T2DM) in individuals with metabolically healthy and unhealthy obesity phenotypes (MHO and MUO) and evaluate the contribution of metabolic syndrome (MS) components to the 12-year risk of developing T2DM according to a prospective study

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Summary

МАТЕРИАЛ И МЕТОДЫ

Формирование выборки для исследования осуществлялось следующим образом. Из 9360 человек, обследованных с 2003 по 2005 г. на базо‐ вом скрининге проекта HAPIEE, были отобраны все лица с индексом массы тела (ИМТ) ≥30 кг/м2 и без СД2, всего 1958 человек, из них мужчин — 450 (23%), женщин — 1508 (73%). По критериям IDF к метаболически здоровым отнесены лица с ожи‐ рением (ИМТ от 30 кг/м2 и более) и с ОТ≥94 см у мужчин и ≥80 см у женщин и при наличии у них одного из следующих компонентов МС: содержание триглицеридов (ТГ) ≥1,7 ммоль/л или предшествующее лечение (гипертриглице‐ ридемия), содержание ХС-ЛПВП 88 см у женщин, содержание ТГ ≥ 1,7 ммоль/л, ХС ЛПВП

Курение в настоящем
Количество компонентов МС
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