Karin Andréasson, Jon Edqvist, Martin Adiels, Lena Björck, Martin Lindgren, Naveed Sattar, Marcus Lind, Maria Åberg, Annika Rosengren
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden.
Sahlgrenska University Hospital, Gothenburg, Sweden.
EClinicalMedicine. 2022 Mar 21;46:101356. doi: 10.1016/j.eclinm.2022.101356. eCollection 2022 Apr.
Obesity is a predominant factor in development of type 2 diabetes but to which extent adolescent obesity influences adult diabetes is unclear. We investigated the association between body mass index (BMI) in young men and subsequent type 2 diabetes and how, in diagnosed diabetes, adolescent BMI relates to glycemic control and diabetes complications.
Baseline data from the Swedish Conscript Register for men drafted 1968-2005 was combined with data from the National Diabetes and Patient registries. Diabetes risk was estimated through Cox regression and Kaplan-Meier survival estimates. Relationships between BMI, glycemic control and diabetes complications were assessed through multiple linear and logistic regression.
Among 1,647,826 men, 63,957 (3·88%) developed type 2 diabetes over a median follow-up of 29.0 years (IQR[21.0-37.0]). The risk of diabetes within 40 years after conscription was nearly 40% in individuals with adolescent BMI ≥35 kg/m. Compared to BMI 18·5-<20 kg/m (reference), diabetes risk increased in a linear fashion from HR 1·18(95%CI 1·15-1·21) for BMI 20-<22·5 kg/m to HR 15·93(95%CI 14·88-17·05) for BMI ≥35 kg/m, and a difference in age at onset of 11·4 years was seen. Among men who developed diabetes, higher adolescent BMI was associated with higher HbA1c levels and albuminuria rates.
Rising adolescent BMI was associated with increased risk of type 2 diabetes diagnosed at a younger age, with poorer metabolic control, and a greater prevalence of albuminuria, all suggestive of worse prognosis.
肥胖是2型糖尿病发病的主要因素，但青少年肥胖对成人糖尿病的影响程度尚不清楚。我们调查了年轻男性的体重指数（BMI）与后续2型糖尿病之间的关联，以及在已诊断的糖尿病患者中，青少年BMI与血糖控制和糖尿病并发症之间的关系。
将1968 - 2005年应征入伍的瑞典男性征兵登记册中的基线数据与国家糖尿病和患者登记册中的数据相结合。通过Cox回归和Kaplan-Meier生存估计来评估糖尿病风险。通过多元线性和逻辑回归评估BMI、血糖控制和糖尿病并发症之间的关系。
在1,647,826名男性中，在中位随访29.0年（四分位间距[21.0 - 37.0]）期间，有63,957人（3.88%）患上了2型糖尿病。应征入伍后40年内，青少年BMI≥35 kg/m的个体患糖尿病的风险近40%。与BMI 18.5 - <20 kg/m（参照组）相比，糖尿病风险呈线性增加，BMI 20 - <22.5 kg/m时风险比（HR）为1.18（95%置信区间1.15 - 1.21），BMI≥35 kg/m时HR为15.93（95%置信区间14.88 - 17.05），发病年龄相差11.4岁。在患糖尿病的男性中，青少年BMI越高，糖化血红蛋白（HbA1c）水平和白蛋白尿率越高。
青少年BMI的升高与在较年轻时被诊断出2型糖尿病的风险增加、代谢控制较差以及白蛋白尿患病率较高相关，所有这些都提示预后较差。
