ArticleDiabetes, obesity & metabolism2026
Associations of obesity, systemic inflammation, and hyperinsulinemia with the incidence of non-communicable chronic disease and mortality: A prospective cohort study.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsObesity, systemic inflammation, and hyperinsulinemia are all features of metabolic syndrome and frequently occur together. We aimed to evaluate the association of body mass index (BMI) with incident non-communicable chronic disease (NCD) or all-cause mortality, independent of C-reactive protein (CRP) and fasting insulin.
methodsThis prospective population-representative cohort included Canadian residents aged ≥18 years from the Canadian Health Measure Survey. The exposures were BMI, CRP, and fasting insulin and the outcomes were mortality and incident NCDs. Results were externally validated using data from the United States (NHANES) and the United Kingdom (UK Biobank). We report hazards ratios (HRs) from Cox models using percentiles for the continuous exposures: 99th, 95th, 85th, 50th, 15th, 1st versus the 5th percentile. The fifth percentile for BMI was 19.6 kg/m
resultsOf ~8280 participants: 24.4% had obesity (BMI ≥30 kg/m
conclusionsAfter adjustment for confounding by systemic inflammation and hyperinsulinemia, obesity was associated with a lower risk of death but with a higher risk of incident NCD. As there are more people with metabolic syndrome without obesity than with obesity, future research should prioritise the study of how to best diagnose, monitor and treat inflammation and hyperinsulinemia rather than obesity.
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