Resnick H E, Valsania P, Halter J B, Lin X
MedStar Research Institute, 108 Irving Street, NW, Washington, DC 20010, USA.
J Epidemiol Community Health. 2000 Aug;54(8):596-602. doi: 10.1136/jech.54.8.596.
To determine whether long term weight gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults.
Prospective cohort. Baseline overweight was defined as BMI>/=27.3 for women and BMI>/=27. 8 for men. Annual weight change (kg/year) over 10 years was calculated using measured weight at subjects' baseline and first follow up examinations. In the 10 years after measurement of weight change, incident cases of diabetes were ascertained by self report, hospital discharge records, and death certificates.
Community.
1929 overweight, non-diabetic adults.
Incident diabetes was ascertained in 251 subjects. Age adjusted cumulative incidence increased from 9.6% for BMI<29 to 26. 2% for BMI>/=37. Annual weight change over 10 years was higher in subjects who become diabetic compared with those who did not for all BMI<35. Relative to overweight people with stable weight, each kg of weight gained annually over 10 years was associated with a 49% increase in risk of developing diabetes in the subsequent 10 years. Each kg of weight lost annually over 10 years was associated with a 33% lower risk of diabetes in the subsequent 10 years.
Weight gain was associated with substantially increased risk of diabetes among overweight adults, and even modest weight loss was associated with significantly reduced diabetes risk. Minor weight reductions may have major beneficial effects on subsequent diabetes risk in overweight adults at high risk of developing diabetes.
确定超重的非糖尿病成年人长期体重增加和体重减轻是否与随后患2型糖尿病的风险相关。
前瞻性队列研究。基线超重定义为女性BMI≥27.3，男性BMI≥27.8。使用受试者基线和首次随访检查时测量的体重计算10年期间的年体重变化（千克/年）。在测量体重变化后的10年里，通过自我报告、医院出院记录和死亡证明确定糖尿病的发病病例。
社区。
1929名超重的非糖尿病成年人。
251名受试者确诊患糖尿病。年龄调整后的累积发病率从BMI<29时的9.6%增至BMI≥37时的26.2%。对于所有BMI<35的受试者，患糖尿病者10年期间的年体重变化高于未患糖尿病者。相对于体重稳定的超重者，10年期间每年每增加1千克体重，随后10年患糖尿病的风险增加49%。10年期间每年每减轻1千克体重，随后10年患糖尿病的风险降低33%。
体重增加与超重成年人患糖尿病的风险大幅增加相关，即使是适度体重减轻也与糖尿病风险显著降低相关。轻微的体重减轻可能对有患糖尿病高风险的超重成年人随后的糖尿病风险产生重大有益影响。
