Department of Community Health, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Am J Epidemiol. 2010 Mar 1;171(5):550-6. doi: 10.1093/aje/kwp433. Epub 2010 Jan 28.
The authors examined the association between weight patterns during middle age and incident type 2 diabetes mellitus using a subset (n = 1,476) of the Framingham Heart Study original cohort limited-access data set (1948-2003). Participants diagnosed with diabetes before age 50 years were excluded. A functional principal components analysis of body mass index from age 40 years to age 50 years was used to define weight patterns in terms of overall weight status (normal weight, overweight, or obese), weight change (weight loss, stable weight, or weight gain), and weight cycling. Overall overweight and obesity were associated with higher rates of diabetes (for overall overweight, crude hazard ratio (HR) = 3.2, 95% confidence interval (CI): 2.3, 4.6; for overall obesity, crude HR = 8.8, 95% CI: 6.0, 12.8). Weight cycling was also associated with higher rates of diabetes (crude HR = 1.6, 95% CI: 1.2, 2.1). Neither weight loss nor weight gain was associated with incident diabetes. After adjustment for overall weight status, weight cycling was no longer associated with higher rates of diabetes. This study underscores the importance of obesity in diabetes risk and the importance of preventing the development of overweight and obesity earlier in life.
作者使用弗雷明汉心脏研究原始队列有限访问数据集（1948-2003 年）的一个子集（n=1476）检查了中年体重模式与 2 型糖尿病发病的关系。排除了 50 岁以前被诊断为糖尿病的参与者。使用 40 岁至 50 岁期间体重指数的功能主成分分析来定义体重模式，包括总体体重状况（正常体重、超重或肥胖）、体重变化（体重减轻、稳定体重或体重增加）和体重循环。总体超重和肥胖与更高的糖尿病发病率相关（总体超重，粗危险比（HR）=3.2，95%置信区间（CI）：2.3，4.6；总体肥胖，粗 HR=8.8，95%CI：6.0，12.8）。体重循环也与更高的糖尿病发病率相关（粗 HR=1.6，95%CI：1.2，2.1）。体重减轻或体重增加与糖尿病发病无关。在调整了总体体重状况后，体重循环与更高的糖尿病发病率不再相关。这项研究强调了肥胖在糖尿病风险中的重要性，以及在生命早期预防超重和肥胖发展的重要性。
