Abstract
Introduction: Risk of diabetes mellitus type 2 (T2DM) is variable between individuals due to different metabolic phenotypes. In present network meta-analysis, we aimed to evaluate the risk of T2DM related with current definitions of metabolic health in different body mass index (BMI) categories. Methods: Relevant articles were collected by systematically searching PubMed and Scopus databases up to 20 March 2018 and for analyses we used a random-effects model. Nineteen prospective cohort studies were included in the analyses and metabolically healthy normal weight (MHNW) was considered as the reference group in direct comparison for calculating indirect comparisons in difference type of BMI categories. Results: Total of 199403 participants and 10388 cases from 19 cohort studies, were included in our network meta-analysis. Metabolically unhealthy obesity (MUHO) group poses highest risk for T2DM development with 10 times higher risk when is compared with MHNW (10.46 95% CI; 8.30, 13.18) and after that Metabolically unhealthy overweight (MUOW) individuals were at highest risk of T2DM with 7 times higher risk comparing with MHNW (7.25, 95% CI; 5.49, 9.57). Metabolically healthy overweight and obese (MHOW/MHO) individuals have (1.77, 95% CI; 1.33, 2.35) and (3.00, 95% CI; 2.33, 3.85) risk ratio for T2DM development in comparison with MHNW respectively. Conclusion: In conclusion we found that being classified as overweight and obese increased the risk of T2DM in comparison with normal weight. In addition, metabolically unhealthy (MUH) individuals are at higher risk of T2DM in all categories of BMI compared with metabolically healthy individuals.
Highlights
Risk of diabetes mellitus type 2 (T2DM) is variable between individuals due to different metabolic phenotypes
MHNW, metabolically healthy normal weight; Metabolically healthy obese (MHO),metabolically healthy obesity; Metabolically unhealthy obesity (MUHO),metabolically unhealthy obesity; MHOW,metabolically healthy overweight; MUHOW,metabolically unhealthy overweight; MUHNW,metabolically unhealthy normal weight addition MUH individuals are at higher risk of T2DM in all categories of body mass index (BMI) compared with MH individuals
MUHO group demonstrates the highest risk for T2DM development when compared with MHNW with 10 times higher (10.46 95% confidence intervals (CI); 8.30, 13.18) and after that Metabolically unhealthy overweight (MUOW) individuals were at highest risk of T2DM with 7 times higher risk when compared with MHNW .Metabolically healthy overweight and obese individuals has (1.77, 95% CI; 1.33, 2.35) and (3.00, 95% CI; 2.33, 3.85) risk ratio for T2DM development in comparison with MHNW respectively
Summary
Risk of diabetes mellitus type 2 (T2DM) is variable between individuals due to different metabolic phenotypes. The prevalence of diabetes has been increasing, and it is been rising among overweight and obese people.[1] Obesity is a risk factor for developing diabetes, postulated by mediation with pathways related with fat tissue metabolism include abnormal beta cell dysfunction and aggravated insulin resistance (IR).[2] Metabolically healthy obese (MHO) is the one of subcategories of obesity without lipid disorders, IR or hypertension.[3] Generally, there is no evidence that these individuals are permanently protected from the risk of obesity-related co-morbidities.[4] Several prospective cohort studies have shown the combined effect of a higher body mass index (BMI) and metabolic abnormalities in the development of diabetes Some of these have reported that MHO individuals are not at increased risk for diabetes mellitus type 2 (T2DM) in comparison with metabolically healthy nonobese subjects[5,6,7] and might not benefit from lifestyle interventions.
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