How many cases of Type 2 diabetes mellitus are due to being overweight in middle age? Evidence from the Midspan prospective cohort studies using mention of diabetes mellitus on hospital discharge or death records
How many cases of Type 2 diabetes mellitus are due to being overweight in middle age? Evidence from the Midspan prospective cohort studies using mention of diabetes mellitus on hospital discharge or death records
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DOI：
10.1111/j.1464-5491.2007.02016.x
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发表时间：
2007-01-01
影响因子：
3.5
通讯作者：
Smith, G. Davey
中科院分区：
文献类型：
--
作者：
Hart, C. L.;Hole, D. J.;Smith, G. Davey
目的与体重指数（BMI）在中年发展的糖尿病mellitus.Methods参与者是6927名男性和8227名女性的伦弗鲁/佩斯利一般人群的研究和3993名男性的合作职业研究。他们的年龄为45-64岁，未报告糖尿病。从1970-1976年至2004年3月31日筛选期间的急性出院数据和死亡证明中确定的糖尿病病例与筛选时的BMI相关。结果伦弗鲁/佩斯利研究男性5.4%、女性4.8%和协作研究男性5%发生糖尿病。超重组（BMI 25至< 30 kg/m2）患糖尿病的比值比高于正常体重组（BMI 18.5至< 25 kg/m2），肥胖组（BMI >= 30 kg/m2）患糖尿病的比值比最高。与正常体重组相比，超重和肥胖伦弗鲁/佩斯利男性的年龄调整优势比分别为2.73 [95%置信区间（CI）2.05，3.64]和7.26（95% CI 5.26，10.04）。进一步细分正常，超重和肥胖组显示随着BMI的增加，即使在正常水平较高的情况下，比值比也会增加。假设存在因果关系，如果每个人都有正常体重，大约60%的糖尿病病例是可以预防的。结论超重和肥胖是糖尿病患者的主要病因。随着最近超重流行率的增加，与糖尿病有关的疾病负担可能显著增加。肥胖的一级预防将是降低人群中糖尿病发病率的主要策略。
Aims To relate body mass index (BMI) in middle age to development of diabetes mellitus.Methods Participants were 6927 men and 8227 women from the Renfrew/Paisley general population study and 3993 men from the Collaborative occupational study. They were aged 45-64 years and did not have reported diabetes mellitus. Cases who developed diabetes mellitus, identified from acute hospital discharge data and from death certificates in the period from screening in 1970-1976 to 31 March 2004, were related to BMI at screening.Results Of Renfrew/Paisley study men 5.4%, 4.8% of women and 5% of Collaborative study men developed diabetes mellitus. Odds ratios for diabetes mellitus were higher in the overweight group (BMI 25 to < 30 kg/m(2)) than in the normal weight group (BMI 18.5 to < 25 kg/m(2)) and highest in the obese group (BMI >= 30 kg/m(2)). Compared with the normal weight group, age-adjusted odds ratios for overweight and obese Renfrew/Paisley men were 2.73 [95% confidence interval (CI) 2.05, 3.64] and 7.26 (95% CI 5.26, 10.04), respectively. Further subdividing the normal, overweight and obese groups showed increasing odds ratios with increasing BMI, even at the higher normal level. Assuming a causal relation, around 60% of cases of diabetes could have been prevented if everyone had been of normal weight. Conclusions Overweight and obesity account for a major proportion of diabetes mellitus, as identified from hospital discharge and death records. With recent increases in the prevalence of overweight, the burden of disease related to diabetes mellitus is likely to increase markedly. Primordial prevention of obesity would be a major strategy for reducing the incidence of diabetes mellitus in populations.