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Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study
OBJECTIVE: To determine whether insulin resistance (IR) measured by homeostasis model of insulin resistance (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low risk and non-obese, high risk individuals. METHODS: Using the Jackson Heart Study...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909037/ https://www.ncbi.nlm.nih.gov/pubmed/31871895 http://dx.doi.org/10.1016/j.jcte.2019.100210 |
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author | Lee, Sean Lacy, Mary E. Jankowich, Mathew Correa, Adolfo Wu, Wen-Chih |
author_facet | Lee, Sean Lacy, Mary E. Jankowich, Mathew Correa, Adolfo Wu, Wen-Chih |
author_sort | Lee, Sean |
collection | PubMed |
description | OBJECTIVE: To determine whether insulin resistance (IR) measured by homeostasis model of insulin resistance (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low risk and non-obese, high risk individuals. METHODS: Using the Jackson Heart Study cohort, we categorized participants without diabetes into four phenotypes: non-obese/insulin-sensitive, non-obese/IR, obese/insulin-sensitive and obese/IR. Obesity was defined as BMI ≥ 30 or BMI 25–30 plus an increased waist circumference. IR was defined as HOMA-IR ≥ 2. We used modified Poisson regression models to estimate the incident risk-ratios (IRR) of diabetes across these phenotypes adjusting for potential confounders and HbA1c. RESULTS: Among 3219 AAs without diabetes, 14.0% were non-obese/insulin-sensitive, 24.6% non-obese/IR, 6.2% obese/insulin-sensitive, and 55.3% obese/IR. The overall crude incidence rate of diabetes was 29.91 cases/1000 person-years. In fully-adjusted models, compared to the non-obese/insulin-sensitive group, the relative risk of diabetes was highest in obese/IR (IRR = 2.35; 95% CI: 1.53, 3.60), followed by non-obese/IR (IRR = 1.59; 95% CI: 1.02, 2.46), and non-significant for the obese/insulin-sensitive (IRR = 1.70; 95% CI: 0.97, 2.99) group. CONCLUSIONS: HOMA-IR can further stratify diabetes risk in AA adults beyond obesity, identifying non-obese high-risk and lower-risk obese individuals. However, diabetes risk should still be carefully monitored in obese populations despite insulin sensitivity. |
format | Online Article Text |
id | pubmed-6909037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-69090372019-12-23 Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study Lee, Sean Lacy, Mary E. Jankowich, Mathew Correa, Adolfo Wu, Wen-Chih J Clin Transl Endocrinol Research Paper OBJECTIVE: To determine whether insulin resistance (IR) measured by homeostasis model of insulin resistance (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low risk and non-obese, high risk individuals. METHODS: Using the Jackson Heart Study cohort, we categorized participants without diabetes into four phenotypes: non-obese/insulin-sensitive, non-obese/IR, obese/insulin-sensitive and obese/IR. Obesity was defined as BMI ≥ 30 or BMI 25–30 plus an increased waist circumference. IR was defined as HOMA-IR ≥ 2. We used modified Poisson regression models to estimate the incident risk-ratios (IRR) of diabetes across these phenotypes adjusting for potential confounders and HbA1c. RESULTS: Among 3219 AAs without diabetes, 14.0% were non-obese/insulin-sensitive, 24.6% non-obese/IR, 6.2% obese/insulin-sensitive, and 55.3% obese/IR. The overall crude incidence rate of diabetes was 29.91 cases/1000 person-years. In fully-adjusted models, compared to the non-obese/insulin-sensitive group, the relative risk of diabetes was highest in obese/IR (IRR = 2.35; 95% CI: 1.53, 3.60), followed by non-obese/IR (IRR = 1.59; 95% CI: 1.02, 2.46), and non-significant for the obese/insulin-sensitive (IRR = 1.70; 95% CI: 0.97, 2.99) group. CONCLUSIONS: HOMA-IR can further stratify diabetes risk in AA adults beyond obesity, identifying non-obese high-risk and lower-risk obese individuals. However, diabetes risk should still be carefully monitored in obese populations despite insulin sensitivity. Elsevier 2019-11-20 /pmc/articles/PMC6909037/ /pubmed/31871895 http://dx.doi.org/10.1016/j.jcte.2019.100210 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Lee, Sean Lacy, Mary E. Jankowich, Mathew Correa, Adolfo Wu, Wen-Chih Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title | Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title_full | Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title_fullStr | Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title_full_unstemmed | Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title_short | Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study |
title_sort | association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in african americans: the jackson heart study |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909037/ https://www.ncbi.nlm.nih.gov/pubmed/31871895 http://dx.doi.org/10.1016/j.jcte.2019.100210 |
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