Brancati F L, Wang N Y, Mead L A, Liang K Y, Klag M J
Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Arch Intern Med. 1999 May 10;159(9):957-63. doi: 10.1001/archinte.159.9.957.
Obesity in middle age is a well-known risk factor for the development of type 2 diabetes mellitus. However, the importance of weight and weight gain at younger ages is less certain.
To determine the relationship of body weight patterns from 20 to 49 years of age with the subsequent risk for type 2 diabetes mellitus.
An ongoing longitudinal study of former medical students.
Nine hundred sixteen white men without diabetes at 50 years of age.
Weight and height measured in medical school, then assessed by mailed questionnaire to 49 years of age.
Incident type 2 diabetes mellitus based on physician self-report.
During 14 255 person-years of follow-up, there were 35 incident cases of type 2 diabetes mellitus (2.5 per 1000 person-years). After simultaneous adjustment for age, physical activity, lifetime maternal history of diabetes, and smoking, body mass indexes (BMIs; calculated as weight in kilograms divided by the square of height in meters) at 25, 35, and 45 years of age were all strongly associated with diabetes risk (relative risks for overweight [BMI> or =25.0] vs. not overweight, >3.0; all Ps<.05), as were maximum and average BMI to 49 years of age. The relationship of BMI at 25 years of age to diabetes risk was substantially attenuated by adjustment for BMI at 45 years of age and average BMI, but was independent of weight change, weight variability, or maximum BMI.
In men, overweight at 25 years of age strongly predicts diabetes risk in middle age, largely through its association with overweight at 45 years of age and high average BMI to 49 years of age.
中年肥胖是2型糖尿病发生的一个众所周知的危险因素。然而，年轻时体重及体重增加的重要性尚不确定。
确定20至49岁期间的体重模式与随后发生2型糖尿病风险之间的关系。
一项针对既往医学生的正在进行的纵向研究。
916名50岁时无糖尿病的白人男性。
在医学院测量体重和身高，然后通过邮寄问卷评估至49岁。
基于医生自我报告的2型糖尿病发病情况。
在14255人年的随访期间，有35例2型糖尿病发病病例（每1000人年2.5例）。在同时调整年龄、体力活动、母亲糖尿病家族史和吸烟因素后，25岁、35岁和45岁时的体重指数（BMI；计算方法为体重千克数除以身高米数的平方）均与糖尿病风险密切相关（超重[BMI≥25.0]与未超重相比的相对风险>3.0；所有P<0.05），49岁时的最大BMI和平均BMI也是如此。25岁时BMI与糖尿病风险之间的关系在调整45岁时的BMI和平均BMI后大幅减弱，但与体重变化、体重波动或最大BMI无关。
在男性中，25岁时超重强烈预示中年时患糖尿病的风险，这在很大程度上是通过其与45岁时超重以及49岁时高平均BMI的关联实现的。
