Metabolically Healthy Individuals Have Lower Prediabetes Risk Regardless of Body Weight

Conceitos Básicos

Metabolically healthy individuals, regardless of their body weight status, have a lower frequency of impaired glucose metabolism compared to their metabolically unhealthy counterparts.

Resumo

This study investigated the prevalence of prediabetes conditions (impaired fasting glucose, impaired glucose tolerance, and combined impaired fasting glucose and impaired glucose tolerance) among individuals with different body mass index (BMI) and metabolic health statuses.
The researchers first validated the use of estimated glucose disposal rate (eGDR), an index of insulin sensitivity, in a cohort of 350 individuals without diabetes. They then stratified 2,201 participants without diabetes from the CATAMERI study into normal weight, overweight, and obese groups, and further divided each BMI group into metabolically healthy (MH) and metabolically unhealthy (MU) subgroups based on their eGDR values.
The key findings are:

The MH overweight and MH obese groups showed comparable glycemic parameters to the MH normal weight group.
The MU overweight and MU obese groups exhibited higher HbA1c levels and fasting and 2-hour post-load glucose compared to the MH normal weight group.
The frequencies of prediabetes conditions were similar among the MH groups regardless of BMI, but were higher in the MU overweight and MU obese groups compared to the MU normal weight group.
Compared to the MH normal weight group, the odds of prediabetes were at least 2 times higher in the MU obese and MU overweight groups, but not significantly different in the MU normal weight, MH obese, and MH overweight groups.
The authors conclude that metabolically healthy individuals with overweight or obesity have a more favorable metabolic risk profile compared to metabolically unhealthy individuals with overweight or obesity.

Estatísticas

"Overall, the results of this cross-sectional study support the notion that metabolically healthy individuals with overweight or obesity have a more favorable metabolic risk profile in comparison to metabolically unhealthy subjects with overweight or obesity."
The odds of prediabetes were at least 2 times higher in the MU obese (OR 2.54, p<0.001) and MU overweight (OR 2.06, p<0.001) groups compared to the MH normal weight group.

Citações

"The MH overweight and MH obesity groups showed comparable glycemic parameters as the MH normal weight group, whereas the MU overweight and MU obesity groups exhibited higher A1c levels and fasting and 2-hour post-load glucose than the MH normal weight group."
"The frequencies of IFG, IGT, and IFG+IGT conditions were similar among the MH normal weight, MH overweight, and MH obesity groups but were higher in the MU overweight and MU obesity groups than in the MU normal weight group."

Principais Insights Extraídos De

Metabolic Health Tied to Lower Prediabetes Risk

by Shrabasti Bh... às www.medscape.com 06-19-2024

https://www.medscape.com/viewarticle/metabolic-health-tied-lower-prediabetes-risk-2024a1000bem

Perguntas Mais Profundas

What are the potential underlying mechanisms that contribute to the metabolically healthy phenotype in individuals with overweight or obesity?

Individuals with metabolically healthy phenotypes despite being overweight or obese may exhibit certain underlying mechanisms that contribute to their favorable metabolic profile. One key factor could be the distribution of body fat, where those with metabolically healthy characteristics tend to have more subcutaneous fat rather than visceral fat. Subcutaneous fat is less metabolically active and associated with lower levels of inflammation and insulin resistance. Additionally, genetic factors, such as variations in genes related to metabolism and insulin sensitivity, could play a role in determining metabolic health in the context of excess body weight. Furthermore, factors like adipose tissue function, mitochondrial health, and hormonal regulation may also contribute to the maintenance of metabolic health in individuals with overweight or obesity.

How do lifestyle factors, such as diet and physical activity, differ between metabolically healthy and unhealthy individuals across the BMI spectrum?

Lifestyle factors, particularly diet and physical activity, play a crucial role in determining metabolic health status across the BMI spectrum. Metabolically healthy individuals, regardless of their weight category, tend to engage in healthier dietary patterns characterized by a higher intake of fruits, vegetables, whole grains, and lean proteins, while limiting the consumption of processed foods, sugary beverages, and saturated fats. They also exhibit a higher level of physical activity, which helps in improving insulin sensitivity, reducing inflammation, and maintaining a healthy body composition. In contrast, metabolically unhealthy individuals often have poor dietary habits, such as high consumption of refined carbohydrates and unhealthy fats, coupled with sedentary lifestyles, leading to increased risk of insulin resistance, inflammation, and metabolic dysfunction.

Given the importance of metabolic health, should clinical guidelines and public health interventions focus more on metabolic health status rather than just body weight?

Considering the significant impact of metabolic health on overall well-being and disease risk, it is essential for clinical guidelines and public health interventions to shift their focus towards assessing and improving metabolic health status rather than solely concentrating on body weight. Metabolic health encompasses various factors beyond weight, including insulin sensitivity, lipid profile, blood pressure, and inflammatory markers, which are crucial indicators of metabolic function and overall health. By emphasizing metabolic health, healthcare providers can better identify individuals at risk for metabolic disorders like prediabetes and cardiovascular disease, enabling early intervention and personalized treatment strategies. Public health initiatives promoting healthy lifestyle behaviors, such as balanced nutrition and regular physical activity, can also target metabolic health improvement, leading to reduced disease burden and improved quality of life for populations. Therefore, integrating metabolic health assessments into clinical practice and public health policies can enhance preventive efforts and better address the root causes of metabolic dysfunction.