title: 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.
  
  
  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).
  
  
  CONCLUSIONS
  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: Key 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.
authors: Jieli
authors: J
authors: Lu
authors: Key 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.
authors: Yufang
authors: Y
authors: Bi
authors: Key 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.
authors: Tiange
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authors: Wang
authors: Key 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.
authors: Weiqing
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authors: Wang
authors: People's Liberation Army General Hospital, China.
authors: Yiming
authors: Y
authors: Mu
authors: Shandong Provincial Hospital, China.
authors: Jiajun
authors: J
authors: Zhao
authors: Jiangsu Province Hospital on integration of Chinese and Western Medicine, China.
authors: Chao
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authors: Liu
authors: Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, China.
authors: Lulu
authors: L
authors: Chen
authors: University of Guizhou School of Medicine, China.
authors: Lixin
authors: L
authors: Shi
authors: University of Haerbin School of Medicine, China.
authors: Qiang
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authors: Li
authors: University of Luzhou School of Medicine, China.
authors: Qin
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authors: Wan
authors: Xinjiang Kelamayi Peoples Hospital, China.
authors: Shengli
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authors: Wu
authors: University of Zhengzhou School of Medicine, China.
authors: Guijun
authors: G
authors: Qin
authors: University of Nanjing School of Medicine, China.
authors: Tao
authors: T
authors: Yang
authors: University of Zhongshan School of Medicine, China.
authors: Li
authors: L
authors: Yan
authors: University of Jilin School of Medicine, China.
authors: Yan
authors: Y
authors: Liu
authors: University of Jilin School of Medicine, China.
authors: Guixia
authors: G
authors: Wang
authors: University of Guangxi School of Medicine, China.
authors: Zuojie
authors: Z
authors: Luo
authors: University of Lanzhou School of Medicine, China.
authors: Xulei
authors: X
authors: Tang
authors: University of Fujian School of Medicine, China.
authors: Gang
authors: G
authors: Chen
authors: Jiangxi People's Hospital, China.
authors: Yanan
authors: Y
authors: Huo
authors: University of Dalian School of Medicine, China.
authors: Zhengnan
authors: Z
authors: Gao
authors: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors: Qing
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authors: Su
authors: Zhejiang Center for Disease Control and Prevention, China.
authors: Zhen
authors: Z
authors: Ye
authors: University of Anhui School of Medicine, China.
authors: Youming
authors: Y
authors: Wang
authors: University of Chongqing School of Medicine, China.
authors: Huacong
authors: H
authors: Deng
authors: Wuhan Tongji Hospital, China.
authors: Xuefeng
authors: X
authors: Yu
authors: Wenzhou University School of Medicine, China.
authors: Feixia
authors: F
authors: Shen
authors: Qilu Hospital, University of Shandong School of Medicine, China.
authors: Li
authors: L
authors: Chen
authors: Key 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.
authors: Liebing
authors: L
authors: Zhao
authors: Key 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.
authors: Meng
authors: M
authors: Dai
authors: Key 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.
authors: Min
authors: M
authors: Xu
authors: Key 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.
authors: Yu
authors: Y
authors: Xu
authors: Key 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.
authors: Yuhong
authors: Y
authors: Chen
authors: Johns Hopkins University School of Medicine, Baltimore, United States.
authors: Shenghan
authors: S
authors: Lai
authors: Key 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.
authors: Guang
authors: G
authors: Ning
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cardiovascular diseases; Epidemiology; Insulin resistance; Obesity