TY - JOUR
T1 - Risk of type 2 diabetes according to the cumulative exposure to metabolic syndrome or obesity
T2 - A nationwide population-based study
AU - Lee, You Bin
AU - Kim, Da Hye
AU - Kim, Seon Mee
AU - Kim, Nan Hee
AU - Choi, Kyung Mook
AU - Baik, Sei Hyun
AU - Park, Yong Gyu
AU - Han, Kyungdo
AU - Yoo, Hye Jin
N1 - Funding Information:
Dr HJ Yoo was supported by the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education (2018R1D1A1B07047587). The funding sources had no role in the design, collection, analysis and interpretation of data; writing of the report; and decision to submit the article for publication. This work was carried out using the database from the Korean NHIS. The National Health Information Database constructed by the NHIS was used, and the results do not necessarily represent the opinion of the National Health Insurance Corporation.
Funding Information:
Dr HJ Yoo was supported by the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education (2018R1D1A1B07047587). The funding sources had no role in the design, collection, analysis and interpretation of data; writing of the report; and decision to submit the article for publication. This work was carried out using the database from the Korean NHIS. The National Health Information Database constructed by the NHIS was used, and the results do not necessarily represent the opinion of the National Health Insurance Corporation.
Publisher Copyright:
© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Aims/Introduction: We investigated the risk of incident type 2 diabetes according to the cumulative exposure to obesity or metabolic syndrome (MetS) during annual or biennial health examinations. Materials and Methods: The Korean National Health Insurance Service datasets from 2002 to 2017 were used for this retrospective longitudinal study. The risk for type 2 diabetes was analyzed according to the cumulative exposure to obesity and MetS among individuals who underwent four health examinations from 2009 to 2012 or 2013 (n = 2,851,745). Results: During examinations, 28.56 and 17.86% of the total participants showed fluctuations in metabolic health state and obesity, respectively. During a mean 5.01 years of follow up, 98,950 new type 2 diabetes cases developed. The risk for type 2 diabetes increased with the increase in exposure to MetS (hazard ratio [HR] 2.92, 95% confidence interval [CI] 2.86–2.99; HR 4.96, 95% CI 4.85–5.08; HR 7.46, 95% CI 7.30–7.63; HR 12.24, 95% CI 12.00–12.49 in groups with number of exposures one to four, respectively) and obesity (HR 1.60, 95% CI 1.56–1.65; HR 1.87, 95% CI 1.81–1.92; HR 2.25, 95% CI 2.19–2.31; HR 3.46, 95% CI 3.41–3.51 in groups with number of exposures one to four, respectively), showing a more detrimental effect of cumulative exposure to MetS, when compared with the exposure to obesity. Conclusions: Metabolic health and obesity fluctuated within a relatively short period of 4–5 years. Although the impact was much greater for MetS than for obesity, the cumulative duration of both obesity and MetS was associated with an increased risk of type 2 diabetes in a dose-response manner. Therefore, continuously maintaining metabolic health and normal weight is crucial to prevent incident type 2 diabetes.
AB - Aims/Introduction: We investigated the risk of incident type 2 diabetes according to the cumulative exposure to obesity or metabolic syndrome (MetS) during annual or biennial health examinations. Materials and Methods: The Korean National Health Insurance Service datasets from 2002 to 2017 were used for this retrospective longitudinal study. The risk for type 2 diabetes was analyzed according to the cumulative exposure to obesity and MetS among individuals who underwent four health examinations from 2009 to 2012 or 2013 (n = 2,851,745). Results: During examinations, 28.56 and 17.86% of the total participants showed fluctuations in metabolic health state and obesity, respectively. During a mean 5.01 years of follow up, 98,950 new type 2 diabetes cases developed. The risk for type 2 diabetes increased with the increase in exposure to MetS (hazard ratio [HR] 2.92, 95% confidence interval [CI] 2.86–2.99; HR 4.96, 95% CI 4.85–5.08; HR 7.46, 95% CI 7.30–7.63; HR 12.24, 95% CI 12.00–12.49 in groups with number of exposures one to four, respectively) and obesity (HR 1.60, 95% CI 1.56–1.65; HR 1.87, 95% CI 1.81–1.92; HR 2.25, 95% CI 2.19–2.31; HR 3.46, 95% CI 3.41–3.51 in groups with number of exposures one to four, respectively), showing a more detrimental effect of cumulative exposure to MetS, when compared with the exposure to obesity. Conclusions: Metabolic health and obesity fluctuated within a relatively short period of 4–5 years. Although the impact was much greater for MetS than for obesity, the cumulative duration of both obesity and MetS was associated with an increased risk of type 2 diabetes in a dose-response manner. Therefore, continuously maintaining metabolic health and normal weight is crucial to prevent incident type 2 diabetes.
KW - Metabolic syndrome
KW - Obesity
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85087149774&partnerID=8YFLogxK
U2 - 10.1111/jdi.13304
DO - 10.1111/jdi.13304
M3 - Article
C2 - 32449283
AN - SCOPUS:85087149774
SN - 2040-1116
VL - 11
SP - 1583
EP - 1593
JO - Journal of Diabetes Investigation
JF - Journal of Diabetes Investigation
IS - 6
ER -
