title: Metabolic Health Has Greater Impact on Diabetes than Simple Overweight/Obesity in Mexican Americans.
abstract: OBJECTIVE
  To compare the risk for diabetes in each of 4 categories of metabolic health and BMI.
  
  
  METHODS
  Participants were drawn from the Cameron County Hispanic Cohort, a randomly selected Mexican American cohort in Texas on the US-Mexico border. Subjects were divided into 4 phenotypes according to metabolic health and BMI: metabolically healthy normal weight, metabolically healthy overweight/obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight/obese. Metabolic health was defined as having less than 2 metabolic abnormalities. Overweight/obese status was assessed by BMI higher than 25 kg/m(2). Diabetes was defined by the 2010 ADA definition or by being on a diabetic medication.
  
  
  RESULTS
  The odds ratio for diabetes risk was 2.25 in the metabolically healthy overweight/obese phenotype (95% CI 1.34, 3.79), 3.78 (1.57, 9.09) in the metabolically unhealthy normal weight phenotype, and 5.39 (3.16, 9.20) in metabolically unhealthy overweight/obese phenotype after adjusting for confounding factors compared with the metabolically healthy normal weight phenotype.
  
  
  CONCLUSIONS
  Metabolic health had a greater effect on the increased risk for diabetes than overweight/obesity. Greater focus on metabolic health might be a more effective target for prevention and control of diabetes than emphasis on weight loss alone.
authors.affiliation: Department of Epidemiology & Biostatistics, University of Texas Health Science Center at San Antonio, Laredo Campus, Laredo, TX 78045, USA.
authors.forename: Shenghui
authors.initials: S
authors.lastname: Wu
authors.affiliation: Division of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Brownsville Campus, Brownsville, TX 78520, USA.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.affiliation: Division of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Brownsville Campus, Brownsville, TX 78520, USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Reninger
authors.affiliation: Division of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Brownsville Campus, Brownsville, TX 78520, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Vatcheva
authors.affiliation: Division of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Brownsville Campus, Brownsville, TX 78520, USA.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
mesh_terms: D000367:Age Factors; D003920:Diabetes Mellitus / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009765:Obesity / Q000209:etiology / Q000378:metabolism*; D050177:Overweight / Q000209:etiology / Q000378:metabolism*