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Associations of Metabolic/Obesity Phenotypes with Insulin Resistance and C-Reactive Protein: Results from the CNTR Study

Authors Liao C, Gao W, Cao W, Lv J, Yu C, Wang S, Pang Z, Cong L, Wang H, Wu X, Li L

Received 23 December 2020

Accepted for publication 17 February 2021

Published 15 March 2021 Volume 2021:14 Pages 1141—1151


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Juei-Tang Cheng

Chunxiao Liao,1 Wenjing Gao,1 Weihua Cao,1 Jun Lv,1 Canqing Yu,1 Shengfeng Wang,1 Zengchang Pang,2 Liming Cong,3 Hua Wang,4 Xianping Wu,5 Liming Li1

1Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, People’s Republic of China; 2Qingdao Center for Diseases Control and Prevention, Qingdao, 266033, People’s Republic of China; 3Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, People’s Republic of China; 4Jiangsu Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China; 5Sichuan Center for Disease Control and Prevention, Chengdu, 610041, People’s Republic of China

Correspondence: Liming Li; Wenjing Gao
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 XueYuan Road, HaiDian District, Beijing, 100191, People’s Republic of China
Tel +86 10 82801528
Fax +86 10 82801528 Ext. 322
Email [email protected]; [email protected]

Background: Obesity is a heterogeneous condition in terms of metabolic status. Different obesity phenotypes have various health risks. The aim of this work was to define different subtypes of obesity and investigate their relationship with inflammatory-cardiometabolic abnormalities among Chinese adult twins.
Methods: The analyses used data from 1113 adult twins in 4 provinces (Shandong, Zhejiang, Jiangsu and Sichuan) from Chinese National Twin Registry (CNTR) which collected detailed information. We defined those with 0 or 1 metabolic syndrome (MetS) components excluding waist circumference as metabolically healthy, and those with waist circumference ≥ 90 cm (for men) and ≥ 85 cm (for women) as obese. The two-category obesity status and metabolic states are combined to generate four metabolic/obesity phenotypes. High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as surrogate measure of insulin resistance. Mixed-effect linear regression models and fixed-effect linear regression models were used to analyse the correlation between HOMA-IR, hsCRP and different metabolic/obesity phenotypes.
Results: In cross-sectional analyses of 1113 individuals (mean [SD] age, 46.6 [12.9] years; 463 obese [41.6%]), 20.3% obese twins were metabolic healthy and 64.2% non-obese twins were metabolic unhealthy. Serum HOMA-IR level was higher in metabolically unhealthy non-obesity (MUNO) (β=0.42, 95% CI: 0.21– 0.64), metabolically healthy obesity (MHO) (β=0.68, 95% CI: 0.36– 1.00) and metabolically unhealthy obesity (MUO) (β=0.69, 95% CI: 0.46– 0.91) twins, compared with their metabolically healthy non-obesity (MHNO) counterparts. HsCRP was similar between MHO and MUO, which differed significantly to metabolic healthy non-obesity (MHNO).
Conclusion: MHO and MUNO phenotypes were common in Chinese twin population. Both phenotypes were associated with elevated IR and hsCRP which may not be benign and need to be concerned.

Keywords: metabolic status, insulin resistance, chronic inflammation, twin study

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