Adiposity increase type 2 diabetes risk in the absence of metabolic dysfunction

Even without accompanying metabolic dysfunction, adiposity appears to be a risk factor for type 2 diabetes, according to recent findings.

Additionally, the existence of metabolic dysfunction is associated with an increased risk for type 2 diabetes across all categories of BMI, the researchers wrote.

Frank L. Visseren, MD, PhD, of the University Medical Center Utrecht in the Netherlands, and colleagues evaluated data from 6,997 participants from the SMART cohort study to determine the role of BMI and metabolic dysfunction on the risk for development of type 2 diabetes in patients at high risk for or with manifest vascular disease.

Participants were stratified into groups based on BMI category. Normal weight was defined as BMI of less than 25 kg/m2, overweight was classified as BMI between 25 kg/m2 and 30 kg/m2, and obesity was classified as BMI 30 kg/m2 or more. Metabolic dysfunction was assessed within these subgroups and was defined by an adapted version of the National Cholesterol Education Program (NCEP) revised criteria for metabolic syndrome. Follow-up was a median of 6 years.

The researchers found that over the course of follow-up, 519 participants developed type 2 diabetes. In cases without metabolic dysfunction as defined by NCEP criteria, adiposity was associated with an increased risk for type 2 diabetes (HR = 2.5; 95% CI, 1.5-4.2 for participants with overweight and HR = 4.3; 95% CI, 2.2-8.6 for participants with obesity). Where metabolic dysfunction was present ( 3 NCEP criteria) an elevated risk for type 2 diabetes was seen in patients with normal BMI (HR = 4.7; 95% CI, 2.8-7.8) participants with overweight (HR = 8.5; 95% CI, 5.5-13.4) and participants with obesity (HR = 16.3; 95% CI, 10.4-25.6) compared with participants with normal BMI and no metabolic dysfunction.

“In conclusion, overweight and obese patients without metabolic dysfunction and with manifest vascular disease or at high risk for [CV] events are at increased risk for developing type 2 diabetes compared with normal weight patients,” the researchers wrote. “This risk becomes increasingly higher with the presence of metabolic dysfunction and increases with BMI. These findings support adequate assessment and treatment of both adiposity and metabolic dysfunction.” – by Jennifer Byrne

Source: www.healio.com