OBJECTIVE: Some obese individuals have normal insulin sensitivity. It is controversial whether this phenotype is associated with increased all-cause mortality risk. RESEARCH DESIGN AND METHODS: Fifteen-year all-cause mortality data were obtained through the Regional Health Registry for 2,011 of 2,074 Caucasian middle-aged individuals of the Cremona Study, a population study on the prevalence of diabetes in Italy. Individuals were divided in four categories according to BMI (nonobese: <30 kg/m²; obese: ≥30 kg/m²) and estimated insulin resistance (insulin sensitive: homeostasis model assessment of insulin resistance <2.5; insulin resistant ≥2.5). RESULTS: Obese insulin-sensitive subjects represented 11% (95% CI 8.1-14.5) of the obese population. This phenotype had similar BMI but lower waist circumference, blood pressure, fasting glucose, triglycerides, and fibrinogen and higher HDL cholesterol than obese insulin-resistant subjects. In the 15-year follow-up, 495 deaths (cardiovascular disease [CVD]: n = 221; cancer: n = 180) occurred. All-cause mortality adjusted for age and sex was higher in the obese insulin-resistant subjects (hazard ratio 1.40 [95% CI 1.08-1.81], P = 0.01) but not in the obese insulin-sensitive subjects (0.99 [0.46-2.11], P = 0.97) when compared with nonobese insulin-sensitive subjects. Also, mortality for CVD and cancer was higher in the obese insulin-resistant subjects but not in the obese insulin-sensitive subjects when compared with nonobese insulin-sensitive subjects. CONCLUSIONS: In contrast to obese insulin-resistant subjects, metabolically healthy obese individuals are less common than previously thought and do not show increased all-cause, cancer, and CVD mortality risks in a 15-year follow-up study.
Prevalence, metabolic features and prognosis of metabolically-healthy obese Italian individuals : the Cremona Study / G. Calori, G. Lattuada, L. Piemonti, M.P. Garancini, F. Ragogna, M. Villa, S. Mannino, P. Crosignani, E. Bosi, L. Luzi, G. Ruotolo, G. Perseghin. - In: DIABETES CARE. - ISSN 0149-5992. - 34:1(2011 Jan), pp. 210-215.
|Titolo:||Prevalence, metabolic features and prognosis of metabolically-healthy obese Italian individuals : the Cremona Study|
PERSEGHIN, GIANLUCA (Ultimo)
|Parole Chiave:||homeostasis model assessment ; cardiovascular-disease ; insulin sensivity ; glucose-tolerance ; population ; resistance ; profile ; humans ; WOMEN ; risk|
|Settore Scientifico Disciplinare:||Settore MED/13 - Endocrinologia|
Settore MED/50 - Scienze Tecniche Mediche Applicate
|Data di pubblicazione:||gen-2011|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.2337/dc10-0665|
|Appare nelle tipologie:||01 - Articolo su periodico|