Association of childhood-adulthood body size trajectories with risk of micro- and macrovascular complications among individuals with type 2 diabetes: a prospective study.

AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.