Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes
Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes
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DOI：
10.1056/nejmoa1713231
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发表时间：
2018-04-05
影响因子：
158.5
通讯作者：
Baker, Jennifer L.
中科院分区：
文献类型：
--
作者：
Bjerregaard, Lise G.;Jensen, Britt W.;Baker, Jennifer L.
背景
儿童期超重与成年后患2型糖尿病的风险增加有关。我们研究了在成年早期之前超重情况缓解是否会降低这种风险。
方法
我们开展了一项涉及62565名丹麦男性的研究，这些男性在7岁、13岁以及成年早期（17 - 26岁）测量了体重和身高。超重是根据美国疾病控制与预防中心的标准定义的。关于2型糖尿病患病情况的数据（年龄≥30岁，共6710人）来自一个国家健康登记处。
结果
7岁时超重（62565名男性中有3373人；5.4%）、13岁时超重（62565名中有3418人；5.5%）或成年早期超重（62565名中有5108人；8.2%）都与2型糖尿病的风险呈正相关；在超重年龄较大以及2型糖尿病诊断年龄较小时，这种相关性更强。在13岁之前超重情况缓解的男性在30 - 60岁被诊断患有2型糖尿病的风险与从未超重的男性相似（风险比，0.96；95%置信区间[CI]，0.75 - 1.21）。与从未超重的男性相比，在7岁和13岁超重但在成年早期不超重的男性患2型糖尿病的风险更高（风险比，1.47；95%CI，1.10 - 1.98），但他们的风险低于持续超重的男性（风险比[持续超重与从未超重相比]，4.14；95%CI，3.57 - 4.79）。即使在7岁时体重正常的男性中，7岁到成年早期之间身体质量指数的增加也与2型糖尿病风险增加有关。
结论
7岁时儿童期超重只有在持续到青春期或更晚年龄时才与成年后患2型糖尿病的风险增加有关。
BACKGROUNDChildhood overweight is associated with an increased risk of type 2 diabetes in adulthood. We investigated whether remission of overweight before early adulthood reduces this risk.METHODSWe conducted a study involving 62,565 Danish men whose weights and heights had been measured at 7 and 13 years of age and in early adulthood (17 to 26 years of age). Overweight was defined in accordance with Centers for Disease Control and Prevention criteria. Data on type 2 diabetes status (at age >= 30 years, 6710 persons) were obtained from a national health registry.RESULTSOverweight at 7 years of age (3373 of 62,565 men; 5.4%), 13 years of age (3418 of 62,565; 5.5%), or early adulthood (5108 of 62,565; 8.2%) was positively associated with the risk of type 2 diabetes; associations were stronger at older ages at overweight and at younger ages at diagnosis of type 2 diabetes. Men who had had remission of overweight before the age of 13 years had a risk of having type 2 diabetes diagnosed at 30 to 60 years of age that was similar to that among men who had never been overweight (hazard ratio, 0.96; 95% confidence interval [CI], 0.75 to 1.21). As compared with men who had never been overweight, men who had been overweight at 7 and 13 years of age but not during early adulthood had a higher risk of type 2 diabetes (hazard ratio, 1.47; 95% CI, 1.10 to 1.98), but their risk was lower than that among men with persistent overweight (hazard ratio [persistantly overweight vs. never overweight], 4.14; 95% CI, 3.57 to 4.79). An increase in body-mass index between 7 years of age and early adulthood was associated with an increased risk of type 2 diabetes, even among men whose weight had been normal at 7 years of age.CONCLUSIONSChildhood overweight at 7 years of age was associated with increased risks of adult type 2 diabetes only if it continued until puberty or later ages.