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

Amber R.Cordola Hsu, Susan L. Ames, Bin Xie, Darleen V. Peterson, Lorena Garcia, Scott B. Going, Lawrence S. Phillips, Joann E. Manson, Hoda Anton-Culver, Nathan D. Wong

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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/m2, and waist circumference (WC) <88 cm and overweight/obesity as a BMI =25 kg/m2or 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.

Original languageEnglish (US)
Pages (from-to)640-647
Number of pages8
JournalMenopause
Volume27
Issue number6
DOIs
StatePublished - 2020

Keywords

  • Cardiometabolic
  • Diabetes
  • Obesity
  • Postmenopausal women
  • Women's Health Initiative

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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