Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
Diabetes Care. 2010 Jun;33(6):1364-9. doi: 10.2337/dc10-0100. Epub 2010 Mar 9.
To determine how childhood overweight, in conjunction with other life course weight characteristics, relates to the development of type 2 diabetes in adulthood.
Among 109,172 women in the Nurses' Health Study II, body fatness at ages 5, 10, and 20 years was assessed by recall using 9-level pictorial diagrams (somatotypes) representing extreme thinness (category 1) to obesity (category 9). Recalled weights at age 18 years and adulthood were used to derive BMI. Self-reported cases of type 2 diabetes were confirmed by supplementary questionnaire.
Somatotypes at ages 5 and 10 years were positively associated with diabetes risk (P(trend) < 0.0001). The adjusted relative risk (RR) of women with somatotype >or=6 (vs. 2) at age 5 years was 2.19 (95% CI 1.79-2.67) and at age 10 years was 2.57 (2.20-3.01). Increases in size by somatotype or by weight gain since age 18 were associated with increased risk. Compared with women who were never overweight at any age, women who were overweight as an adult (BMI >25 kg/m(2)) but not previously had an adjusted RR of 8.23 (7.41-9.15). The adjusted RR was 15.10 (13.21-17.26) for women who were also overweight at age 10 (somatotype >or=5) and 18 (BMI >25 kg/m(2)). Increased childhood size was not associated with risk among women who did not continue to be overweight in adulthood.
Increased body size starting from childhood is associated with a greater risk of diabetes in adulthood. However, women who become lean in adulthood do not have an increased risk.
探讨儿童期超重与其他生命历程体重特征相结合与成年后患 2 型糖尿病的关系。
在护士健康研究 II 中，共有 109172 名女性参与研究，她们通过使用代表从极瘦（第 1 类）到肥胖（第 9 类）的 9 级图片图表（体型）来回忆 5 岁、10 岁和 20 岁时的体脂。根据 18 岁和成年时的体重回忆值来计算 BMI。通过补充问卷来确认 2 型糖尿病的自我报告病例。
5 岁和 10 岁时的体型与糖尿病风险呈正相关（P(trend) < 0.0001）。与体型为 5 岁时 2 型（体型 >或=6）的女性相比，体型为 5 岁时的调整相对风险（RR）为 2.19（95%CI 1.79-2.67），体型为 10 岁时的 RR 为 2.57（2.20-3.01）。体型或自 18 岁以来体重增加与风险增加有关。与任何年龄都从未超重的女性相比，成年时超重（BMI >25 kg/m(2))但之前没有调整 RR 的女性，RR 为 8.23（7.41-9.15）。对于 10 岁（体型 >或=5）和 18 岁（BMI >25 kg/m(2))时也超重的女性，调整 RR 为 15.10（13.21-17.26）。对于成年后不再超重的女性，儿童时期体型增加与风险无关。
从儿童期开始增加的身体大小与成年后患糖尿病的风险增加有关。然而，成年后变瘦的女性不会增加风险。
