体重变化与 2 型糖尿病事件风险：德黑兰血脂和血糖研究的短期、中期和长期随访。

Weight change and risk of incident type 2 diabetes: short, medium and long-term follow-up in tehran lipid and glucose study.

机构信息

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Islamic Republic of Iran.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Cardiovasc Diabetol. 2024 Jun 18;23(1):207. doi: 10.1186/s12933-024-02297-w.

DOI:10.1186/s12933-024-02297-w

PMID:38890609

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11186083/

Abstract

BACKGROUND

Despite the high burden of obesity and Type 2 diabetes (T2DM) in the Middle East/West Asia region, the effect of weight change on the development of T2DM is poorly addressed. Therefore, we aimed to assess the impact of 3-year body weight change on incident of T2DM over 3-, 6-, and 9-year periods among Iranian adults.

METHODS

A total of 6930 participants (men = 2567) aged ≥ 20 years free of T2DM or cancer at baseline were included. Weight measurements were taken at baseline (2002-2005) and approximately 3 years later. Participants were categorized based on their weight change ratio into ≥ 5% loss, stable (± 5%), and ≥ 5% gain. Generalized estimating equations (GEE), adjusted with age, sex, education levels, baseline measurements of fasting plasma glucose, weight, waist circumference, triglycerides to high-density lipoprotein cholesterol ratio, family history of diabetes, current smoker, hypertension, and prevalent cardiovascular disease were applied to estimate the Odds ratios (ORs) and 95% confidence intervals (CIs) of weight change categories for incident T2DM, considering stable weight as a reference.

RESULTS

During median follow-ups of 3-, 6-, and 9-year, 295, 505, and 748 cases of T2DM occurred, respectively. Weight gain of ≥ 5%, as compared to stable weight group (± 5%), was associated with increased T2DM risk, with ORs of 1.58 (95% CI 1.16-2.14), 1.76 (1.41-2.20), and 1.70 (1.40-2.05) for the 3-, 6-, and 9-year follow-ups, respectively, in multivariable analysis; corresponding values for weight loss ≥ 5% were 0.48 (0.29-0.80), 0.57 (0.40-0.81), and 0.51 (0.38-0.68), respectively. This association persisted even after adjusting for attained weight. Subgroup analysis showed consistent associations across age, gender, and body mass index categories.

CONCLUSION

Weight gain and loss of ≥ 5% were associated with increased and decreased risks of incident T2DM, respectively, regardless of attained weight. This association was consistent over various follow-up durations among the Iranian population as recommended by guidelines.

摘要

背景

尽管中东/西亚地区肥胖症和 2 型糖尿病（T2DM）的负担很高，但体重变化对 T2DM 发展的影响仍未得到充分关注。因此，我们旨在评估伊朗成年人在 3 年、6 年和 9 年期间体重变化对 T2DM 发生的影响。

方法

共纳入 6930 名参与者（男性=2567 名），年龄≥20 岁，基线时无 T2DM 或癌症。体重测量在基线（2002-2005 年）和大约 3 年后进行。参与者根据体重变化比分为体重减轻≥5%、稳定（±5%）和体重增加≥5%。应用广义估计方程（GEE），调整年龄、性别、教育程度、空腹血糖、体重、腰围、甘油三酯与高密度脂蛋白胆固醇比值、糖尿病家族史、当前吸烟者、高血压和心血管疾病的基线测量值，以估计体重变化类别对 T2DM 发生的比值比（OR）和 95%置信区间（CI），将稳定体重作为参考。

结果

在中位随访 3 年、6 年和 9 年期间，分别发生了 295、505 和 748 例 T2DM。与稳定体重组（±5%）相比，体重增加≥5%与 T2DM 风险增加相关，多变量分析的 OR 分别为 1.58（95%CI 1.16-2.14）、1.76（1.41-2.20）和 1.70（1.40-2.05）；体重减轻≥5%的相应值分别为 0.48（0.29-0.80）、0.57（0.40-0.81）和 0.51（0.38-0.68）。即使调整了获得的体重，这种关联仍然存在。亚组分析显示，在不同年龄、性别和体重指数类别中，这种关联是一致的。