青年和中年时期体重状态变化及最大体重减重程度与其中老年时期2型糖尿病的关系

目的探讨青年及中年时期人群,发生超重和肥胖后的体重状态变化以及最大体重减重程度与其中老年期发生T2DM的关系。方法基于中国糖尿病和代谢紊乱研究库,选取19878名年龄≥40岁的中老年人群,采用多因素Logistic回归分析既往超重及肥胖[最大BMI(BMIMax)≥24.0 kg/m^2]发生在青年及中年时期人群的体重状态变化及最大体重减重程度与T2DM患病风险的关系。结果与正常体重组(BMIMax及BMI 18.5~23.9 kg/m^2)相比,青年时期持续超重组(BMIMax及BMI≥24.0 kg/m^2)、青年时期既往超重组(BMIMax≥24.0 kg/m^2,BMI 18.5~23.9 kg/m^2)、中年时期持续超重组(BMIMax及BMI≥24.0 kg/m^2)、中年时期既往超重组(BMIMax≥24.0 kg/m^2,BMI 18.5~23.9 kg/m^2)的T2DM患病风险均不同程度增加,以青年时期持续超重组最高(OR 2.57,95%CI 2.21~2.99)。超重人群(BMIMax≥24.0 kg/m^2)中,与减重<5%人群相比,减重≥5%人群T2DM患病风险增高,以减重≥15%人群风险最高(OR 3.58,95%CI 3.07~4.17)。结论无论目前体重正常或超重,青年及中年时期人群发生超重及肥胖均增加其中老年时期T2DM患病风险。超重人群最大体重减重≥5%时,中老年T2DM患病风险增加。

Relationship between the change of body weight status and weight loss from maximum body weight and the incidence of type 2 diabetes mellitus in middle aged and elderly population

Objective To explore the relationship between body weight status change of overweight/obesity and weight loss from maximum body weight occurred in young adults and middle-aged population and the risk of type 2 diabetes mellitus(T2DM).Methods Based on China National Diabetes and Metabolic Disorders Survey,19878 participants aged ≥40 years were included in this study.Multivariate logistic regression was used to analyze the relationship between weight status change of past overweight/obesity maximum body mass index(BMIMax≥24.0 kg/m^2)occurred in young adults and middle-aged and weight loss from maximum body weight and the risk of T2DM.Results Compared with normal body weight group(BMIMax and BMI 18.5~23.9 kg/m^2),the risk of T2DM in continuous overweight from young adults group(BMIMax and BMI≥24.0 kg/m^2),past overweight from young adults group(BMIMax≥24.0 kg/m^2,BMI18.5~23.9 kg/m^2),continuous overweight from middle-aged group(both BMIMax and BMI≥24.0 kg/m^2),past overweight from middle-aged group(BMIMax≥24.0 kg/m^2,BMI 18.5~23.9 kg/m^2)were increased in some degrees.Participants who were continuous overweight from young adults were associated with the highest risk of T2DM(OR 2.57,95%CI 2.21~2.99).In the overweight group(BMIMax≥24.0 kg/m^2),those with weight loss≥5% were at increased risk of T2DM compared with those who lost<5%.Participants who lost≥15% were associated with the highest risk of T2DM(OR 3.58,95%CI 3.07~4.17).Conclusion Overweight/obesity during young adults and middle-aged are both associated with increased risk of T2 DM in middle and older aged population regardless of current BMI.In overweight population(BMIMax≥24.0 kg/m^2),weight loss≥5% from maximum body weight increase the risk of T2DM in middle aged and elderly population.