Hanson R L, Narayan K M, McCance D R, Pettitt D J, Jacobsson L T, Bennett P H, Knowler W C
Diabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85014.
Diabetes. 1995 Mar;44(3):261-6. doi: 10.2337/diab.44.3.261.
The relationships of rate of weight gain and weight fluctuation to incidence of non-insulin-dependent diabetes mellitus (NIDDM) were examined in Pima Indians. The 1,458 subjects were participants in a prospective study with examinations approximately every 2 years. Rate of weight gain was defined as the slope of the regression line of weight with time for two or more consecutive examinations > or = 2 years apart and weight fluctuation as the root-mean-square departure from this line for four examinations. Among men, incidence of NIDDM was strongly and significantly related to rate of weight gain (e.g., age-adjusted incidence = 56.7/1,000 person-years in those with weight gain > or = 3 kg/year and 16.9/1,000 person-years for those losing weight [Ptrend < 0.01]). In women, weight gain was significantly related to diabetes incidence only in those who were not initially overweight (body mass index < 27.3 kg/m2). In contrast to the relationship with weight gain, weight fluctuation was not associated with incidence of diabetes in either sex. These findings suggest that weight control in overweight individuals may be a more effective strategy for prevention of NIDDM in men than in women, whereas prevention of obesity may prevent diabetes in both sexes. Concern about a diabetogenic effect of weight fluctuation should not deter weight-control efforts.
在皮马印第安人中，研究了体重增加率和体重波动与非胰岛素依赖型糖尿病（NIDDM）发病率之间的关系。1458名受试者参与了一项前瞻性研究，大约每两年进行一次检查。体重增加率定义为两次或更多次相隔≥2年的连续检查中体重随时间变化的回归线斜率，体重波动定义为四次检查中与该线的均方根偏差。在男性中，NIDDM发病率与体重增加率密切相关且具有显著统计学意义（例如，年龄调整后的发病率在体重增加≥3 kg/年的人群中为56.7/1000人年，在体重减轻的人群中为16.9/1000人年[P趋势<0.01]）。在女性中，体重增加仅在最初不超重（体重指数<27.3 kg/m²）的女性中与糖尿病发病率显著相关。与体重增加的关系不同，体重波动在男女中均与糖尿病发病率无关。这些发现表明，对于预防男性NIDDM，超重个体控制体重可能是比女性更有效的策略，而预防肥胖可能对男女预防糖尿病均有效。对体重波动的致糖尿病作用的担忧不应阻碍体重控制努力。
