| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
General Medicine Division and Department of Medicine (J.B.M.) and Diabetes Unit and Department of Medicine (D.M.N.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114; Department of Endocrinology, Diabetes, and Medical Genetics (P.W.F.W.), Medical University of South Carolina, Charleston, South Carolina 29403; The National Heart, Lung, and Blood Institute’s Framingham Heart Study and the Division of Endocrinology, Diabetes, and Hypertension (C.S.F.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115; The National Heart, Lung, and Blood Institute’s Framingham Heart Study and the Evans Department of Medicine, Whitaker Cardiovascular Institute, and Preventive Medicine Section (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02215; and Department of Mathematics, Statistics, and Consulting Unit (L.M.S., R.B.D.), Boston University, Boston, Massachusetts 02118
Address all correspondence and requests for reprints to: James B. Meigs, M.D., M.P.H., General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, Massachusetts 02114. E-mail: jmeigs{at}partners.org.
Context: Metabolic risk conferred by adiposity may be due to associated risk factor clustering.
Objective: The objective of this study was to assess risk for diabetes or cardiovascular disease (CVD) stratified by body mass index (BMI) and the presence or absence of metabolic syndrome (MetS) or insulin resistance (IR).
Design, Setting, and Participants: This was a community-based, longitudinal study of 2902 people (55% women, mean age 53 yr) without diabetes or CVD in 1989–1992 followed for up to 11 yr. We categorized subjects by normal weight (BMI < 25 kg/m2), overweight (25–29.9 kg/m2), or obese (>30 kg/m2) and by the National Cholesterol Education Program’s Adult Treatment Panel MetS or the top quartile of homeostasis model IR. We used proportional hazard models to estimate risk relative to normal weight and no MetS or IR.
Main Outcome Measure: Incident type 2 diabetes (treatment or fasting glucose 
7 mmol/liter, 141 events) or CVD (myocardial infarction, stroke, or claudication, 252 events) were measured.
Results: Among 1056 normal-weight subjects, 7% had MetS and a risk factor-adjusted relative risk for diabetes of 3.97 (95% confidence interval, 1.35–11.6) and for CVD of 3.01 (1.68–5.41). Among 638 obese subjects, 37% did not have MetS or significantly increased risk. Obese subjects with MetS had an adjusted relative risk for diabetes of 10.3 (5.44–19.5) and for CVD of 2.13 (1.43–3.18). Results were similar in analyses of BMI-IR categories.
Conclusions: People with normal weight and MetS or IR or with obesity but no MetS or IR were not uncommon in our sample. Risk factor clustering or IR appear to confer much of the risk for diabetes or CVD commonly associated with elevated BMI.
This article has been cited by other articles:
 |
|
 |
|
  K. Nakajima and M. Saito Lower Vital Capacity Is Associated With Diabetes but Not With Metabolic Syndrome in Nonobese Japanese Men: Response to Oda and Kawai Diabetes Care, November 1, 2009; 32(11): e135 - e135. [Full Text] [PDF]
|
|
|
|
|
|
J.-L. Chiasson Early Insulin Use in Type 2 Diabetes: What are the cons? Diabetes Care, November 1, 2009; 32(suppl_2): S270 - S274. [Full Text] [PDF]
|
|
|
|
|
|
J. B. Meigs Multiple Biomarker Prediction of Type 2 Diabetes Diabetes Care, July 1, 2009; 32(7): 1346 - 1348. [Full Text] [PDF]
|
|
|
|
 |
|
 M.-A. Cornier, D. Dabelea, T. L. Hernandez, R. C. Lindstrom, A. J. Steig, N. R. Stob, R. E. Van Pelt, H. Wang, and R. H. Eckel The Metabolic Syndrome Endocr. Rev., December 1, 2008; 29(7): 777 - 822. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Rosenzweig, E. Ferrannini, S. M. Grundy, S. M. Haffner, R. J. Heine, E. S. Horton, and R. Kawamori Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 3671 - 3689. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Chinali, G. de Simone, M. J. Roman, L. G. Best, E. T. Lee, M. Russell, B. V. Howard, and R. B. Devereux Cardiac Markers of Pre-Clinical Disease in Adolescents With the Metabolic Syndrome: The Strong Heart Study J. Am. Coll. Cardiol., September 9, 2008; 52(11): 932 - 938. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Ford, C. Li, and N. Sattar Metabolic Syndrome and Incident Diabetes: Current state of the evidence Diabetes Care, September 1, 2008; 31(9): 1898 - 1904. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Wassink, Y. Van Der Graaf, S. S Soedamah-Muthu, W. Spiering, and F. L. Visseren Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease Diabetes and Vascular Disease Research, June 1, 2008; 5(2): 114 - 122. [Abstract] [PDF]
|
|
|
|
 |
|
 S Cupisti, N Kajaia, R Dittrich, H Duezenli, M W Beckmann, and A Mueller Body mass index and ovarian function are associated with endocrine and metabolic abnormalities in women with hyperandrogenic syndrome Eur. J. Endocrinol., May 1, 2008; 158(5): 711 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sorisky MD A new predictor for type 2 diabetes? Can. Med. Assoc. J., January 29, 2008; 178(3): 313 - 315. [Full Text] [PDF]
|
|
|
|
|
|
J. B. Meigs, M. G. Larson, C. S. Fox, J. F. Keaney Jr., R. S. Vasan, and E. J. Benjamin Association of Oxidative Stress, Insulin Resistance, and Diabetes Risk Phenotypes: The Framingham Offspring Study Diabetes Care, October 1, 2007; 30(10): 2529 - 2535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Lorenzo, M. Serrano-Rios, M. T. Martinez-Larrad, C. Gonzalez-Villalpando, J. L. Gonzalez-Sanchez, M. J. Martinez-Calatrava, R. Gabriel, and S. M. Haffner Is Waist Circumference an Essential Component of the Metabolic Syndrome? Diabetes Care, August 1, 2007; 30(8): 2141 - 2142. [Full Text] [PDF]
|
|
|
|
 |
|
 C. S. Blaum, N. A. West, and M. N. Haan Is the Metabolic Syndrome, With or Without Diabetes, Associated With Progressive Disability in Older Mexican Americans? J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 766 - 773. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. M. Reaven The Individual Components of the Metabolic Syndrome: Is There a Raison d'Etre? J. Am. Coll. Nutr., June 1, 2007; 26(3): 191 - 195. [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Zenovich and D. A. Taylor CELL THERAPY IN KIDNEY DISEASE: CAUTIOUS OPTIMISM... BUT OPTIMISM NONETHELESS Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S94 - S103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Meigs, M. K. Rutter, L. M. Sullivan, C. S. Fox, R. B. D'Agostino Sr., and P. W.F. Wilson Impact of Insulin Resistance on Risk of Type 2 Diabetes and Cardiovascular Disease in People With Metabolic Syndrome Diabetes Care, May 1, 2007; 30(5): 1219 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Sturmer, J. E. Buring, I-M. Lee, J. M. Gaziano, and R. J. Glynn Metabolic Abnormalities and Risk for Colorectal Cancer in the Physicians' Health Study Cancer Epidemiol. Biomarkers Prev., December 1, 2006; 15(12): 2391 - 2397. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
