Distribution of metabolic/obese phenotypes and association with diabetes: 5 years’ cohort based on 22,276 elderly

Aims To describe the distribution and changes of different metabolic/obese phenotypes among more than 22,000 male elderly in China, and also explore the association with diabetes incidence. Methods A cohort study based on 22,276 male elderly was conducted in Beijing, from 2009 to 2013. Multiple Cox model was used to calculate the relative risk. Results There were only 53.8% of total participants who kept the same phenotype for the 5 years. On the whole, participants with metabolically unhealthy phenotypes had higher relative risks (RRs) than those with metabolically healthy phenotypes. RRs for diabetes showed an increasing trend along with metabolic abnormalities ( p < 0.001). However, no statistically significant difference was found across different obese status with the same number of metabolic abnormalities. Changes of metabolic/obese status also showed the same trend. Those who had kept metabolic unhealthy had the highest RRs for diabetes incidence, which was higher than those who kept obesity. Conclusions Both metabolically healthy obesity and metabolically unhealthy normal weight phenotypes had an increased risk for diabetes incidence, and metabolic abnormalities might have more influence on diabetes than obesity itself. Changes of metabolic/obese status also had an important impact on diabetes incidence.