WEIGHT-GAIN AS A RISK FACTOR FOR CLINICAL DIABETES-MELLITUS IN WOMEN
WEIGHT-GAIN AS A RISK FACTOR FOR CLINICAL DIABETES-MELLITUS IN WOMEN
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DOI：
10.7326/0003-4819-122-7-199504010-00001
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发表时间：
1995-04-01
影响因子：
39.2
通讯作者：
MANSON, JE
中科院分区：
文献类型：
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作者：
COLDITZ, GA;WILLETT, WC;MANSON, JE
目的：研究中年妇女成年体重变化与临床糖尿病风险之间的关系。设计：前瞻性队列研究，随访时间为1976年至1990年。设置：美国各州。参与者：114 281名年龄在30至55岁之间的女性注册护士，未被诊断为糖尿病、冠心病、中风，结果：在149万人年的随访中，诊断出2204例糖尿病。校正年龄后，体重指数是糖尿病风险的主要预测因素。风险随着身体质量指数的增加而增加，即使是平均体重的女性（身体质量指数，24.0 kg/m2）也有风险增加。与体重稳定的女性（18岁至1976年期间体重增加或减少少于5 kg）相比，在调整年龄和18岁时的体重指数后，体重增加5.0至7.9 kg的女性患糖尿病的相对风险为1.9（95%CI，1.5至2.3）。体重增加8.0至10.9 kg的女性的相应相对风险为2.7（CI，2.1至3.3）。相比之下，减肥超过5.0公斤的女性患糖尿病的风险降低了50%或更多。这些结果独立于糖尿病家族史。结论：即使是适度和典型的成人体重增加的糖尿病的额外风险是巨大的。这些发现支持了在整个成年生活中保持恒定体重的重要性，并表明1990年美国农业部的指导方针允许35岁后体重大幅增加是误导性的。
Objective: To examine the relation between adult weight change and the risk for clinical diabetes mellitus among middle-aged women.Design: Prospective cohort study with follow-up from 1976 to 1990.Setting: if U.S. states.Participants: 114 281 female registered nurses aged 30 to 55 years who did not have diagnosed diabetes mellitus, coronary heart disease, stroke, or cancer in 1976.Outcome Measures: Non-insulin-dependent diabetes mellitus.Results: 2204 cases of diabetes were diagnosed during 1.49 million person-years of follow-up. After adjustment for age, body mass index was the dominant predictor of risk for diabetes mellitus. Risk increased with greater body mass index, and even women with average weight (body mass index, 24.0 kg/m(2)) had an elevated risk. Compared with women with stable weight (those who gained or lost less than 5 kg between age 18 years and 1976) and after adjustment for age and body mass index at age 18 years, the relative risk for diabetes mellitus among women who had a weight gain of 5.0 to 7.9 kg was 1.9 (95% CI, 1.5 to 2.3). The corresponding relative risk for women who gained 8.0 to 10.9 kg was 2.7 (CI, 2.1 to 3.3). In contrast, women who lost more than 5.0 kg reduced their risk for diabetes mellitus by 50% or more. These results were independent of family history of diabetes.Conclusion: The excess risk for diabetes with even modest and typical adult weight gain is substantial. These findings support the importance of maintaining a constant body weight throughout adult life and suggest that the 1990 U.S. Department of Agriculture guidelines that allow a substantial weight gain after 35 years of age are misleading.