Association of obesity phenotypes in adolescents and incidence of early adulthood type 2 diabetes mellitus: Tehran lipid and glucose study

Abstract

Objective Obesity and metabolic syndrome, which has an increasing prevalence among adolescence, are associated with metabolic abnormalities. This study investigates the role of adolescent obesity phenotypes in predicting the incidence of early adulthood type 2 diabetes mellitus (T2DM). Research Design and Methods Participants were divided into four obesity phenotypes: Metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). Multivariate‐adjusted hazard ratios (HRs) were calculated for T2DM incidence. Results In this cohort study, 2306 Tehranian adolescents with an average age of 15.1 ± 2.4 years were included. The median (IQ 25–75) follow‐up was 15.5 (12.8–17.1) years and the median (IQ 25–75) age of participants at the end of follow‐up was 30 (26–32) years old. The incidence rate of T2DM during the early adulthood was [1.37 (95% CI: 0.89–2.10)] and [3.18 (95% CI: 2.44–4.16)] per 1000 person per year in boys and girls, respectively. MHO phenotype was not associated with an increased risk of T2DM for both sexes. Adjusted HRs for MUO were [4.30 95% CI (1.48–12.43)] and [3.39 95% CI (1.78–6.45)] in boys and girls, respectively. MUNW phenotype was associated with an increased risk of T2DM only in boys. After adjustment for adulthood BMI, all the phenotypes for both sexes lost their significance, except for boys with MUNW phenotype [HR = 3.46 95% CI (1.15–10.45)]. Conclusions Unhealthy obesity phenotypes; in contrast with MHO; had an increased risk of T2DM incidence, apart from girls with MUNW. After adjusting the adulthood BMI, all phenotypes turn insignificant, except for boys with MUNW.

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“…This cross-sectional study was performed among a sample of 203 Iranian overweight/obese adolescents (102 girls and 101 boys), aged 12–18 years. The sample size of the study was determined based on data from previously published studies [ 26 , 27 ], estimating that 40–60% of the Iranian overweight and obese adolescents have been recognized as MUO. Thus, considering a power of 80% and type I error of 0.05, desired confidence interval of 0.95, and precision (d) of 7%, the minimum required sample size was estimated to be 188 subjects.…”

Association of Dietary Insulin Index and Dietary Insulin Load With Metabolic Health Status in Iranian Overweight and Obese Adolescents

“…The current cross-sectional study was conducted on a representative sample of adolescents living in Iran in 2020. The sample size of this study was calculated based on previously published investigations ( 26 , 27 ), which showed that approximately 60% of overweight and obese Iranian adolescents suffer from MUO. Thus, with a power of 80%, type I error of 0.05, desired CI of 0.95, and precision ( d ) of 7%, the minimum required sample size was calculated to be 188 subjects.…”

Adherence to Mediterranean Diet and Its Association with Metabolic Health Status in Overweight and Obese Adolescents

“…The present cross-sectional study was performed among 203 Iranian adolescents (102 girls and 101 boys) aged 12–18 years. The sample size of the current study was calculated based on the previously published investigations [ 26 , 27 ], which have shown approximately 60% of overweight and obese adolescents suffered from MUO. Thus, considering a power of 80% and type I error of 0.05, desired confidence interval of 0.95, and precision (d) of 7%, the minimum required sample size was calculated to be 188 subjects.…”