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Int J Cardiol. 2014 Mar 15;172(2):388-94. doi: 10.1016/j.ijcard.2014.01.073. Epub 2014 Jan 25.

The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population: results of the REACTION study.

Lu J1, Bi Y1, Wang T1, Wang W1, Mu Y2, Zhao J3, Liu C4, Chen L5, Shi L6, Li Q7, Wan Q8, Wu S9, Qin G10, Yang T11, Yan L12, Liu Y13, Wang G13, Luo Z14, Tang X15, Chen G16, Huo Y17, Gao Z18, Su Q19, Ye Z20, Wang Y21, Deng H22, Yu X23, Shen F24, Chen L25, Zhao L1, Dai M1, Xu M1, Xu Y1, Chen Y1, Lai S26, Ning G27.

Author information

  • 1Key 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.
  • 2People's Liberation Army General Hospital, China.
  • 3Shandong Provincial Hospital, China.
  • 4Jiangsu Province Hospital on integration of Chinese and Western Medicine, China.
  • 5Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, China.
  • 6University of Guizhou School of Medicine, China.
  • 7University of Haerbin School of Medicine, China.
  • 8University of Luzhou School of Medicine, China.
  • 9Xinjiang Kelamayi Peoples Hospital, China.
  • 10University of Zhengzhou School of Medicine, China.
  • 11University of Nanjing School of Medicine, China.
  • 12University of Zhongshan School of Medicine, China.
  • 13University of Jilin School of Medicine, China.
  • 14University of Guangxi School of Medicine, China.
  • 15University of Lanzhou School of Medicine, China.
  • 16University of Fujian School of Medicine, China.
  • 17Jiangxi People's Hospital, China.
  • 18University of Dalian School of Medicine, China.
  • 19Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, China.
  • 20Zhejiang Center for Disease Control and Prevention, China.
  • 21University of Anhui School of Medicine, China.
  • 22University of Chongqing School of Medicine, China.
  • 23Wuhan Tongji Hospital, China.
  • 24Wenzhou University School of Medicine, China.
  • 25Qilu Hospital, University of Shandong School of Medicine, China.
  • 26Johns Hopkins University School of Medicine, Baltimore, United States.
  • 27Key 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.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

Cardiovascular diseases; Epidemiology; Insulin resistance; Obesity

PMID:
24502884
[PubMed - in process]
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