Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, China.
Front Endocrinol (Lausanne). 2024 Feb 19;15:1306551. doi: 10.3389/fendo.2024.1306551. eCollection 2024.
Weight gain in adulthood can influence the development of diabetes and cardiovascular diseases. It is speculated that weight gain is related to cardiometabolic multimorbility (CMM). This study was designed to examine the relationships between weight changes from early to middle adulthood and the risk of CMM.
Data of the National Health and Nutrition Examination Survey (NHANES) 1999-2018 cycles were analyzed in the present study. Weights at age 25 years and 10 years before recruitment were self-reported and were used to define five weight change patterns including stable normal, maximum overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity patterns. Meanwhile, absolute weight changes were classified into five groups: weight loss≥ 2.5 kg, weight change within 2.5 kg, 2.5 kg≤ weight gain < 10.0 kg, 10.0 kg≤ weight gain < 20.0 kg, and weight gain≥ 20.0 kg. CMM was defined as the coexistence of two or three of diabetes, coronary heart disease (CHD), and stroke.
A total of 25,994 participants were included. Across adulthood, compared to stable normal weight, maximal overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity were consistently associated with increased risks of diabetes, CHD, and CMM. For instance, stable obesity was respectively related to 358.0% (: 4.58, : 4.57, 4.58), 88.0% (: 1.88, : 1.88, 1.88), and 292.0% (: 3.92, : 3.91, 3.92) higher risks of diabetes, CHD, and CMM. Meanwhile, any account of weight loss and gain was linked to higher risks of diabetes, CHD, and CMM than weight change within 2.5 kg. However, participants with maximum overweight had a decreased incidence of stroke (: 0.85, : 0.85, 0.86), and weight loss ≥ 2.5 kg and weight gain ≥ 2.5 and <20 kg were also related to a lower risk of stroke. J-shaped or U-shaped associations of absolute weight changes with the risks of diabetes, CHD, and CMM were observed.
Maintaining a stable normal weight can benefit more from the prevention of diabetes, CHD, and CMM. Both weight gain and loss across adulthood were accompanied by increased risks of diabetes, CHD, and CMM.
成年人的体重增加会影响糖尿病和心血管疾病的发展。据推测，体重增加与心脏代谢多种疾病（CMM）有关。本研究旨在研究从成年早期到中期体重变化与 CMM 风险之间的关系。
本研究分析了 1999-2018 年国家健康和营养检查调查（NHANES）的数据。25 岁和招募前 10 年的体重由自我报告，并用于定义五种体重变化模式，包括稳定正常、最大超重、肥胖到非肥胖、非肥胖到肥胖和稳定肥胖模式。同时，绝对体重变化分为五组：体重减轻≥2.5kg、体重变化在 2.5kg 以内、2.5kg≤体重增加<10.0kg、10.0kg≤体重增加<20.0kg 和体重增加≥20.0kg。CMM 定义为糖尿病、冠心病（CHD）和中风两种或三种并存。
共纳入 25994 名参与者。在整个成年期，与稳定的正常体重相比，最大超重、肥胖到非肥胖、非肥胖到肥胖和稳定肥胖与糖尿病、CHD 和 CMM 的风险增加一致相关。例如，稳定肥胖分别与糖尿病、CHD 和 CMM 的风险增加 358.0%（比值比[OR]：4.58，95%置信区间[CI]：4.57，4.58）、88.0%（OR：1.88，95%CI：1.88，1.88）和 292.0%（OR：3.92，95%CI：3.91，3.92）有关。同时，与体重变化在 2.5kg 以内相比，任何体重减轻和增加都与糖尿病、CHD 和 CMM 的风险增加有关。然而，最大超重的参与者中风发生率降低（OR：0.85，95%CI：0.85，0.86），体重减轻≥2.5kg 和体重增加≥2.5kg 且<20kg 也与中风风险降低有关。绝对体重变化与糖尿病、CHD 和 CMM 风险之间呈 J 形或 U 形关联。
保持稳定的正常体重更有利于预防糖尿病、CHD 和 CMM。整个成年期的体重增加和减轻都会增加糖尿病、CHD 和 CMM 的风险。
