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jeudi 21 novembre 2013

It is not cholesterol which drives your CVD or D2 risk! Obesity equals smoking: between 2.5 and 3.9 increase!



  • ARTICLE

Risk of Developing Diabetes and Cardiovascular Disease in Metabolically Unhealthy Normal-Weight and Metabolically Healthy Obese Individuals

  1. Steven M. Haffner
-Author Affiliations
  1. Department of Medicine, University of Texas Health Science Center, San Antonio, Texas 78229
  1. Address all correspondence and requests for reprints to: Carlos Lorenzo, MD, Department of Medicine, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, Texas 78229. E-mail: lorenzo@uthscsa.edu.

Abstract

Context: The risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (DM) associated with obesity appears to be influenced by the coexistence of other metabolic abnormalities.
Objective: We examined the risk of developing CVD and DM in metabolically healthy obese (MHO) and metabolically unhealthy normal weight (MUH-NW) individuals.
Design and Setting: We analyzed prospective data of the San Antonio Heart Study, a population-based study among Mexican Americans and non-Hispanic whites (median follow-up, 7.4 y).
Participants: Incident DM and CVD were assessed in 2814 and 3700 participants aged 25 to 64 years, respectively.
Main Measures: MHO was defined as obesity (body mass index ≥ 30 kg/m2) with no more than one metabolic abnormality, and MUH-NW was defined as body mass index <25 kg="" m="" style="border: 0px; font-family: inherit; font-size: 0.85em; font-style: inherit; line-height: 0; margin: 0px; outline-style: none; padding: 0px; position: relative; text-align: inherit; top: -0.6em; vertical-align: baseline;" sup="">2
 with two or more abnormalities.
Results: In logistic regression models, BMI was associated with incident DM after controlling for demographics, family history of DM, and fasting glucose (odds ratio × 1 SD, 1.7 [1.5–2.0]). Both MUH-NW and MHO individuals had an increased DM risk (2.5 [1.1–5.6] and 3.9 [2.0–7.4], respectively). Similarly, BMI was related to incident CVD after adjusting for demographics and Framingham risk score (1.3 [1.1–1.6]). Incident CVD was also increased in MUH-NW and MHO individuals (2.9 [1.3–6.4] and 3.9 [1.9–7.8], respectively). Results were consistent across gender and ethnic categories.
Conclusion: The risk of developing DM and CVD is increased in MUH-NW and MHO individuals. Screening for obesity and other metabolic abnormalities should be routinely performed in clinical practice to institute appropriate preventive measures.




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