{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:41:12Z","timestamp":1790336472221,"version":"4.1.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,8,1]]},"DOI":"10.1210\/jc.2013-4427","type":"journal-article","created":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T17:56:47Z","timestamp":1400003807000},"page":"2952-2960","source":"Crossref","is-referenced-by-count":68,"title":["Metabolically Healthy Obesity, Presence or Absence of Fatty Liver, and Risk of Type 2 Diabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 20 (TOPICS 20)"],"prefix":"10.1210","volume":"99","author":[{"given":"Yoriko","family":"Heianza","sequence":"first","affiliation":[{"name":"Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951\u20138510, Japan"},{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuji","family":"Arase","sequence":"additional","affiliation":[{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"},{"name":"Okinaka Memorial Institute for Medical Research (Y.A., H.T., S.D.H., S.H.), Toranomon Hospital, Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"},{"name":"Okinaka Memorial Institute for Medical Research (Y.A., H.T., S.D.H., S.H.), Toranomon Hospital, Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Fujihara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951\u20138510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951\u20138510, Japan"},{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"},{"name":"Ibaraki Prefectural University of Health Sciences Hospital (K.S.), Ibaraki 300-0394, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiun Dong","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"},{"name":"Okinaka Memorial Institute for Medical Research (Y.A., H.T., S.D.H., S.H.), Toranomon Hospital, Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology (S.T.), Graduate School of Medicine and Public Health, Kyoto University, Kyoto 606-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Kodama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951\u20138510, Japan"},{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeko","family":"Hara","sequence":"additional","affiliation":[{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"},{"name":"Okinaka Memorial Institute for Medical Research (Y.A., H.T., S.D.H., S.H.), Toranomon Hospital, Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Y.H., K.F., K.S., S.K., H.S.), Niigata University Faculty of Medicine, Niigata 951\u20138510, Japan"},{"name":"Health Management Center (Y.H., Y.A., H.T., K.S., S.D.H., S.K., S.H., H.S.), Tokyo 105\u20138470, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"key\n\t\t\t\t2019041113330047800_B1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/nrendo.2011.183","article-title":"The worldwide epidemiology of type 2 diabetes mellitus\u2014present and future perspectives","volume":"8","author":"Chen","year":"2012","journal-title":"Nat Rev Endocrinol"},{"key":"key\n\t\t\t\t2019041113330047800_B2","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.2337\/dc08-0423","article-title":"Metabolic syndrome and incident diabetes: current state of the evidence","volume":"31","author":"Ford","year":"2008","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B3","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1053\/meta.2001.27213","article-title":"Are there persons who are obese, but metabolically healthy?","volume":"50","author":"Sims","year":"2001","journal-title":"Metabolism"},{"key":"key\n\t\t\t\t2019041113330047800_B4","first-page":"1020","article-title":"What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women?","volume":"86","author":"Brochu","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B5","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1210\/jc.2004-0165","article-title":"Metabolic and body composition factors in subgroups of obesity: what do we know?","volume":"89","author":"Karelis","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B6","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1001\/archinte.168.15.1617","article-title":"The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999\u20132004)","volume":"168","author":"Wildman","year":"2008","journal-title":"Arch Intern Med"},{"key":"key\n\t\t\t\t2019041113330047800_B7","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1001\/archinte.168.15.1609","article-title":"Identification and characterization of metabolically benign obesity in humans","volume":"168","author":"Stefan","year":"2008","journal-title":"Arch Intern Med"},{"key":"key\n\t\t\t\t2019041113330047800_B8","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1038\/oby.2010.86","article-title":"Body fat distribution and inflammation among obese older adults with and without metabolic syndrome","volume":"18","author":"Koster","year":"2010","journal-title":"Obesity (Silver Spring)"},{"key":"key\n\t\t\t\t2019041113330047800_B9","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1002\/oby.20326","article-title":"A metabolically healthy obese phenotype in Hispanic participants in the IRAS family study","volume":"21","author":"Samaropoulos","year":"2013","journal-title":"Obesity (Silver Spring)"},{"key":"key\n\t\t\t\t2019041113330047800_B10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s00125-013-3066-y","article-title":"Characterising metabolically healthy obesity in weight-discordant monozygotic twins","volume":"57","author":"Naukkarinen","year":"2014","journal-title":"Diabetologia"},{"key":"key\n\t\t\t\t2019041113330047800_B11","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.numecd.2013.07.005","article-title":"Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis","volume":"24","author":"Sung","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"key\n\t\t\t\t2019041113330047800_B12","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1038\/ijo.2010.216","article-title":"Characterizing the profile of obese patients who are metabolically healthy","volume":"35","author":"Primeau","year":"2011","journal-title":"Int J Obes (Lond)"},{"key":"key\n\t\t\t\t2019041113330047800_B13","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1038\/ijo.2010.235","article-title":"Open questions about metabolically normal obesity","volume":"34","author":"Pataky","year":"2010","journal-title":"Int J Obes (Lond)"},{"key":"key\n\t\t\t\t2019041113330047800_B14","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/S2213-8587(13)70062-7","article-title":"Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications","volume":"1","author":"Stefan","year":"2013","journal-title":"Lancet Diabetes Endocrinol"},{"key":"key\n\t\t\t\t2019041113330047800_B15","doi-asserted-by":"crossref","first-page":"2906","DOI":"10.1210\/jc.2006-0594","article-title":"Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease","volume":"91","author":"Meigs","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B16","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1210\/jc.2012-4253","article-title":"Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study","volume":"98","author":"Soriguer","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2337\/dc10-0955","article-title":"Impact of BMI and the metabolic syndrome on the risk of diabetes in middle-aged men","volume":"34","author":"Arnlov","year":"2011","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B18","doi-asserted-by":"crossref","first-page":"962","DOI":"10.3945\/ajcn.112.040006","article-title":"Prognostic implications for insulin-sensitive and insulin-resistant normal-weight and obese individuals from a population-based cohort","volume":"96","author":"Bo","year":"2012","journal-title":"Am J Clin Nutr"},{"key":"key\n\t\t\t\t2019041113330047800_B19","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1186\/1471-2458-11-383","article-title":"\u201cPredictability of body mass index for diabetes: affected by the presence of metabolic syndrome?\u201d","volume":"11","author":"Hadaegh","year":"2011","journal-title":"BMC Public Health"},{"key":"key\n\t\t\t\t2019041113330047800_B20","doi-asserted-by":"crossref","first-page":"717","DOI":"10.2337\/dc11-1853","article-title":"Combined influence of insulin resistance, overweight\/obesity, and fatty liver as risk factors for type 2 diabetes","volume":"35","author":"Sung","year":"2012","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B21","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.2337\/dc12-1971","article-title":"Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study","volume":"36","author":"Appleton","year":"2013","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B22","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1210\/jc.2013-2832","article-title":"Risk of developing diabetes and cardiovascular disease in metabolically unhealthy normal-weight and metabolically healthy obese individuals","volume":"99","author":"Aung","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B23","first-page":"227","article-title":"Prevalence of metabolically healthy obesity and its impacts on incidences of hypertension, diabetes and the metabolic syndrome in Taiwan","volume":"21","author":"Hwang","year":"2012","journal-title":"Asia Pac J Clin Nutr"},{"key":"key\n\t\t\t\t2019041113330047800_B24","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1089\/met.2011.0143","article-title":"Independent impact of body mass index and metabolic syndrome on the risk of type 2 diabetes in Koreans","volume":"10","author":"Kim","year":"2012","journal-title":"Metab Syndr Relat Disord"},{"key":"key\n\t\t\t\t2019041113330047800_B25","doi-asserted-by":"crossref","first-page":"S62","DOI":"10.2337\/dc10-S062","article-title":"Diagnosis and classification of diabetes mellitus","volume":"33","author":"American Diabetes Association","year":"2010","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B26","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s13340-012-0069-8","article-title":"International clinical harmonization of glycated hemoglobin in Japan: from Japan Diabetes Society to National Glycohemoglobin Standardization Program values","volume":"3","author":"Kashiwagi","year":"2012","journal-title":"Diabetol Int"},{"key":"key\n\t\t\t\t2019041113330047800_B27","unstructured":"The International Diabetes Federation (IDF). The IDF consensus worldwide definition of the metabolic syndrome. 2006. http:\/\/www.idf.org\/webdata\/docs\/IDF_Meta_def_final.pdf."},{"key":"key\n\t\t\t\t2019041113330047800_B28","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/sim.2929","article-title":"Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond","volume":"27","author":"Pencina","year":"2008","journal-title":"Stat Med"},{"key":"key\n\t\t\t\t2019041113330047800_B29","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1210\/jc.2012-3093","article-title":"Clinical review: nonalcoholic fatty liver disease: a novel cardiometabolic risk factor for type 2 diabetes and its complications","volume":"98","author":"Targher","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t2019041113330047800_B30","doi-asserted-by":"crossref","first-page":"617","DOI":"10.3109\/07853890.2010.518623","article-title":"Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity","volume":"43","author":"Musso","year":"2011","journal-title":"Ann Med"},{"key":"key\n\t\t\t\t2019041113330047800_B31","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1210\/er.2008-0009","article-title":"Causes and metabolic consequences of fatty liver","volume":"29","author":"Stefan","year":"2008","journal-title":"Endocr Rev"},{"key":"key\n\t\t\t\t2019041113330047800_B32","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.2337\/db11-0231","article-title":"The metabolically benign and malignant fatty liver","volume":"60","author":"Stefan","year":"2011","journal-title":"Diabetes"},{"issue":"6","key":"key\n\t\t\t\t2019041113330047800_B33","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/obr.12157","article-title":"Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies","volume":"15","author":"Bell","year":"2014","journal-title":"Obes Rev"},{"key":"key\n\t\t\t\t2019041113330047800_B34","article-title":"Impact of body mass index, metabolic health, and weight change on incident diabetes in a Korean population [published online April 4, 2014]","author":"Jung","journal-title":"Obesity (Silver Spring)"},{"key":"key\n\t\t\t\t2019041113330047800_B35","article-title":"Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study [published online March 26, 2014]","author":"Hinnouho","journal-title":"Eur Heart J"},{"key":"key\n\t\t\t\t2019041113330047800_B36","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1007\/s00125-010-2006-3","article-title":"Effects of a lifestyle intervention in metabolically benign and malign obesity","volume":"54","author":"Kantartzis","year":"2011","journal-title":"Diabetologia"},{"key":"key\n\t\t\t\t2019041113330047800_B37","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.2337\/dc10-0547","article-title":"Effects of weight loss among metabolically healthy obese men and women","volume":"33","author":"Janiszewski","year":"2010","journal-title":"Diabetes Care"},{"key":"key\n\t\t\t\t2019041113330047800_B38","doi-asserted-by":"crossref","first-page":"758","DOI":"10.7326\/0003-4819-159-11-201312030-00008","article-title":"Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis","volume":"159","author":"Kramer","year":"2013","journal-title":"Ann Intern Med"},{"key":"key\n\t\t\t\t2019041113330047800_B39","doi-asserted-by":"crossref","first-page":"722","DOI":"10.7326\/0003-4819-143-10-200511150-00009","article-title":"The metabolic syndrome as a predictor of nonalcoholic fatty liver disease","volume":"143","author":"Hamaguchi","year":"2005","journal-title":"Ann Intern Med"},{"key":"key\n\t\t\t\t2019041113330047800_B40","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1002\/hep.24452","article-title":"Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis","volume":"54","author":"Hernaez","year":"2011","journal-title":"Hepatology"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/99\/8\/2952\/9050580\/jcem2952.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T12:05:26Z","timestamp":1565438726000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/99\/8\/2952\/2538360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,1]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,8,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2013-4427","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,1]]}}}