体重维持和减轻对糖尿病风险及负担的影响：一项基于33184名参与者的人群研究。
Impact of weight maintenance and loss on diabetes risk and burden: a population-based study in 33,184 participants.
作者信息
Feldman Adina L, Griffin Simon J, Ahern Amy L, Long Grainne H, Weinehall Lars, Fhärm Eva, Norberg Margareta, Wennberg Patrik
机构信息
MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
出版信息
BMC Public Health. 2017 Feb 6;17(1):170. doi: 10.1186/s12889-017-4081-6.
BACKGROUND
Weight loss in individuals at high risk of diabetes is an effective prevention method and a major component of the currently prevailing diabetes prevention strategies. The aim of the present study was to investigate the public health potential for diabetes prevention of weight maintenance or moderate weight loss on a population level in an observational cohort with repeated measurements of weight and diabetes status.
METHODS
Height, weight and diabetes status were objectively measured at baseline and 10 year follow-up in a population-based cohort of 33,184 participants aged 30-60 years between 1990 and 2013 in Västerbotten County, Sweden. The association between risk of incident diabetes and change in BMI or relative weight was modelled using multivariate logistic regression. Population attributable fractions (PAF) were used to assess population impact of shift in weight.
RESULTS
Mean (SD) BMI at baseline was 25.0 (3.6) kg/m. Increase in relative weight between baseline and follow-up was linearly associated with incident diabetes risk, odds ratio (OR) 1.05 (95% confidence interval (CI) 1.04-1.06) per 1% change in weight. Compared to weight maintenance (±1.0 kg/m), weight gain of > +1.0 kg/m was associated with an increased risk of incident diabetes, OR 1.52 (95% CI 1.32, 1.74), representing a PAF of 21.9% (95% CI 15.8, 27.6%). For moderate weight loss (-1.0 to -2.0 kg/m) the OR was 0.72 (95% CI 0.52, 0.99).
CONCLUSIONS
Weight maintenance in adulthood is strongly associated with reduced incident diabetes risk and there is considerable potential for diabetes prevention in promoting this as a whole population strategy.
背景
糖尿病高危个体的体重减轻是一种有效的预防方法，也是当前流行的糖尿病预防策略的主要组成部分。本研究的目的是在一个对体重和糖尿病状态进行重复测量的观察性队列中，探讨在人群水平上维持体重或适度减轻体重对预防糖尿病的公共卫生潜力。
方法
在瑞典韦斯特博滕县1990年至2013年期间，对33184名年龄在30 - 60岁的人群进行了基于人群的队列研究，在基线和10年随访时客观测量身高、体重和糖尿病状态。使用多变量逻辑回归对新发糖尿病风险与体重指数（BMI）或相对体重变化之间的关联进行建模。人群归因分数（PAF）用于评估体重变化对人群的影响。
结果
基线时的平均（标准差）BMI为25.0（3.6）kg/m²。基线与随访之间相对体重的增加与新发糖尿病风险呈线性相关，体重每变化1%，比值比（OR）为1.05（95%置信区间（CI）1.04 - 1.06）。与体重维持（±1.0 kg/m²）相比，体重增加> +1.0 kg/m²与新发糖尿病风险增加相关，OR为1.52（95% CI 1.32, 1.74），人群归因分数为21.9%（95% CI 15.8, 27.6%）。对于适度体重减轻（-1.0至-2.0 kg/m²），OR为0.72（95% CI 0.52, 0.99）。
结论
成年期维持体重与降低新发糖尿病风险密切相关，将其作为一项全人群策略来推广，在预防糖尿病方面具有相当大的潜力。
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