Study: Current Metabolic Health Definitions Are Misleading

Current binary classifications of metabolic health that are based on weight, such as “healthy obese” and "unhealthy lean," do not adequately or accurately represent individuals’ risk of conditions like type 2 diabetes, according to a recent study.

In order to assess the predictive relevance of various definitions of metabolic health based on body mass index (BMI), researchers conducted a systematic evaluation of 140,845 participants from 14 different cohorts. 
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Relative risks (RRs) specific to every BMI category were derived by meta-analysis and the resulting findings were pooled through random-effects models.

Researchers classified participants, regardless of whether they were lean, overweight, or obese, as either metabolically healthy or metabolically unhealthy.

Overall, 5963 cases of type 2 diabetes were diagnosed during follow-up. Individuals classified as metabolically unhealthy had a higher relative risk (RR) of developing type 2 diabetes compared to those classified as metabolically healthy.

While cumulative incidence of type 2 diabetes over 10 years was higher in those classified as metabolically unhealthy obese (7.6%), they remained elevated in those classified as metabolically healthy obese (3.1%) and metabolically unhealthy lean (2.2%) as well.

“Although individuals classified as metabolically unhealthy have a higher RR of type 2 diabetes compared with individuals classified as healthy in all BMI categories, current binary definitions of metabolic health have limited relevance to the prediction of future type 2 diabetes.”

The complete study is published in the October issue of Diabetes Care.

-Michelle Canales Butcher

Reference:

Lotta LA, Abbasi A, Sharp SJ, et al. Definitions of metabolic health and risk of future type 2 diabtes in BMI categories: a systematic review and network meta-analysis Diabetes Care. 2015 October [epub ahead of print] doi: 10.2337/dc15-1218.