Prevalence and characteristics of non‐obese diabetes in J apanese men and women: the Y uport M edical C heckup C enter Study 日本男性与女性非肥胖者的糖尿病患病率与特征：Yuport医学体检中心研究

BACKGROUND: This study examined the prevalence and characteristics of type 2 diabetes in non-obese subjects to compare their cardiometabolic markers to those without diabetes. METHODS: Data were used from 17,098 men and 17,199 women from a voluntary health checkup program between 1998 and 2006 conducted in Japan. The prevalence of diabetes (fasting plasma glucose ≥ 7.0 mmol/L, hemoglobin A1c ≥ 6.5%, or known diabetes) was calculated in each subgroup of body mass index (group 1, <22; group 2, 22-25; group 3, 25-27.5; and group 4, ≥ 27.5). The effect of diabetes and obesity on risk of an abnormal level of cardiometabolic marker was evaluated with a logistic regression model. RESULTS: In men, the prevalence of diabetes was 9.5% in total, 6.4%, 9.4%, 11.3% and 16.2% in group 1 through 4, respectively. In women, it accounted for 4.3% in total, 2.4%, 4.5%, 8.7% and 12.3% per group, respectively. Non-obese diabetic subjects (in group 1 and 2) accounted for 60.8% and 62.0% of all the diabetic subjects in men and women, respectively. Non-obese population accounted for 71.2% and 83.6% of all men and women, respectively. Levels of cardiometabolic markers were higher in diabetic subjects than in non-diabetic subjects in each subgroup. Diabetes was associated with each abnormal level of cardiometabolic marker independent of obesity. CONCLUSION: Over 60% of the diabetic subjects in this Japanese population were not obese. Non-obese diabetes is not widely addressed and should be considered for increased public attention. The elevated levels of cardiometabolic markers may contribute to an increased risk of cardiovascular disease in non-obese diabetes.