PMID- 31884741
OWN - NLM
STAT- MEDLINE
DCOM- 20200602
LR  - 20200602
IS  - 2093-5978 (Electronic)
IS  - 2093-596X (Print)
IS  - 2093-596X (Linking)
VI  - 34
IP  - 4
DP  - 2019 Dec
TI  - Impact of the Dynamic Change of Metabolic Health Status on the Incident Type 2 
      Diabetes: A Nationwide Population-Based Cohort Study.
PG  - 406-414
LID - 10.3803/EnM.2019.34.4.406 [doi]
AB  - BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. 
      We examined the effect of the dynamic change of metabolic health status on the 
      incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight 
      individuals. METHODS: We analyzed 3,479,514 metabolically healthy subjects aged 
      over 20 years from the Korean National Health Screening Program, who underwent 
      health examination between 2009 and 2010, with a follow-up after 4 years. The 
      relative risk for T2DM incidence until the December 2017 was compared among the 
      four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, 
      stable MHO, and unstable MHO. RESULTS: During the 4 years, 11.1% of subjects in 
      the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy 
      phenotype. In the multivariate adjusted model, the unstable MHO group showed the 
      highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 
      to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group 
      ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The 
      stable MHO group showed a higher risk of T2DM than the stable MHNW group. The 
      influence of the transition into a metabolically unhealthy phenotype on T2DM 
      incidence was greater in subjects with aged <65 years, women, and those with 
      weight gain. CONCLUSION: Metabolically healthy phenotype was transient both in 
      normal weight and obese individuals. Maintaining metabolic health was critical 
      for the prevention of T2DM, irrespective of their baseline body mass index.
CI  - Copyright (c) 2019 Korean Endocrine Society.
FAU - Kim, Jung A
AU  - Kim JA
AUID- ORCID: 0000-0002-6595-6551
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea 
      University College of Medicine, Seoul, Korea.
FAU - Kim, Da Hye
AU  - Kim DH
AD  - Department of Biostatistics, College of Medicine, The Catholic University of 
      Korea, Seoul, Korea.
FAU - Kim, Seon Mee
AU  - Kim SM
AD  - Department of Family Medicine, Korea University College of Medicine, Seoul, 
      Korea.
FAU - Park, Yong Gyu
AU  - Park YG
AD  - Department of Biostatistics, College of Medicine, The Catholic University of 
      Korea, Seoul, Korea.
FAU - Kim, Nan Hee
AU  - Kim NH
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea 
      University College of Medicine, Seoul, Korea.
FAU - Baik, Sei Hyun
AU  - Baik SH
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea 
      University College of Medicine, Seoul, Korea.
FAU - Choi, Kyung Mook
AU  - Choi KM
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea 
      University College of Medicine, Seoul, Korea.
FAU - Han, Kyungdo
AU  - Han K
AUID- ORCID: 0000-0002-6096-1263
AD  - Department of Biostatistics, College of Medicine, The Catholic University of 
      Korea, Seoul, Korea. hkd917@naver.com.
FAU - Yoo, Hye Jin
AU  - Yoo HJ
AUID- ORCID: 0000-0003-0600-0266
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea 
      University College of Medicine, Seoul, Korea. deisy21@naver.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Korea (South)
TA  - Endocrinol Metab (Seoul)
JT  - Endocrinology and metabolism (Seoul, Korea)
JID - 101554139
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Biomarkers/analysis
MH  - Blood Glucose/analysis
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/*epidemiology/pathology
MH  - Female
MH  - Follow-Up Studies
MH  - *Health Status
MH  - Humans
MH  - Incidence
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Obesity, Metabolically Benign/*physiopathology
MH  - Prognosis
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Weight Gain
MH  - Young Adult
PMC - PMC6935776
OTO - NOTNLM
OT  - Diabetes mellitus, type 2
OT  - Metabolic syndrome
OT  - Obesity
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2019/12/31 06:00
MHDA- 2020/06/03 06:00
PMCR- 2019/12/01
CRDT- 2019/12/30 06:00
PHST- 2019/09/25 00:00 [received]
PHST- 2019/10/23 00:00 [revised]
PHST- 2019/11/25 00:00 [accepted]
PHST- 2019/12/30 06:00 [entrez]
PHST- 2019/12/31 06:00 [pubmed]
PHST- 2020/06/03 06:00 [medline]
PHST- 2019/12/01 00:00 [pmc-release]
AID - 34.406 [pii]
AID - 10.3803/EnM.2019.34.4.406 [doi]
PST - ppublish
SO  - Endocrinol Metab (Seoul). 2019 Dec;34(4):406-414. doi: 10.3803/EnM.2019.34.4.406.