Hu Huanhuan, Nagahama Satsue, Nanri Akiko, Tomita Kentaro, Akter Shamima, Okazaki Hiroko, Kuwahara Keisuke, Imai Teppei, Nishihara Akiko, Kashino Ikuko, Sasaki Naoko, Ogasawara Takayuki, Eguchi Masafumi, Kochi Takeshi, Miyamoto Toshiaki, Nakagawa Tohru, Honda Toru, Yamamoto Shuichiro, Murakami Taizo, Shimizu Makiko, Uehara Akihiko, Yamamoto Makoto, Hori Ai, Nishiura Chihiro, Kabe Isamu, Mizoue Tetsuya, Kunugita Naoki, Dohi Seitaro
Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
All Japan Labour Welfare Foundation, Tokyo, Japan.
Prev Med. 2017 Mar;96:118-123. doi: 10.1016/j.ypmed.2016.12.046. Epub 2016 Dec 28.
We prospectively examined diabetes risk in association with a summary measure of degree and duration of weight change. The study participants were 51,777 employees from multiple companies in Japan, who were aged 30-59years, free of diabetes at baseline, and followed up for 7years (2008-2015). Exposure was cumulative body mass index (BMI)-years, which was defined as the area of BMI units above or below baseline BMI during follow-up, and was treated as a time-dependent variable in the Cox proportional hazards regression models. During the 263,539 person-years of follow-up, 3465 participants developed diabetes. The adjusted hazard ratio (HR) of diabetes for a 1-unit increase in cumulative BMI-years was 1.11 (95% confidence interval (CI): 1.09, 1.12). The association was more pronounced among overweight (HR=1.11; 95% CI: 1.08, 1.14) and obese (HR=1.12; 95% CI: 1.08, 1.15) adults compared with normal- and under-weight (HR=1.07; 95% CI: 1.03, 1.11) adults (P for interaction of cumulative BMI-years X baseline BMI-group=0.002). The association of higher cumulative BMI-years with incident diabetes did not substantially differ by metabolic phenotype. The present results emphasize the importance of avoiding additional weight gain over an extended period of time for the prevention of type 2 diabetes, especially among overweight and obese adults, irrespective of metabolic health status.
我们前瞻性地研究了与体重变化程度和持续时间的综合指标相关的糖尿病风险。研究参与者为来自日本多家公司的51777名员工，年龄在30 - 59岁之间，基线时无糖尿病，并随访7年（2008 - 2015年）。暴露因素为累积体重指数（BMI）-年，定义为随访期间高于或低于基线BMI的BMI单位面积，并在Cox比例风险回归模型中作为时间依存变量处理。在263539人年的随访期间，3465名参与者患糖尿病。累积BMI-年每增加1个单位，糖尿病的调整风险比（HR）为1.11（95%置信区间（CI）：1.09，1.12）。与正常体重和体重不足的成年人（HR = 1.07；95% CI：1.03，1.11）相比，超重（HR = 1.11；95% CI：1.08，1.14）和肥胖成年人（HR = 1.12；95% CI：1.08，1.15）中的这种关联更为明显（累积BMI-年×基线BMI组的交互作用P = 0.002）。较高的累积BMI-年与新发糖尿病的关联在代谢表型方面没有显著差异。目前的结果强调了在较长时间内避免额外体重增加对预防2型糖尿病的重要性，特别是在超重和肥胖成年人中，无论其代谢健康状况如何。
