Obesity Clinical Trial
Official title:
Insulin-sensitive Obesity: Prospective and Interventional Studies
People who are overweight and/or obese are at risk of insulin resistance and type 2 diabetes.
However, research has shown that some overweight and/or obese individuals remain
insulin-sensitive and metabolically healthy despite their unhealthy body weight.
The investigators hypothesise that overweight and/or obese people who were deemed
insulin-sensitive in previous studies will maintain their insulin sensitivity and metabolic
health over time. The investigators also hypothesise that the preservation of insulin
sensitivity will be accompanied by key metabolic health markers.
While obesity is a risk factor for metabolic disease, sub cohorts with obesity not
complicated by the metabolic syndrome have been described. These so called "metabolically
healthy obese" may have reduced risk of type 2 diabetes, cardiovascular disease and all-cause
mortality compared with individuals with obesity who present with components of the metabolic
syndrome.
Longitudinal studies with diabetes and cardiovascular disease risk endpoints reported that
individuals with obesity who are metabolically healthy (MHO) held an intermediate health
status, such that they were still worse off than the healthy normal-weight individuals. While
there have been studies evaluating the stability of the MHO phenotype over time, no study has
reported the durability of insulin-sensitivity per se, as measured by the gold-standard
hyperinsulinaemic-euglycaemic clamp. In the present study, we aimed to trace the change in
insulin resistance/sensitivity, and to uncover predictors of insulin resistance in older age.
The secondary aims were to trace the change in body composition, fat distribution and
metabolic markers over time in a well-phenotyped cohort studied approximately 5-6 years
apart.
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