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Title: Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies
Authors: Bell, Joshua A.
Kivimaki, Mika
Hamer, Mark
Keywords: Metabolic health
Type 2 diabetes
Issue Date: 2014
Publisher: © The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity.
Citation: BELL, J.A., KIVIMAKI, M. and HAMER, M., 2014. Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies. Obesity Reviews, 15 (6), pp. 504–515.
Abstract: The risk of type 2 diabetes among obese adults who are metabolically healthy has not been established. We systematically searched Medline (1946–August 2013) and Embase (1947–August 2013) for prospective studies of type 2 diabetes incidence (defined by blood glucose levels or self-report) among metabolically healthy obese adults (defined by body mass index [BMI] and normal cardiometabolic clustering, insulin profile or risk score) aged ≥18 years at baseline. We supplemented the analysis with an original effect estimate from the English Longitudinal Study of Ageing (ELSA), with metabolically healthy obesity defined as BMI ≥ 30 kg m−2 and <2 of hypertension, impaired glycaemic control, systemic inflammation, adverse high-density lipoprotein cholesterol and adverse triglycerides. Estimates from seven published studies and ELSA were pooled using random effects meta-analyses (1,770 healthy obese participants; 98 type 2 diabetes cases). The pooled adjusted relative risk (RR) for incident type 2 diabetes was 4.03 (95% confidence interval = 2.66–6.09) in healthy obese adults and 8.93 (6.86–11.62) in unhealthy obese compared with healthy normal-weight adults. Although there was between-study heterogeneity in the size of effects (I2 = 49.8%; P = 0.03), RR for healthy obesity exceeded one in every study, indicating a consistently increased risk across study populations. Metabolically healthy obese adults show a substantially increased risk of developing type 2 diabetes compared with metabolically healthy normal-weight adults. Prospective evidence does not indicate that healthy obesity is a harmless condition.
Description: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Sponsor: National Institute on Aging in the United States. Grant Numbers: 2RO1AG7644-01A1, 2RO1AG017644, AG034454 Economic and Social Research Council (ESRC) Medical Research Council. Grant Number: K013351 National Heart, Lung and Blood Institute. Grant Number: HL36310 Academy of Finland an ESRC professorial fellowship British Heart Foundation. Grant Number: RE/10/005/28296
Version: Published
DOI: 10.1111/obr.12157
URI: https://dspace.lboro.ac.uk/2134/19272
Publisher Link: http://dx.doi.org/10.1111/obr.12157
ISSN: 1467-7881
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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