Dataset Information

Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women's Health Initiative.

ABSTRACT:

Objective

To determine the relationship of metabolic weight categories with incident diabetes mellitus (DM) in postmenopausal women.

Methods

The Women's Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50 to 79 years. We included those with cardiovascular disease (CVD) biomarkers and free of CVD and prevalent DM (n = 17,043) at baseline. Normal weight was defined as a body mass index (BMI) ≥18.5 and <25 kg/m, and waist circumference (WC) <88 cm and overweight/obesity as a BMI ≥25 kg/m or WC ≥88 cm. Metabolically healthy was based on <2 and metabolically unhealthy ≥2 traits of the following: triglycerides ≥150 mg/dL, systolic blood pressure (BP) ≥130 mm Hg or diastolic BP ≥85 mm Hg, or antihypertensives or diuretics, fasting glucose ≥100 mg/dL or DM medication, and high-density lipoprotein cholesterol <50 mg/dL. Cox regression was performed to determine the risk of incident DM among metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO).

Results

Among our sample, 2,253 (13.3%) participants developed DM over a mean ± standard deviation follow-up time of 15.6 ± 3.4 years. Compared with MHNW (n = 162 incident DM cases), an increased risk of incident DM was observed in MUHNW (n = 102 cases) (hazard ratio [HR] 2.24, 95% confidence interval [CI] 1.74-2.88, P < 0.0001), MHO (n = 624 cases) (HR 1.68, 95% CI 1.40-2.00, P < 0.0001), and MUHO (n = 1,365 cases) (HR 4.51, 95% CI 3.82-5.35, P < 0.0001).

Conclusions

Among postmenopausal women, MUHNW and MHO confer an approximate doubling in the risk and MUHO more than a four-fold increased risk for developing DM.

SUBMITTER: Cordola Hsu AR

PROVIDER: S-EPMC11324332 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women's Health Initiative.

Cordola Hsu Amber R AR Ames Susan L SL Xie Bin B Peterson Darleen V DV Garcia Lorena L Going Scott B SB Phillips Lawrence S LS Manson JoAnn E JE Anton-Culver Hoda H Wong Nathan D ND

Menopause (New York, N.Y.) 20200601 6

<h4>Objective</h4>To determine the relationship of metabolic weight categories with incident diabetes mellitus (DM) in postmenopausal women.<h4>Methods</h4>The Women's Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50 to 79 years. We included those with cardiovascular disease (CVD) biomarkers and free of CVD and prevalent DM (n = 17,043) at baseline. Normal weight was defined as a body mass index (BMI) ≥18.5 and <25 kg/m, and waist circumference (WC) <88 cm and overweight/obe ...[more]

PMID: 32108731

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Project description:ObjectivesTo determine associations between postmenopausal change in body weight and incidence of fracture and associations between voluntary and involuntary weight loss and risk of fracture.DesignPost hoc analysis of data from the Women's Health Initiative Observational Study and Clinical Trials.Setting40 clinical centers in the United States.Participants120,566 postmenopausal women, aged 50-79 at baseline (1993-98), followed through 2013 (mean fracture follow-up duration 11 years from baseline).ExposuresAnnualized percentage change in measured body weight from baseline to year 3, classified as stable (<5% change), weight loss (≥ 5%), or weight gain (≥ 5%). Self assessment of whether weight loss was intentional or unintentional. Cox proportional hazards regression models were adjusted for age, race/ethnicity, baseline body mass index (BMI), smoking, alcohol intake, level of physical activity, energy expenditure, calcium and vitamin D intake, physical function score, oophorectomy, hysterectomy, previous fracture, comorbidity score, and drug use.Main outcomesIncident self reported fractures of the upper limbs, lower limbs, and central body; hip fractures confirmed by medical records.ResultsMean participant age was 63.3. Mean annualized percent weight change was 0.30% (95% confidence interval 0.28 to 0.32). Overall, 79,279 (65.6%) had stable weight; 18,266 (15.2%) lost weight; and 23,021 (19.0%) gained weight. Compared with stable weight, weight loss was associated with a 65% higher incidence rates of fracture in hip (adjusted hazard ratio 1.65, 95% confidence interval 1.49 to 1.82), upper limb (1.09, 1.03 to 1.16), and central body (1.30, 1.20 to 1.39); weight gain was associated with higher incidence rates of fracture in upper limb (1.10, 1.05 to 1.18) and lower limb (1.18, 1.12 to 1.25). Compared with stable weight, unintentional weight loss was associated with a 33% higher incidence rates of hip fracture (1.33, 1.19 to 1.47) and increased incidence rates of vertebral fracture (1.16, 1.06 to 1.26); intentional weight loss was associated with increased incidence rates of lower limb fracture (1.11, 1.05 to 1.17) and decreased incidence of hip fracture (0.85, 0.76 to 0.95).ConclusionsWeight gain, weight loss, and intentional weight loss are associated with increased incidence of fracture, but associations differ by fracture location. Clinicians should be aware of fracture patterns after weight gain and weight loss.

Project description:BackgroundThe aim of this study was to evaluate the prognostic impact of computed tomography (CT)-based body composition parameters in metabolically unhealthy normal-weight patients (MUHNW) with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).MethodsThis prospective cohort study involved adults with normal weight scheduled for TAVR. Patients were divided into two groups: metabolically healthy normal-weight (MHNW) and MUHNW. The primary outcome was major adverse cardiovascular events (MACEs), and the secondary outcomes were all-cause mortality and prolonged hospital stay. Logistic regression was used to explore the relationships between variables and outcomes, and Cox regression models were applied to examine the effects of different parameters on patient prognosis. Incremental discriminative improvement (IDI) and the C-index were used to determine the influence of hybrid parameters on the predictive efficiency of the model.ResultsThe cohort study included 182 patients divided into two groups: MHNW metabolically healthy normal-weight (n = 97) and MUHNW (n = 85). Over a median follow-up of 0.8 years, multivariable logistic regression analysis revealed significant associations of the skeletal muscle index (SMind) (HR: 0.50, 95% CI: 0.29 - 0.84, p = 0.01), subcutaneous adipose tissue index (SATind) (HR: 0.63, 95% CI: 0.45 - 0.88, p = 0.01), and visceral adipose tissue index (VATind) (HR: 1.34, 95% CI: 1.10 - 1.63, p < 0.01) with the risk of experiencing MACEs, whereas epicardial adipose tissue (EAT) was not significantly associated with the risk of experiencing MACEs in the multivariable model (HR: 1.10, 95% CI: 0.97 - 1.24, p = 0.14). For the primary outcome, adjusted for significant covariates, the model had an IDI of 0.25 and a C-index of 0.8, with significant associations of SMind (HR: 0.73, 95% CI: 0.62 - 0.87, p < 0.01), SATind (HR: 0.87, 95% CI: 0.78 - 0.97, p = 0.01), and VATind (HR: 1.25, 95% CI: 1.12-1.40, p < 0.01) with the risk of experiencing MACEs. For the secondary outcome, the model had an IDI of 0.36 and a C-index of 0.93, with EAT showing a significant protective effect against all-cause mortality and prolonged hospital stay (HR: 0.97, 95% CI: 0.93 - 0.99; p = 0.04).ConclusionsBody composition parameters, including, VATind, SMind, and SATind, are significant predictors of MACEs in patients undergoing TAVR. Additionally, EAT shows a significant protective effect against all-cause mortality and prolonged hospital stay. These findings highlight the potential importance of comprehensive body composition assessments in the risk stratification and management of AS patients.

Dataset Information

Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women's Health Initiative.

Objective

Methods

Results

Conclusions

Publications

Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women's Health Initiative.

Similar Datasets

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