Chronic Disease Epidemiology and Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
Eur J Epidemiol. 2010 May;25(5):333-9. doi: 10.1007/s10654-010-9444-6. Epub 2010 Mar 30.
Risk of weight change and fluctuation for type 2 diabetes was studied in a prospective study among 20,952 Finnish male smokers aged 50-69 years. Baseline data on lifestyle and medical history were collected, and height and weight measured. Weight was measured thrice after the baseline, 1 year apart. Weight change was defined as the slope of the regression line fitted to the four measurements and weight fluctuation as the root-mean-square-error deviation from this line. Incident cases of diabetes were identified from a national medication reimbursement register; 535 cases up to 9 years' follow-up. The Cox proportional hazards model served to estimate relative risk [RR, 95% confidence interval (CI)]. Weight gain and fluctuation associated with higher risk for diabetes, multivariate RR = 1.77, 95% CI 1.44-2.17, for weight gain of at least 4 kg compared with those of weight change less than 4 kg, and RR = 1.64, 95% CI 1.24-2.17 in the highest weight fluctuation quintile compared to the lowest. These RRs remained similar when weight change and fluctuation were adjusted for each other. Large weight fluctuation increased the risk of diabetes both in men who gained weight (>or=4 kg), had stable weight (+/- <4 kg), and lost weight (>or=4 kg); RR = 2.17, 95% CI 1.60-2.94, RR = 1.47, 95% CI 1.14-1.91, and RR = 2.04, 95% CI 1.47-2.83, respectively, compared to those with stable weight and moderate fluctuation. Short-term weight gain and large weight fluctuation are independent risk factors for diabetes.
在一项针对 20952 名年龄在 50-69 岁的芬兰男性吸烟者的前瞻性研究中，研究了 2 型糖尿病的体重变化和波动风险。收集了生活方式和病史的基线数据，并测量了身高和体重。体重在基线后每 1 年测量 3 次。体重变化定义为拟合至 4 次测量的回归线的斜率，体重波动定义为偏离该线的均方根误差偏差。通过国家药物报销登记册确定了糖尿病的发病情况；随访 9 年期间共发生 535 例病例。Cox 比例风险模型用于估计相对风险[RR，95%置信区间（CI）]。体重增加和波动与糖尿病风险增加相关，多变量 RR = 1.77，95%CI 1.44-2.17，与体重变化小于 4kg 的人相比，体重增加至少 4kg 的人风险更高，而与体重波动最低的五分位数相比，体重波动最高的五分位数的 RR = 1.64，95%CI 1.24-2.17。当体重变化和波动相互调整时，这些 RR 仍然相似。体重波动较大增加了体重增加（≥4kg）、体重稳定（±<4kg）和体重减轻（≥4kg）的男性患糖尿病的风险；RR = 2.17，95%CI 1.60-2.94，RR = 1.47，95%CI 1.14-1.91，RR = 2.04，95%CI 1.47-2.83，与体重稳定和中度波动的人相比。短期体重增加和体重波动较大是糖尿病的独立危险因素。
