Jieli Lu1, Yufang Bi1, Tiange Wang1, Weiqing Wang1, Yiming Mu2, Jiajun Zhao3, Chao Liu4, Lulu Chen5, Lixin Shi6, Qiang Li7, Qin Wan8, Shengli Wu9, Guijun Qin10, Tao Yang11, Li Yan12, Yan Liu13, Guixia Wang13, Zuojie Luo14, Xulei Tang15, Gang Chen16, Yanan Huo17, Zhengnan Gao18, Qing Su19, Zhen Ye20, Youming Wang21, Huacong Deng22, Xuefeng Yu23, Feixia Shen24, Li Chen25, Liebing Zhao1, Meng Dai1, Min Xu1, Yu Xu1, Yuhong Chen1, Shenghan Lai26, Guang Ning27. 1. Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, China; Shanghai Clinical Center for Endocrine and Metabolic Diseases, National Clinical Research Center, Department of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, China. 2. People's Liberation Army General Hospital, China. 3. Shandong Provincial Hospital, China. 4. Jiangsu Province Hospital on integration of Chinese and Western Medicine, China. 5. Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, China. 6. University of Guizhou School of Medicine, China. 7. University of Haerbin School of Medicine, China. 8. University of Luzhou School of Medicine, China. 9. Xinjiang Kelamayi Peoples Hospital, China. 10. University of Zhengzhou School of Medicine, China. 11. University of Nanjing School of Medicine, China. 12. University of Zhongshan School of Medicine, China. 13. University of Jilin School of Medicine, China. 14. University of Guangxi School of Medicine, China. 15. University of Lanzhou School of Medicine, China. 16. University of Fujian School of Medicine, China. 17. Jiangxi People's Hospital, China. 18. University of Dalian School of Medicine, China. 19. Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, China. 20. Zhejiang Center for Disease Control and Prevention, China. 21. University of Anhui School of Medicine, China. 22. University of Chongqing School of Medicine, China. 23. Wuhan Tongji Hospital, China. 24. Wenzhou University School of Medicine, China. 25. Qilu Hospital, University of Shandong School of Medicine, China. 26. Johns Hopkins University School of Medicine, Baltimore, United States. 27. Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, China; Shanghai Clinical Center for Endocrine and Metabolic Diseases, National Clinical Research Center, Department of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address: gning@sibs.ac.cn.
Abstract
OBJECTIVE: Obesity and insulin resistance are risk factors for cardiovascular diseases. Whether insulin-sensitive obese individuals are at higher risk for cardiovascular diseases is still debated. We aim to investigate whether insulin-sensitive obesity associates with prevalent cardiovascular diseases and 10-year coronary heart disease (CHD) risk. RESEARCH DESIGN AND METHODS: At the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, 211,641 participants aged 40 years or older were recruited from 25 communities across the China mainland, in 2011 to 2012. Participants were categorized by insulin-sensitive/resistant and general/abdominal obese status. Cardiovascular diseases included CHD, stroke, and myocardial infarction. Framingham risk score (FRS) was calculated according to National Cholesterol Education Program-Adult Treatment Panel III and FRS greater than 20% or cardiovascular diseases were identified as high risk for 10-year CHD. RESULTS: Controlling for potential confounders, compared with insulin-sensitive normal weight individuals, insulin-sensitive general obese individuals had increased risks for prevalent cardiovascular diseases (men: OR, 2.55, 95% CI, 2.04-3.18; women: 1.73, 1.45-2.06) and 10-year Framingham risk for CHD (men: 2.26, 1.86-2.76; women: 1.73, 1.46-2.06). Compared with insulin-sensitive normal waist subgroup, insulin-sensitive abdominal obesity was associated with higher risks for prevalent cardiovascular diseases (men: 1.32, 1.20-1.46; women: 1.36, 1.27-1.47) and 10-year Framingham risk for CHD (men, 1.34, 1.23-1.45; women, 1.37, 1.27-1.47). CONCLUSION: Both general and abdominal obesity were associated with elevated prevalent cardiovascular diseases and 10-year CHD risk, regardless of the presence or absence of insulin resistance.
OBJECTIVE:Obesity and insulin resistance are risk factors for cardiovascular diseases. Whether insulin-sensitive obese individuals are at higher risk for cardiovascular diseases is still debated. We aim to investigate whether insulin-sensitive obesity associates with prevalent cardiovascular diseases and 10-year coronary heart disease (CHD) risk. RESEARCH DESIGN AND METHODS: At the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, 211,641 participants aged 40 years or older were recruited from 25 communities across the China mainland, in 2011 to 2012. Participants were categorized by insulin-sensitive/resistant and general/abdominal obese status. Cardiovascular diseases included CHD, stroke, and myocardial infarction. Framingham risk score (FRS) was calculated according to National Cholesterol Education Program-Adult Treatment Panel III and FRS greater than 20% or cardiovascular diseases were identified as high risk for 10-year CHD. RESULTS: Controlling for potential confounders, compared with insulin-sensitive normal weight individuals, insulin-sensitive general obese individuals had increased risks for prevalent cardiovascular diseases (men: OR, 2.55, 95% CI, 2.04-3.18; women: 1.73, 1.45-2.06) and 10-year Framingham risk for CHD (men: 2.26, 1.86-2.76; women: 1.73, 1.46-2.06). Compared with insulin-sensitive normal waist subgroup, insulin-sensitive abdominal obesity was associated with higher risks for prevalent cardiovascular diseases (men: 1.32, 1.20-1.46; women: 1.36, 1.27-1.47) and 10-year Framingham risk for CHD (men, 1.34, 1.23-1.45; women, 1.37, 1.27-1.47). CONCLUSION: Both general and abdominal obesity were associated with elevated prevalent cardiovascular diseases and 10-year CHD risk, regardless of the presence or absence of insulin resistance.
Authors: Chi Chen; Qin Li; Xiaomin Nie; Bing Han; Yi Chen; Fangzhen Xia; Hualing Zhai; Ningjian Wang; Yingli Lu Journal: Environ Sci Pollut Res Int Date: 2017-08-10 Impact factor: 4.223