Volume 30, Issue 8 pp. 1681-1690
ORIGINAL ARTICLE

Diabesity phenotype and the risks of cardiovascular disease and subclinical atherosclerosis: A prospective cohort study

Lijie Kong

Lijie Kong

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yan Qi

Yan Qi

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Chaojie Ye

Chaojie Ye

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yiying Wang

Yiying Wang

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Zhiyun Zhao

Zhiyun Zhao

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Mian Li

Mian Li

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Shuangyuan Wang

Shuangyuan Wang

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Hong Lin

Hong Lin

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yu Xu

Yu Xu

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Min Xu

Min Xu

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Jieli Lu

Jieli Lu

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yuhong Chen

Yuhong Chen

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Weiqing Wang

Weiqing Wang

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Guang Ning

Guang Ning

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yufang Bi

Yufang Bi

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Tiange Wang

Corresponding Author

Tiange Wang

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Correspondence

Tiange Wang, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine and Metabolic Diseases, State Key Laboratory for Endocrine Tumor, State Key Laboratory for Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China.

Email: [email protected]

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First published: 18 July 2022
Citations: 1

Lijie Kong and Yan Qi contributed equally to the article.

Funding information: National Natural Science Foundation of China, Grant/Award Numbers: 81970706, 82022011, 82088102, 81970728, 81730023, 81941017; Chinese Academy of Medical Sciences, Grant/Award Numbers: 2018PT32017, 2019PT330006; Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support, Grant/Award Number: 20171901 Round 2; Shanghai Hospital Development Center, Grant/Award Numbers: SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B; Shanghai Jiao Tong University School of Medicine, Grant/Award Number: DLY201801; Ruijin Hospital, Grant/Award Number: 2018CR002

Abstract

Objective

The aim of this study was to investigate the associations of diabesity with incident cardiovascular disease (CVD) and subclinical atherosclerosis.

Methods

The prospective cohort study included 8,006 participants without baseline CVD. Diabesity was categorized as (i) normal glucose tolerance (NGT) with nonobesity; (ii) NGT with obesity; (iii) prediabetes with nonobesity; (iv) prediabetes with obesity; (v) diabetes with nonobesity; and (vi) diabetes with obesity. The hazard ratios (HRs) for incident CVD and odds ratios (ORs) for subclinical atherosclerosis associated with diabesity categories were examined.

Results

Compared with the category of NGT with nonobesity, the categories of NGT with obesity (HR 1.68; 95% CI: 1.10–2.57), diabetes with nonobesity (HR 1.42; 95% CI: 1.08–1.88), and diabetes with obesity (HR 1.78; 95% CI: 1.24–2.55) were associated with higher risks of CVD. Prediabetes with or without obesity conferred no excess risk for CVD but higher risks for subclinical atherosclerosis. The diabetes with obesity category was associated with the highest risk for elevated pulse pressure (OR 3.07; 95% CI: 2.06–4.58) and albuminuria (OR 3.39; 95% CI: 2.31–4.99), and diabetes with or without obesity showed comparable ORs for elevated brachial–ankle pulse wave velocity.

Conclusions

The association patterns between diabesity and CVD risks support the value of diabesity as a prevention target for CVD.

CONFLICT OF INTEREST

The authors declared no conflict of interest.

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