Wanwan Sun1, Lixin Shi2, Zhen Ye3, Yiming Mu4, Chao Liu5, Jiajun Zhao6, Lulu Chen7, Qiang Li8, Tao Yang9, Li Yan10, Qin Wan11, Shengli Wu12, Yan Liu13, Guixia Wang13, Zuojie Luo14, Xulei Tang15, Gang Chen16, Yanan Huo17, Zhengnan Gao18, Qing Su19, Youmin Wang20, Guijun Qin21, Huacong Deng22, Xuefeng Yu23, Feixia Shen24, Li Chen25, Liebin Zhao1, Jichao Sun1,26, Lin Ding1, Yu Xu1, Min Xu1, Meng Dai1, Tiange Wang1, Di Zhang1, Jieli Lu1, Yufang Bi1, Shenghan Lai1,27, Donghui Li28, Weiqing Wang1, Guang Ning1,26. 1. National Clinical Research Center for Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Affiliated Hospital of Guiyang Medical College, Guiyang, China. 3. Zhejiang Provincial Center for Disease Control and Prevention, China. 4. Chinese People's Liberation Army General Hospital, Beijing, China. 5. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. 6. Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. 7. Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 8. The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 9. The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. 10. Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. 11. The Affiliated Hospital of Luzhou Medical College, Luzhou, China. 12. Karamay Municipal People's Hospital, Xinjiang, China. 13. The First Hospital of Jilin University, Changchun, China. 14. The First Affiliated Hospital of Guangxi Medical University, Nanning, China. 15. The First Hospital of Lanzhou University, Lanzhou, China. 16. Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China. 17. Jiangxi People's Hospital, Nanchang, China. 18. Dalian Municipal Central Hospital, Dalian, China. 19. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. 20. The First Affiliated Hospital of Anhui Medical University, Hefei, China. 21. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 22. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 23. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 24. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 25. Qilu Hospital of Shandong University, Jinan, China. 26. Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China. 27. Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 28. Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Abstract
OBJECTIVE: To clarify the quantitative relationship of body mass index (BMI) change from early adulthood to midlife with presence of type 2 diabetes mellitus (T2DM) after midlife. METHODS: This study included 120,666 middle-aged and elderly, whose retrospectively self-reported body weight at 20 and 40 years and measured height were available. BMI at 20 and 40 years and BMI change in between were defined as early-adulthood BMI, midlife BMI, and early-adulthood BMI change. RESULTS: The odds ratio (OR) for T2DM associated with an 1-unit increment of early-adulthood or midlife BMI was 1.08 (95% confidence interval (CI), 1.07-1.08) and 1.09 (95% CI, 1.09-1.10) respectively. In the cross-tabulation of both early-adulthood BMI and BMI change, the prevalence of T2DM increased across both variables. Compared with participants with normal early-adulthood weight and BMI increase/decrease ≤1, the OR (95% CI) for T2DM of participants with early-adulthood overweight/obesity and BMI increase ≥4 kg/m(2) was 3.49 (3.05-4.00). For participants with early-adulthood underweight and BMI increase/decrease ≤ 1, the OR (95% CI) was 0.85 (0.75-0.97). Subgroup analysis according to sex and age showed similar trends. CONCLUSIONS: Early-adulthood BMI may influence T2DM prevalence after midlife independent of current BMI. T2DM prevalence after midlife was positively associated with early-adulthood weight gain and inversely related to early-adulthood weight loss, while early-adulthood weight loss could not completely negate the adverse effect of early-adulthood overweight/obesity on diabetes.
OBJECTIVE: To clarify the quantitative relationship of body mass index (BMI) change from early adulthood to midlife with presence of type 2 diabetes mellitus (T2DM) after midlife. METHODS: This study included 120,666 middle-aged and elderly, whose retrospectively self-reported body weight at 20 and 40 years and measured height were available. BMI at 20 and 40 years and BMI change in between were defined as early-adulthood BMI, midlife BMI, and early-adulthood BMI change. RESULTS: The odds ratio (OR) for T2DM associated with an 1-unit increment of early-adulthood or midlife BMI was 1.08 (95% confidence interval (CI), 1.07-1.08) and 1.09 (95% CI, 1.09-1.10) respectively. In the cross-tabulation of both early-adulthood BMI and BMI change, the prevalence of T2DM increased across both variables. Compared with participants with normal early-adulthood weight and BMI increase/decrease ≤1, the OR (95% CI) for T2DM of participants with early-adulthood overweight/obesity and BMI increase ≥4 kg/m(2) was 3.49 (3.05-4.00). For participants with early-adulthood underweight and BMI increase/decrease ≤ 1, the OR (95% CI) was 0.85 (0.75-0.97). Subgroup analysis according to sex and age showed similar trends. CONCLUSIONS: Early-adulthood BMI may influence T2DM prevalence after midlife independent of current BMI. T2DM prevalence after midlife was positively associated with early-adulthood weight gain and inversely related to early-adulthood weight loss, while early-adulthood weight loss could not completely negate the adverse effect of early-adulthood overweight/obesity on diabetes.
Authors: Inge Verkouter; Raymond Noordam; Saskia le Cessie; Rob M van Dam; Hildo J Lamb; Frits R Rosendaal; Diana van Heemst; Renée de Mutsert Journal: J Clin Med Date: 2019-09-28 Impact factor: 4.241