Colditz G A, Willett W C, Stampfer M J, Manson J E, Hennekens C H, Arky R A, Speizer F E
Channing Laboratory, Harvard Medical School, Boston, MA 02115.
Am J Epidemiol. 1990 Sep;132(3):501-13. doi: 10.1093/oxfordjournals.aje.a115686.
To determine the relation of body mass index (weight/height2) with the risk of clinical non-insulin-dependent diabetes, the authors analyzed data from a cohort of 113,861 US women aged 30-55 years in 1976. During 8 years of follow-up (826,010 person-years), 873 definite cases were identified among women initially free from diagnosed diabetes. Among women of average body mass index, 23-23.9 kg/m2, the relative risk was 3.6 times that of women having a body mass index less than 22 kg/m2. The risk continued to increase above this level of body mass index. The authors observed a much weaker positive association with weight at age 18, and this association was eliminated after adjustment for current body mass index. Thus, weight gain after age 18 was a major determinant of risk. For an increase of 20-35 kg, the relative risk was 11.3, and for an increase of more than 35 kg, the relative risk was 17.3. Adjusting for family history did not appreciably alter the strong relation observed among women at average levels of body mass index. These data indicate that, at even average weight, women are at increased risk of clinical non-insulin-dependent diabetes and that the relation between body mass index and risk of diabetes is continuous.
为了确定体重指数（体重/身高²）与临床非胰岛素依赖型糖尿病风险之间的关系，作者分析了1976年一组年龄在30至55岁之间的113,861名美国女性的数据。在8年的随访期间（826,010人年），在最初未被诊断患有糖尿病的女性中确定了873例确诊病例。在平均体重指数为23至23.9 kg/m²的女性中，相对风险是体重指数低于22 kg/m²的女性的3.6倍。在这个体重指数水平之上，风险继续增加。作者观察到18岁时体重与糖尿病风险的正相关性较弱，并且在对当前体重指数进行调整后这种相关性消失了。因此，18岁以后体重增加是风险的主要决定因素。体重增加20至35 kg，相对风险为11.3，体重增加超过35 kg，相对风险为17.3。调整家族史并未明显改变在平均体重指数水平的女性中观察到的强相关性。这些数据表明，即使是平均体重的女性，患临床非胰岛素依赖型糖尿病的风险也会增加，并且体重指数与糖尿病风险之间的关系是连续的。
