The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population: Results of the REACTION study

Jieli Lu, Yufang Bi, Tiange Wang, Weiqing Wang, Yiming Mu, Jiajun Zhao, Chao Liu, Lulu Chen, Lixin Shi, Qiang Li, Qin Wan, Shengli Wu, Guijun Qin, Tao Yang, Li Yan, Yan Liu, Guixia Wang, Zuojie Luo, Xulei Tang, Gang ChenYanan Huo, Zhengnan Gao, Qing Su, Zhen Ye, Youming Wang, Huacong Deng, Xuefeng Yu, Feixia Shen, Li Chen, Liebing Zhao, Meng Dai, Min Xu, Yu Xu, Yuhong Chen, Shenghan Lai, Guang Ning

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

Objective Obesity and insulin resistance are risk factors for cardiovascular diseases. Whether insulin-sensitive obese individuals are at higher risk for cardiovascular diseases is still debated. We aim to investigate whether insulin-sensitive obesity associates with prevalent cardiovascular diseases and 10-year coronary heart disease (CHD) risk. Research design and methods At the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, 211,641 participants aged 40 years or older were recruited from 25 communities across the China mainland, in 2011 to 2012. Participants were categorized by insulin-sensitive/resistant and general/abdominal obese status. Cardiovascular diseases included CHD, stroke, and myocardial infarction. Framingham risk score (FRS) was calculated according to National Cholesterol Education Program-Adult Treatment Panel III and FRS greater than 20% or cardiovascular diseases were identified as high risk for 10-year CHD. Results Controlling for potential confounders, compared with insulin-sensitive normal weight individuals, insulin-sensitive general obese individuals had increased risks for prevalent cardiovascular diseases (men: OR, 2.55, 95% CI, 2.04-3.18; women: 1.73, 1.45-2.06) and 10-year Framingham risk for CHD (men: 2.26, 1.86-2.76; women: 1.73, 1.46-2.06). Compared with insulin-sensitive normal waist subgroup, insulin-sensitive abdominal obesity was associated with higher risks for prevalent cardiovascular diseases (men: 1.32, 1.20-1.46; women: 1.36, 1.27-1.47) and 10-year Framingham risk for CHD (men, 1.34, 1.23-1.45; women, 1.37, 1.27-1.47). Conclusion Both general and abdominal obesity were associated with elevated prevalent cardiovascular diseases and 10-year CHD risk, regardless of the presence or absence of insulin resistance.

Original languageEnglish (US)
Pages (from-to)388-394
Number of pages7
JournalInternational Journal of Cardiology
Volume172
Issue number2
DOIs
StatePublished - Mar 15 2014
Externally publishedYes

Keywords

  • Cardiovascular diseases
  • Epidemiology
  • Insulin resistance
  • Obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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