| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
Submitted on March 16, 2006
Accepted on May 18, 2006
General Medicine Division and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Dept. of Endocrinology, Diabetes, and Medical Genetics, Medical University of South Carolina, Charleston, SC.; The NHLBI’s Framingham Heart Study and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; The NHLBI’s Framingham Heart Study and the Evans Department of Medicine, Whitaker Cardiovascular Institute, and Preventive Medicine Section, Boston University School of Medicine, Boston, MA.; Diabetes Unit and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.; Dept. of Mathematics, Statistics, and Consulting Unit, Boston University, Boston, MA
* To whom correspondence should be addressed. E-mail: jmeigs{at}partners.org.
Context: Metabolic risk conferred by adiposity may be due to associated risk factor clustering.
Objective: 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: 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-<30) or obese (>=30) and by ATP3 MetS or the top quartile of homeostasis model IR. We used proportional hazards 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/l, 141 events) or CVD (myocardial infarction, stroke, or claudication, 252 events).
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:
 |
|
 |
|
  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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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 |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
