RT Journal Article
SR Electronic
T1 Metabolically healthy overweight/obesity with no metabolic abnormalities and incident hyperglycaemia in Chinese adults: analysis of a retrospective cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e087307
DO 10.1136/bmjopen-2024-087307
VO 15
IS 1
A1 Gao, Qin
A1 Liang, Boya
A1 Li, Hongmin
A1 Xie, Ruining
A1 Xu, Yaru
A1 Tong, Yeqing
A1 Jiang, Shunli
YR 2025
UL http://bmjopen.bmj.com/content/15/1/e087307.abstract
AB Objectives To explore whether metabolically healthy overweight (MHOW) and/or metabolically healthy obesity (MHO) increase hyperglycaemia risk in a Chinese population with a broad age range.Design Retrospective cohort study.Setting Secondary analysis of data from the DATADRYAD database, comprising health check records of participants from 32 regions and 11 cities in China between 2010 and 2016.Participants A total of 47 391 metabolically healthy participants with none of the metabolic abnormalities were selected.Outcome measures Hyperglycaemia includes incident diabetes and impaired fasting glucose (IFG). Diabetes was diagnosed with fasting blood glucose ≥7.0 mmol/L and typical clinical symptoms and/or on self-report during follow-up. The fasting plasma glucose level of IFG was from 5.6 to 6.9 mmol/L.Results With an average follow-up of 3.06 years, 5274 participants (11.13%) developed hyperglycaemia over 144 804 person-years, with an incidence rate of 36.42 per 1000 person-years. Adjusted model revealed a higher risk of incident hyperglycaemia in the MHOW group (HR=1.23, 95% CIs 1.16 to 1.30) and the MHO group (HR=1.49, 95% CI 1.33 to 1.67) compared with the metabolically healthy normal weight group. With 1 unit increase of body mass index, the risk of hyperglycaemia increased by 6% (HR=1.06, 95% CI 1.04 to 1.07). The stratified analyses and interaction tests showed the robustness of the association, and there was a stronger association in women (p for interaction<0.001).Conclusions The MHOW and MHO phenotypes were positively associated with a higher risk of hyperglycaemia in this population, and the association was particularly stronger in women.Data are available in a public, open access repository. The data used in this analysis can be accessed via the Dryad data repository at http://datadryad.org/withthedoi:10.5061/dryad.ft8750v.