ArticleEndocrinology, diabetes & metabolism2025
Metabolic Scarring: The Persistent Impact of Past Obesity on Long-Term Metabolic Health Despite Weight Loss.
Article in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Purine salvage pathway protects CD8Nature immunology · 2026Article
- Association of Body Mass Index Trajectories with Kidney Stone Disease: An Analysis Based on the NHANES Database.Kidney & blood pressure research · 2026Article
- Metabolic Scarring: The Persistent Impact of Past Obesity on Long-Term Metabolic Health Despite Weight Loss.Endocrinology, diabetes & metabolism · 2025Article
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2 authors.
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Abstract
backgroundConventional cardiometabolic risk assessment relies primarily on a patient's current body mass index, yet individuals who have lost weight after a period of obesity may continue to harbour elevated metabolic risk. We sought to quantify the persistent impact of past obesity on glycaemic control and to develop a clinical risk score that integrates weight history with current risk factors.
methodsWe performed a cross-sectional analysis of 15,422 adults (≥ 18 years) from the 2011-2020 NHANES cycles. Participants with complete self-reported weight history (highest adult weight, weight 1 year ago, number of ≥ 5% weight-loss episodes) and measured BMI were included. Metabolic scarring was defined by elevated haemoglobin A1c (HbA1c ≥ 5.7%) or HOMA-IR ≥ 2.5. We applied inverse-probability-weighted logistic regression to estimate the association between prior obesity and current HbA1c, adjusting for confounders. We then refit a survey-weighted logistic model using age per decade, current BMI, weight-history category, sex and race/ethnicity, converting regression coefficients into an integer point-based score. Discrimination was evaluated by survey-weighted area under the receiver-operating characteristic curve (AUC).
resultsFormerly obese individuals exhibited significantly higher HbA1c than never-obese peers (adjusted β = 0.58%, p < 0.002), indicative of metabolic scarring. The derived risk score ranged from -31 to +90 points (median = 6; IQR = -3 to 16) and achieved an AUC of 0.79 (95% CI 0.77-0.81). Age per decade, BMI, and weight history contributed 4, 1 and up to 4 points, respectively; female sex and Non-Hispanic White race subtracted points. Calibration across predicted-risk deciles was excellent (slope = 0.98).
conclusionsA history of obesity imparts a lasting glycemic risk that is not captured by current BMI alone. Our metabolic scarring risk score offers a pragmatic tool for identifying individuals at elevated metabolic risk despite weight normalisation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.