(21-05-11) THE IMPACT OF BODY MASS INDEX AND THE METABOLIC SYNDROME ON THE RISK OF DIABETES IN MIDDLE-AGED MEN

1. Johan ?rnl?v, MD, PhD ([email protected])1,5,
2. Johan Sundstr?m, MD, PhD2,3,
3. Erik Ingelsson, MD, PhD1,4 and
4. Lars Lind, MD, PhD2
+ Author Affiliations
1. 1 Department of Public Health and Caring Sciences/Geriatrics
2. 2 Department of Medical Sciences, and
3. 3 Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
4. 4 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and
5. 5 School of Health and Social Studies, Dalarna University, Falun, Sweden
Abstract
Objective: The existence of an obese sub-group, with a healthy metabolic profile and low diabetes risk, has been proposed. Yet, long term data is lacking. We aimed to investigate associations between combinations of body mass index (BMI)-categories and metabolic syndrome (MetS), and risk of type 2 diabetes in middle-aged men.
Research design and methods: At age 50, cardiovascular risk factors were assessed in 1675 participants without diabetes in the community-based ULSAM-study. According to BMI/MetS-status, they were categorized as normal weight (BMI<25 kg/m2) without MetS (NCEP-criteria, n=853), normal weight with MetS (n=60), overweight (BMI 25-30 kg/m2) without MetS (n=557), overweight with MetS (n=117), obese (BMI>30 kg/m2) without MetS (n=28), and obese with MetS (n=60). We investigated the associations between BMI/MetS-categories at baseline and diabetes incidence.
Results: After 20 years, 160 participants had developed diabetes. In logistic regression models adjusting for age, smoking, and physical activity, increased risks for diabetes were observed in normal-weight with MetS (odds ratio [OR] 3.28, 95%CI 1.38-7.81, p=0.007), overweight without MetS (OR 3.49, 95%CI 2.26-5.42, p<0.001), overweight with MetS (OR 7.77, 95%CI 4.44-13.62, p<0.001), obese without MetS (OR 11.72, 95%CI 4.88-28.16, p<0.001) and obese with MetS (OR 10.06, 95%CI 5.19-19.51, p<0.001), compared to normal-weight without MetS.
Conclusions: Overweight or obese men without MetS, were at increased risk for diabetes. Our data provide further evidence that overweight and obesity in the absence of the MetS should not be considered a harmless condition.
Eur J Endocrinol. 2011 May 4. [Epub ahead of print]
Association between serum TSH concentration within the normal range and adiposity: a review.
Souza AD, Sichieri R.
Source

A Souza, Department of Epidemiology, State University of Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil.
Abstract

Overt hypothyroidism is clearly related to body weight gain and greater adiposity, but the range of hormonal change in serum thyrotropin (TSH) concentration associated to weight gain remains a focus of debate. The aim of this review was to assess studies that evaluated the relationship between anthropometric measures and serum TSH concentration in euthyroid subjects. Studies held on the Ovid MEDLINE database were searched and original articles published from 2000 to 2010 were included. The literature search was restricted to studies conducted in humans aged 18 years or older and written in English, Spanish or Portuguese languages. Studies that evaluated the association between anthropometric measures and serum TSH within the normal range as the primary objective, as well as additional analysis, were included. A total of 29 studies met the inclusion criteria. Sixteen of the twenty-nine studies showed a positive relationship between measures of adiposity and serum TSH. Despite the plausibility of this association, only two studies reported longitudinal findings. The influence of smoking on the association between serum TSH and anthropometric measures was evaluated in only three studies and remains unclear. Thus, further longitudinal studies are needed to better understand the mechanisms by which TSH concentration might impact body weight.
Source: Copyright ? 2011 by the American Diabetes Association
? Print ISSN: 0149-5992
? Online ISSN: 1935-5548

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