The association of maximum body weight on the development of type 2 diabetes and microvascular complications: MAXWEL study.
The association of maximum body weight on the development of type 2 diabetes and microvascular complications: MAXWEL study.
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DOI：
10.1371/journal.pone.0080525
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Wexler DJ
中科院分区：
文献类型：
--
作者：
Lim S;Kim KM;Kim MJ;Woo SJ;Choi SH;Park KS;Jang HC;Meigs JB;Wexler DJ
肥胖先于2型糖尿病（T2D）的发展。然而，体重增加的幅度和速度与T2D发展和并发症之间的关系，特别是在非白人人群中，受到的关注较少。在调整性别、20岁时BMI、生活方式、T2D家族史和/或血压和血脂等因素后，我们确定了2164名年龄≥30岁、新诊断为糖尿病的韩国受试者体重增加率和幅度与T2D诊断时年龄（AgeT2D）、T2D诊断时HbA1c （HbA1cT2D）、微量白蛋白尿和糖尿病视网膜病变的关系。20岁时体重（Wt20y）通过召回或从参与者的医疗、学校或军事记录中获得。参与者回忆了他们在T2D诊断前的最大体重（Wtmax）和最大体重（Agemax_wt）的年龄。体重增加率（Ratemax_wt）由体重增加幅度（ΔWt = Wtmax-Wt20y）除以ΔTime （Agemax_wt -20年）计算得出。平均Agemax_wt和AgeT2D分别为41.5±10.9年和50.1±10.5年。Wt20y和Wtmax分别为59.9±10.5 kg和72.9±11.4 kg。Ratemax_wt为0.56±0.50 kg/年。在调整了危险因素后，更高的ΔWt和更高的Ratemax_wt与更早的AgeT2D、在进一步调整AgeT2D后更高的HbA1cT2D以及在进一步调整HbA1cT2D和脂质谱后的微量白蛋白尿显著相关。更高的ΔWt和更高的Ratemax_wt也与糖尿病视网膜病变显著相关。这一发现支持了公共卫生建议，即通过预防成年早期体重增加来降低T2D及其并发症的风险。
Obesity precedes the development of type 2 diabetes (T2D). However, the relationship between the magnitude and rate of weight gain to T2D development and complications, especially in non-White populations, has received less attention. We determined the association of rate and magnitude of weight gain to age at T2D diagnosis (AgeT2D), HbA1c at T2D diagnosis (HbA1cT2D), microalbuminuria, and diabetic retinopathy after adjusting for sex, BMI at age 20 years, lifestyles, family history of T2D and/or blood pressure and lipids in 2164 Korean subjects aged ≥30 years and newly diagnosed with diabetes. Body weight at age 20 years (Wt20y) was obtained by recall or from participants’ medical, school, or military records. Participants recalled their maximum weight (Wtmax) prior to T2D diagnosis and age at maximum weight (Agemax_wt). The rate of weight gain (Ratemax_wt) was calculated from magnitude of weight gain (ΔWt = Wtmax–Wt20y) divided by ΔTime (Agemax_wt –20 years). The mean Agemax_wt and AgeT2D were 41.5±10.9 years and 50.1±10.5 years, respectively. The Wt20y and Wtmax were 59.9±10.5 kg and 72.9±11.4 kg, respectively. The Ratemax_wt was 0.56±0.50 kg/year. After adjusting for risk factors, greater ΔWt and higher Ratemax_wt were significantly associated with earlier AgeT2D, higher HbA1cT2D after additional adjusting for AgeT2D, and microalbuminuria after further adjusting for HbA1cT2D and lipid profiles. Greater ΔWt and higher Ratemax_wt were also significantly associated with diabetic retinopathy. This finding supports public health recommendations to reduce the risk of T2D and its complications by preventing weight gain from early adulthood.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
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