Sares-Jäske Laura, Knekt Paul, Eranti Antti, Kaartinen Niina E, Heliövaara Markku, Männistö Satu
Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
Department of Public Health, University of Helsinki, Helsinki, Finland.
BMJ Open Diabetes Res Care. 2020 Sep;8(1). doi: 10.1136/bmjdrc-2020-001560.
Observational and intervention studies have verified that weight loss predicts a reduced type 2 diabetes (T2D) risk. At the population level, knowledge on the prediction of self-report intentional weight loss (IWL) on T2D incidence is, however, sparse. We studied the prediction of self-report IWL on T2D incidence during a 15-year follow-up in a general adult population.
The study sample from the representative Finnish Health 2000 Survey comprised 4270 individuals, aged 30-69 years. IWL was determined with questions concerning dieting attempts and weight loss during the year prior to baseline. Incident T2D cases during a 15-year follow-up were drawn from national health registers. The strength of the association between IWL and T2D incidence was estimated with the Cox model.
During the follow-up, 417 incident cases of T2D occurred. IWL predicted an increased risk of T2D incidence (HR 1.44; 95% CI 1.11 to 1.87, p=0.008) in a multivariable model. In interaction analyses comparing individuals with and without IWL, a suggestively elevated risk emerged in men, the younger age group, among less-educated people and in individuals with unfavorable values in several lifestyle factors.
Self-report IWL may predict an increased risk of T2D in long-term, probably due to self-implemented IWL tending to fail. The initial prevention of weight gain and support for weight maintenance after weight loss deserve greater emphasis in order to prevent T2D.
观察性研究和干预性研究已经证实，体重减轻预示着2型糖尿病（T2D）风险降低。然而，在人群层面，关于自我报告的有意体重减轻（IWL）对T2D发病率预测的了解却很少。我们在一般成年人群中进行了一项为期15年的随访研究，以探讨自我报告的IWL对T2D发病率的预测情况。
本研究样本来自具有代表性的芬兰健康2000调查，包括4270名年龄在30 - 69岁之间的个体。通过询问基线前一年的节食尝试和体重减轻情况来确定IWL。15年随访期间的新发T2D病例来自国家健康登记处。使用Cox模型估计IWL与T2D发病率之间关联的强度。
随访期间，共发生417例新发T2D病例。在多变量模型中，IWL预示着T2D发病风险增加（风险比1.44；95%置信区间1.11至1.87，p = 0.008）。在比较有和没有IWL的个体的交互分析中，男性以及年龄较小的群体、受教育程度较低的人群和在几个生活方式因素方面有不利值的个体中，风险有升高的趋势。
自我报告的IWL可能长期预示着T2D风险增加，这可能是由于自我实施的IWL往往会失败。为预防T2D，应更加强调最初预防体重增加以及在体重减轻后支持维持体重。
