Prospective investigation of metabolic characteristics in relation to weight gain in older adults: the Hoorn Study.

The objective of this investigation was to determine the relation between baseline glucose, insulin, adiponectin, and leptin levels and subsequent 6-year weight and waist change in older men and women without diabetes in a prospective cohort study. Participants were 1,198 Dutch men and women without diabetes who were aged 50-77 years when baseline metabolic and anthropometric measurements were evaluated (1989-1991). Approximately 6 years later, body weight and waist circumference were re-measured at a follow-up examination (1996-1998). Metabolic variables (fasting plasma glucose, 2-h postchallenge plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin, and leptin) were evaluated as predictors of changes in weight and waist circumference. Postchallenge plasma glucose (mmol/l) significantly predicted less gain in both weight and waist circumference (beta = -0.28 kg, s.e. = 0.11; beta = -0.31 cm, s.e. = 0.14, respectively) during follow-up. Leptin (microg/l) significantly predicted greater increases in weight (beta = 0.29 kg, s.e. = 0.07) and waist (beta = 0.16 cm, s.e. = 0.08) among men and in waist among women (beta = 0.06 cm, s.e. = 0.02). Fasting plasma glucose (mmol/l) predicted an increase in waist among women (beta = 1.59 cm, s.e. = 0.63), but not in men (beta = -0.74 cm, s.e. = 0.55). Adiponectin and insulin did not predict weight or waist change. The authors conclude that lower postchallenge plasma glucose and higher fasting leptin levels significantly predicted long-term increases in weight and waist circumference. In contrast, measures of insulin resistance and adiponectin were not associated with weight change in this cohort of older persons without diabetes.