Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study.

摘要: Abstract Objective To determine whether insulin resistance (IR) measured by homeostasis model of (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low non-obese, high individuals. Methods Using the Jackson Heart Study cohort, we categorized participants without into four phenotypes: non-obese/insulin-sensitive, non-obese/IR, obese/insulin-sensitive obese/IR. Obesity was defined as BMI ≥ 30 or BMI 25–30 plus an increased waist circumference. IR HOMA-IR ≥ 2. We used modified Poisson regression models to estimate incident risk-ratios (IRR) across these phenotypes adjusting for potential confounders HbA1c. Results Among 3219 AAs diabetes, 14.0% were 24.6% 6.2% obese/insulin-sensitive, 55.3% The overall crude incidence rate 29.91 cases/1000 person-years. In fully-adjusted models, compared non-obese/insulin-sensitive group, relative highest obese/IR (IRR = 2.35; 95% CI: 1.53, 3.60), followed non-obese/IR (IRR = 1.59; 1.02, 2.46), non-significant (IRR = 1.70; 0.97, 2.99) group. Conclusions HOMA-IR AA adults obesity, identifying non-obese high-risk lower-risk obese However, should still be carefully monitored populations despite sensitivity.