title: Stability and changes in metabolically healthy overweight or obesity and risk of future diabetes: Niigata wellness study.
abstract: OBJECTIVE
  Stability and changes in obesity and metabolic health status from a baseline period and longitudinally investigated their impact on predicting future diabetes were assessed.
  
  
  METHODS
  Studied were 27,478 Japanese individuals without diabetes. Metabolically healthy (MH) was indicated by having ≤1 among impaired fasting glucose, hypertension, hypertriglyceridemia and low HDL cholesterol concentration. Metabolically abnormal (MA) was indicated by having ≥2 of those metabolic abnormalities. A cut-off value of BMI 25.0 defined overweight or obesity (O) or normal weight (NW). Hazard ratio (HR) for diabetes for a 6-year period was investigated after changes in phenotypes were assessed during the previous 2 years.
  
  
  RESULTS
  Compared with maintaining MH-NW, transitioning to MH-O from MH-NW resulted in a multivariate-adjusted HR of 1.96 (95% CI: 1.18, 3.25) for diabetes. With a stable MH-O the HR for diabetes was 2.59 (2.00, 3.34) while change from MH-O to MH-NW resulted in an HR of 1.30 (0.61, 2.76). Transitioning to MA-O from MH-O was associated with an HR of 7.09 (5.41, 9.30). With a stable MA-O the risk of diabetes was substantially elevated with an HR of 12.5 (10.5, 14.9).
  
  
  CONCLUSIONS
  Examining the transitory nature of apparently benign or unhealthy obese phenotypes was effective for differentiating high-risk individuals for future diabetes.
authors.affiliation: Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Heianza
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kato
authors.forename: Satoru
authors.initials: S
authors.lastname: Kodama
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Hanyu
authors.forename: Koji
authors.initials: K
authors.lastname: Sato
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism*; D050177:Overweight / Q000097:blood / Q000378:metabolism*; D012307:Risk Factors