Abstract
Background
Methods
Results
ACKNOWLEDGMENTS
SUPPLEMENTARY INFORMATION
Supplemental Table S2.
Supplemental Table S3.
Supplemental Table S4.
Supplemental Table S5.
Supplemental Table S6.
Supplemental Fig. S1.
Supplemental Fig. S2.
Supplemental Fig. S3.
Notes
AUTHOR CONTRIBUTIONS
Conception or design: W.J.L., C.H.J. Acquisition, analysis, or interpretation of data: H.S.K., J.L., Y.K.C., E.H.K., M.J.L., H.K.K., J.Y.P., W.J.L., C.H.J. Drafting the work or revising: H.S.K. Final approval of the manuscript: H.S.K., J.L., Y.K.C., E.H.K., M.J.L., H.K.K., J.Y.P., W.J.L., C.H.J.
REFERENCES
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Fig. 1
![enm-2021-1184f1.gif](/upload/SynapseXML/2008enm/thumb/enm-2021-1184f1.gif)
Fig. 2
![enm-2021-1184f2.gif](/upload/SynapseXML/2008enm/thumb/enm-2021-1184f2.gif)
Fig. 3
![enm-2021-1184f3.gif](/upload/SynapseXML/2008enm/thumb/enm-2021-1184f3.gif)
Fig. 4
![enm-2021-1184f4.gif](/upload/SynapseXML/2008enm/thumb/enm-2021-1184f4.gif)
Table 1
MHNO, metabolically healthy non-obese; MUNO, metabolically unhealthy non-obese; MHO, metabolically healthy obese; MUO, metabolically unhealthy obese; BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycated hemoglobin; FPG, fasting plasma glucose; TC, total cholesterol; TG, triglyceride; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; Cr, creatinine; AST, aspartate aminotransferase; ALT, alanine transaminase; GGT, gamma-glutamyl transferase; hsCRP, high-sensitivity C-reactive protein; HOMA-IR, homeostatic model assessment of insulin resistance; TyG, triglyceride glucose; DM, diabetes mellitus. _
Table 2
Harrell’s C-index (95% CI) | Difference in C-indexes | P value | NRIa (95% CI) | P value | ||
---|---|---|---|---|---|---|
4 Groups by metabolic health and obesity status | 8 Groups by metabolic health and obesity status+TyG | |||||
ATP-III | 0.799 (0.784–0.814) | 0.804 (0.789–0.818) | 0.004 | <0.001 | 0.232 (0.131–0.285) | <0.001 |
Wildman | 0.794 (0.780–0.808) | 0.801 (0.787–0.815) | 0.007 | <0.001 | 0.223 (0.091–0.309) | <0.001 |
Karelis | 0.767 (0.751–0.782) | 0.785 (0.770–0.800) | 0.018 | <0.001 | 0.248 (0.190–0.304) | <0.001 |
HOMA | 0.775 (0.759–0.790) | 0.791 (0.776–0.806) | 0.016 | <0.001 | 0.297 (0.258–0.339) | <0.001 |
Table 3
Definition of metabolic health | ||||
---|---|---|---|---|
|
||||
ATP-III | Wildman | Karelis | HOMA | |
Incidence | ||||
MHNO | 157/22,855 (0.7) | 95/19,790 (0.5) | 141/18,637 (0.8) | 215/22,878 (0.9) |
MUNO | 161/4,614 (3.5) | 223/7,679 (2.9) | 177/8,832 (2.0) | 103/4,591 (2.2) |
MHO | 107/6,895 (1.6) | 54/4,397 (1.2) | 83/4,127 (2.0) | 151/6,695 (2.3) |
MUO | 301/5,054 (6.0) | 354/7,552 (4.7) | 325/7,822 (4.2) | 257/5,254 (4.9) |
|
||||
Unadjusted HRs (95% CI) | ||||
MHNO | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
MUNO | 5.21 (4.18–6.49) | 6.12 (4.82–7.78) | 2.63 (2.11–3.28) | 2.44 (1.93–3.08) |
MHO | 2.25 (1.76–2.87) | 2.53 (1.81–3.53) | 2.64 (2.01–3.46) | 2.34 (1.90–2.89) |
MUO | 8.96 (7.39–10.87) | 9.99 (7.96–12.52) | 5.55 (4.55–6.76) | 5.50 (4.59–6.59) |
|
||||
Adjusted HRs (95% CI)a | ||||
MHNO | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
MUNO | 3.69 (2.91–4.67) | 4.08 (3.16–5.28) | 1.64 (1.29–2.07) | 1.98 (1.56–2.51) |
MHO | 1.39 (1.05–1.83) | 1.62 (1.13–2.32) | 1.34 (1.00–1.81) | 1.32 (1.04–1.67) |
MUO | 4.63 (3.57–6.00) | 5.07 (3.79–6.78) | 2.26 (1.75–2.93) | 2.72 (2.13–3.46) |
Table 4
Definition of metabolic health | ||||
---|---|---|---|---|
|
||||
ATP-III | Wildman | Karelis | HOMA | |
Incidence | ||||
MHNO | ||||
Low TyG | 113/18,344 (0.6) | 74/16,751 (0.4) | 111/16,130 (0.7) | 118/17,615 (0.7) |
High TyG | 44/4,511 (1.0) | 21/3,039 (0.7) | 30/2,507 (1.2) | 97/5,263 (1.8) |
MUNO | ||||
Low TyG | 47/1,603 (2.9) | 86/3,196 (2.7) | 49/3,817 (1.3) | 42/2,332 (1.8) |
High TyG | 114/3,011 (3.8) | 137/4,483 (3.1) | 128/5,015 (2.6) | 61/2,259 (2.7) |
MHO | ||||
Low TyG | 63/5,087 (1.2) | 37/3,651 (1.0) | 54/3,489 (1.5) | 59/4,266 (1.4) |
High TyG | 44/1,808 (2.4) | 17/746 (2.3) | 29/638 (4.5) | 92/2,429 (3.8) |
MUO | ||||
Low TyG | 50/1,248 (4.0) | 76/2,684 (2.8) | 59/2,846 (2.1) | 54/2,069 (2.6) |
High TyG | 251/3,806 (6.6) | 278/4,868 (5.7) | 266/4,976 (5.3) | 203/3,185 (6.4) |
|
||||
Unadjusted HR (95% CI) | ||||
MHNO | ||||
Low TyG | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
High TyG | 1.56 (1.10–2.20) | 1.54 (0.95–2.50) | 1.73 (1.16–2.59) | 2.71 (2.07–3.54) |
MUNO | ||||
Low TyG | 4.97 (3.54–6.98) | 6.24 (4.57–8.51) | 1.86 (1.33–2.60) | 2.74 (1.93–3.90) |
High TyG | 6.21 (4.79–8.05) | 6.92 (5.21–9.18) | 3.66 (2.84–4.72) | 4.09 (3.00–5.57) |
MHO | ||||
Low TyG | 1.98 (1.46–2.69) | 2.26 (1.52–3.35) | 2.21 (1.60–3.07) | 2.00 (1.47–2.74) |
High TyG | 3.99 (2.82–5.65) | 5.19 (3.06–8.78) | 6.86 (4.56–10.33) | 5.52 (4.20–7.25) |
MUO | ||||
Low TyG | 6.61 (4.74–9.22) | 6.42 (4.66–8.85) | 2.98 (2.17–4.09) | 4.02 (2.91–5.54) |
High TyG | 11.08 (8.87–13.84) | 13.32 (10.31–17.21) | 7.93 (6.35–9.89) | 10.15 (8.09–12.74) |
|
||||
Adjusted HR (95% CI)a | ||||
MHNO | ||||
Low TyG | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
High TyG | 1.46 (1.02–2.09) | 1.55 (0.95–2.53) | 1.91 (1.26–2.89) | 2.30 (1.75–3.03) |
MUNO | ||||
Low TyG | 3.59 (2.52–5.11) | 3.97 (2.86–5.51) | 1.12 (0.79–1.58) | 2.32 (1.62–3.30) |
High TyG | 4.14 (3.14–5.44) | 4.57 (3.40–6.15) | 2.29 (1.75–2.98) | 3.13 (2.28–4.30) |
MHO | ||||
Low TyG | 1.19 (0.85–1.67) | 1.40 (0.93–2.13) | 1.12 (0.79–1.60) | 1.16 (0.83–1.62) |
High TyG | 2.57 (1.76–3.75) | 3.72 (2.15–6.43) | 4.13 (2.67–6.38) | 3.05 (2.24–4.15) |
MUO | ||||
Low TyG | 3.37 (2.31–4.92) | 3.19 (2.21–4.60) | 1.23 (0.86–1.76) | 2.09 (1.45–3.00) |
High TyG | 5.64 (4.25–7.49) | 6.79 (4.96–9.30) | 3.30 (2.49–4.37) | 5.24 (3.92–6.99) |