title: Risk of diabetes according to the metabolic health status and degree of obesity.
abstract: OBJECTIVE
  To determine the progression rates from metabolically healthy or unhealthy normal weight, overweight and obese phenotype to type 2 diabetes (T2D) in a non-diabetic high risk population in Isfahan, Iran.
  
  
  METHODS
  T2D incidence during a mean (SD) follow-up of 10.1 (2.3) years was examined among 1,982 non-diabetic first-degree relatives (FDR) of patients with T2D 30-70 years old. Participants were divided into 6 groups based on body mass index and metabolic syndrome component, except waist circumference, at baseline: metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), metabolically unhealthy overweight (MUOW) and metabolically unhealthy obese (MUO).
  
  
  RESULTS
  The MHO, MUOW, and MUO individuals at baseline were associated with incidence of T2D, independently of age and gender. MHO were 3 times (OR 2.96; 95% CI 1.07, 8.24) and MUOW were 2.75 times (95% CI 1.17, 6.45) more likely to develop T2D than those with MHNW. There was excess risk in MUO than MHO (OR 3.86; 95% CI 1.64, 9.11).
  
  
  CONCLUSIONS
  Obesity was a risk factor for T2D, even in the absence of any metabolic abnormalities. Metabolic abnormalities were a stronger predictor of incident T2D than obesity.
authors.affiliation: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: janghorbani@hlth.mui.ac.ir.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Janghorbani
authors.affiliation: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Salamat
authors.affiliation: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Amini
authors.affiliation: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Aminorroaya
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D012307:Risk Factors
keywords: First-degree relatives; Incidence; Metabolic syndrome; Metabolically healthy obese; Obesity; Risk factor; Type 2 diabetes