Yokomichi Hiroshi, Ohde Sachiko, Takahashi Osamu, Mochizuki Mie, Takahashi Atsunori, Yoda Yoshioki, Tsuji Masahiro, Akiyama Yuka, Yamagata Zentaro
Department of Health Sciences, University of Yamanashi, Chuo City, Yamanashi, Japan.
Center for Clinical Epidemiology, St. Luke's International University, Chuo Ward, Tokyo, Japan.
BMJ Open. 2017 Jun 8;7(5):e014684. doi: 10.1136/bmjopen-2016-014684.
To investigate how weight cycling (gaining and losing weight) affects the risk of diabetes.
Cohort studies.
Primary healthcare in urban and rural Japan.
20 708 urban and 9670 rural residents.
ORs for diabetes in those with weight loss, weight loss-gain, stable weight, weight gain-loss and weight gain over 10 years. Weight gain and loss were defined as a change of more than ±4% from baseline weight.
In the urban region, the ORs relative to the stable group for the loss-gain and gain-loss groups were 0.63 (95% CI 0.45 to 0.89) and 0.51 (95% CI 0.32 to 0.82) for men and 0.72 (95% CI 0.39 to 1.34) and 1.05 (95% CI 0.57 to 1.95) for women. In the rural region, they were 1.58 (95% CI 0.78 to 3.17) and 0.44 (95% CI 0.15 to 1.29) in men and 0.41 (95% CI 0.12 to 1.44) and 0.77 (95% CI 0.28 to 2.14) in women. The ORs for an increase in weight between 5 and 10 kg from the age of 20 years were 1.54 (95% CI 1.03 to 2.30) in men and 0.96 (95% CI 0.55 to 1.65) in women.
In Japan, weight cycling was associated with a significant reduction in the risk of diabetes for men from urban regions. The associations were unclear for women from urban regions and both men and women from rural regions. These results differ from those in Western studies, probably because of differences in diet, insulin secretion and sensitivity and weight-consciousness.
研究体重循环（体重增加和减少）如何影响糖尿病风险。
队列研究。
日本城乡的初级医疗保健机构。
20708名城市居民和9670名农村居民。
10年内体重减轻、体重先减后增、体重稳定、体重先增后减及体重增加者患糖尿病的比值比。体重增加和减少定义为相对于基线体重变化超过±4%。
在城市地区，男性中，体重先减后增组和体重先增后减组相对于体重稳定组的比值比分别为0.63（95%可信区间0.45至0.89）和0.51（95%可信区间0.32至0.82），女性分别为0.72（95%可信区间0.39至1.34）和1.05（95%可信区间0.57至1.95）。在农村地区，男性中这两个比值比分别为1.58（95%可信区间0.78至3.17）和0.44（95%可信区间0.15至1.29），女性分别为0.41（95%可信区间0.12至1.44）和0.77（95%可信区间0.28至2.14）。20岁起体重增加5至10千克的男性的比值比为1.54（95%可信区间1.03至2.30），女性为0.96（95%可信区间0.55至1.65）。
在日本，体重循环与城市男性糖尿病风险显著降低相关。城市女性以及农村男性和女性的这种关联不明确。这些结果与西方研究的结果不同，可能是由于饮食、胰岛素分泌和敏感性以及体重意识方面的差异。
