Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Victoria, Australia.
Public Health Nutr. 2011 Jan;14(1):119-26. doi: 10.1017/S1368980010001813. Epub 2010 Jun 29.
The evidence for the association between obesity and the risk of type 2 diabetes has been derived mainly from the analysis of the degree of obesity. The role of the duration of obesity as an independent risk has not been fully explored. The objective of the present study was to investigate the association between the duration of obesity and the risk of type 2 diabetes.
Prospective cohort study.
The Framingham Heart Study (FHS), follow-up from 1948 to 1998.
A total of 1256 FHS participants who were free from type 2 diabetes at baseline, but were obese on at least two consecutive of the study's twenty-four biennial examinations, were included. Type 2 diabetes status was collected throughout the 48 years of follow-up of the study. The relationship between duration of obesity and type 2 diabetes was analysed using time-dependent Cox models, adjusting for a number of covariates.
The unadjusted hazard ratio (HR) for the risk of type 2 diabetes for men was 1.13 (95 % CI 1.09, 1.17) and for women was 1.12 (95 % CI 1.08, 1.16) per additional 2-year increase in the duration of obesity. Adjustment for sociodemographic variables, family history of diabetes, health behaviour and physical activity made little difference to these HR. For women the evidence of a dose-response relationship was less clear than for men, particularly for women with an older age at obesity onset.
The duration of obesity is a relevant risk factor for type 2 diabetes, independent of the degree of BMI.
肥胖与 2 型糖尿病风险之间的关联证据主要来源于肥胖程度的分析。肥胖持续时间作为独立风险因素的作用尚未得到充分探讨。本研究旨在探讨肥胖持续时间与 2 型糖尿病风险之间的关系。
前瞻性队列研究。
弗雷明汉心脏研究（FHS），随访时间为 1948 年至 1998 年。
共纳入 1256 名 FHS 参与者，他们在基线时无 2 型糖尿病，但在研究的 24 次两年一次的检查中至少有两次连续肥胖。在研究的 48 年随访期间，收集了 2 型糖尿病的发病情况。使用时间依赖性 Cox 模型分析肥胖持续时间与 2 型糖尿病之间的关系，并调整了一些协变量。
未调整的男性 2 型糖尿病风险的危险比（HR）为 1.13（95%CI 1.09，1.17），女性为 1.12（95%CI 1.08，1.16），每增加 2 年肥胖持续时间，风险增加 1.13%。调整社会人口统计学变量、糖尿病家族史、健康行为和体力活动对这些 HR 影响不大。对于女性，与男性相比，剂量-反应关系的证据不太明确，尤其是肥胖起始年龄较大的女性。
肥胖持续时间是 2 型糖尿病的一个相关危险因素，与 BMI 程度无关。
