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

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.

• Authors: Jieli Lu, Yufang Bi, Tiange Wang, Weiqing Wang, Yiming Mu, Jiajun Zhao, Chao Liu, Lulu Chen, Lixin Shi, Qiang Li, Qin Wan, Shengli Wu, Guijun Qin, Tao Yang, Li Yan, Yan Liu, Guixia Wang, Zuojie Luo, Xulei Tang, Gang Chen, Yanan Huo, Zhengnan Gao, Qing Su, Zhen Ye, Youming Wang, Huacong Deng, Xuefeng Yu, Feixia Shen, Li Chen, Liebing Zhao, Meng Dai, Min Xu, Yu Xu, Yuhong Chen, Shenghan Lai, Guang Ning
• Journal: International journal of cardiology (Int J Cardiol) Vol. 172 Issue 2 Pg. 388-94 (Mar 15 2014) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 24502884 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Topics

• Aged
• Cardiovascular Diseases (epidemiology, etiology)
• China (epidemiology)
• Female
• Humans
• Insulin Resistance
• Longitudinal Studies
• Male
• Middle Aged
• Obesity (complications)
• Prevalence
• Prospective Studies
• Risk Factors