Zeng Xiaomin, Lian Xingji, Wang Yaxin, Shang Xianwen, Yu Honghua
Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China.
Department of Geriatrics, Guangzhou First People's Hospital, National Key Clinic Specialty, Guangzhou Medical University, Guangzhou, China.
Diabetol Metab Syndr. 2024 Nov 29;16(1):289. doi: 10.1186/s13098-024-01499-2.
This study aimed to investigate the association between childhood-adulthood body size trajectories and the risk of micro- and macrovascular complications in individuals with type 2 diabetes (T2D) using data from the UK Biobank.
Childhood body size (average, thinner, and plumper) was self-reported for age 10, and adulthood body size (normal weight, overweight, obesity) was measured using body mass index at baseline. We defined nine body size trajectories by combining childhood and adulthood body size categories. Cox regression models were used to assess the association between these trajectories and the risk of diabetic complications.
Among 22,123 participants with T2D, 4,693 developed microvascular complications, and 3,640 developed macrovascular complications. Compared to individuals who maintained a normal body size from childhood to adulthood (the Average-Normal weight group), those with a high body size trajectory from childhood to adulthood (the Plumper-Obesity group) showed the highest risk for microvascular complications (HR 1.55; 95% CI: 1.31, 1.83), diabetic neuropathy (HR 2.18; 95% CI: 1.49, 3.21), diabetic nephropathy (HR 1.79; 95% CI: 1.45, 2.21), macrovascular complications (HR 1.30; 95% CI: 1.09, 1.55), and ischemic heart disease (HR 1.51; 95% CI: 1.23, 1.86). In contrast, individuals who were plumper in childhood but maintained a normal weight in adulthood did not show an increased risk of these complications.
A persistent high body size trajectory from childhood to adulthood is associated with the greatest risk of both micro- and macrovascular complications in individuals with T2D, whereas those who were plumper in childhood but achieved a normal weight in adulthood did not show an increased risk of these complications. These findings underscore the importance of weight management from childhood and maintaining a healthy weight throughout adulthood to reduce the risk of diabetic vascular complications in those with T2D.
本研究旨在利用英国生物银行的数据，调查2型糖尿病（T2D）患者儿童期至成年期的体型轨迹与微血管和大血管并发症风险之间的关联。
10岁时自我报告儿童期体型（平均、较瘦、较胖），并在基线时使用体重指数测量成年期体型（正常体重、超重、肥胖）。我们通过组合儿童期和成年期体型类别定义了九种体型轨迹。使用Cox回归模型评估这些轨迹与糖尿病并发症风险之间的关联。
在22123名T2D患者中，4693人发生微血管并发症，3640人发生大血管并发症。与从儿童期到成年期维持正常体型的个体（平均-正常体重组）相比，从儿童期到成年期体型轨迹较高的个体（较胖-肥胖组）微血管并发症风险最高（HR 1.55；95% CI：1.31，1.83）、糖尿病神经病变（HR 2.18；95% CI：1.49，3.21）、糖尿病肾病（HR 1.79；95% CI：1.45，2.21）、大血管并发症（HR 1.30；95% CI：1.09，1.55）和缺血性心脏病（HR 1.51；95% CI：1.23，1.86）。相比之下，儿童期较胖但成年期维持正常体重的个体并未显示这些并发症风险增加。
从儿童期到成年期持续的高体型轨迹与T2D患者微血管和大血管并发症的最大风险相关，而儿童期较胖但成年期体重正常的个体并未显示这些并发症风险增加。这些发现强调了儿童期体重管理以及成年期维持健康体重对于降低T2D患者糖尿病血管并发症风险的重要性。
