Long-term weight-change slope, weight fluctuation and risk of type 2 diabetes mellitus in middle-aged Japanese men and women: findings of Aichi Workers' Cohort Study

The association of long-term trajectories of BMI, its variability, and metabolic syndrome: a 30-year prospective cohort study

Background

Limited data exists on how early-life weight changes relate to metabolic syndrome (MetS) risk in midlife. This study examines the association between long-term trajectories of body mass index (BMI), its variability, and MetS risk in Chinese individuals.

Methods

In the Hanzhong Adolescent Hypertension study (March 10, 1987-June 3, 2017), 1824 participants with at least five BMI measurements from 1987 to 2017 were included. Using group-based trajectory modeling, different BMI trajectories were identified. BMI variability was assessed through standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Logistic regression analyzed the relationship between BMI trajectory, BMI variability, and MetS occurrence in midlife (URL: https://www.clinicaltrials.gov; Unique identifier: NCT02734472).

Findings

BMI trajectories were categorized as low-increasing (34.4%), moderate-increasing (51.8%), and high-increasing (13.8%). Compared to the low-increasing group, the odds ratios (ORs) [95% CIs] for MetS were significantly higher in moderate (4.27 [2.63-6.91]) and high-increasing groups (13.11 [6.30-27.31]) in fully adjusted models. Additionally, higher BMI variabilities were associated with increased MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 2.30 [2.02-2.62], 1.22 [1.19-1.26], and 4.29 [3.38-5.45]). Furthermore, BMI trajectories from childhood to adolescence were predictive of midlife MetS, with ORs in moderate (1.49 [1.00-2.23]) and high-increasing groups (2.45 [1.22-4.91]). Lastly, elevated BMI variability in this period was also linked to higher MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 1.24 [1.08-1.42], 1.00 [1.00-1.01], and 1.21 [1.05-1.38]).

Interpretation

Our study suggests that both early-life BMI trajectories and BMI variability could be predictive of incident MetS in midlife.

Funding

This work was supported by the National Natural Science Foundation of China No. 82070437 (J.-J.M.), the Clinical Research Award of the First Affiliated Hospital of Xi'an Jiaotong University of China (No. XJTU1AF-CRF-2022-002, XJTU1AF2021CRF-021, and XJTU1AF-CRF-2023-004), the Key R&D Projects in Shaanxi Province (Grant No. 2023-ZDLSF-50), the Chinese Academy of Medical Sciences & Peking Union Medical College (2017-CXGC03-2), and the International Joint Research Centre for Cardiovascular Precision Medicine of Shaanxi Province (2020GHJD-14).

The favorable impacts of cardamom on related complications of diabetes: A comprehensive literature systematic review

BACKGROUND AND AIM

Complementary and alternative medicine plays an increasing role in preventing, and regulatory, complications associated with diabetes. There are plenty of polyphenolic compounds found in Elettaria cardamomum (Cardamom) such as luteolin, limonene, pelargonidin, caffeic acid, kaempferol, gallic acid, and quercetin which can be used in many metabolic diseases.

METHOD

The objective of this systematic review was to appraise evidence from clinical and in vivo studies on the effects of cardamom on inflammation, blood glucose, oxidative stress and dyslipidemia of diabetes mellitus. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements, the present study was carried out. Studies were conducted by searching databases such as EMBASE, Scopus, PubMed, Google Scholar, web of sciences, and Cochrane Library from the commencement until April 2022.

RESULTS

All available human and animal studies examining the effects of cardamom on diabetes were published in the form of English articles. Finally, only 14 of the 241 articles met the criteria for analysis. Of the 14 articles, 8 were in vivo studies, and 6 were clinical trial studies. Most studies have indicated the beneficial effects of cardamom on insulin resistance, oxidative stress and inflammation. Cardamom also improved dyslipidemia, but had no substantial effect on weight loss.

CONCLUSION

According to most studies, cardamom supplementation enhanced antioxidant enzyme production and activity in diabetes mellitus and decreased oxidative stress and inflammatory factors. Despite this, the exact mechanism of the disease needs to be identified through more clinical trials.

Association between distinct body mass index trajectories according to the group-based trajectory modeling and the risk of incident diabetes: A systematic review

We aimed to determine the association between distinct body mass index (BMI) trajectories, using group-based trajectory modeling, and the subsequent risk of incident diabetes. Five databases were systematically searched. Fourteen population-based cohort studies that summarized the association between different BMI trajectories and subsequent diabetes, with the four most common BMI trajectories including the "stable," "increasing," "decreasing," and "turning" groups, were included. The rapid increase and stable high-level BMI groups showed the strongest association with the subsequent risk of diabetes compared with the stable normal BMI group. Increased baseline BMI levels resulted in a steeper slope and greater risk of subsequent diabetes. In the decreasing BMI group, one study reported that those aged >50 years showed the highest incidence of subsequent diabetes, whereas the other two studies reported no association between these two variables. In the turning group, an increase followed by a decrease in BMI levels from adolescence to late adulthood could reduce the risk of developing diabetes, although the residual risk remained. By contrast, the incidence of subsequent diabetes remained high in the middle-aged BMI-turning group. This study can provide further insights for identifying populations at high risk of diabetes and for developing targeted prevention strategies.

BMI variability and incident diabetes mellitus, Tehran Lipid and Glucose Study (TLGS)

Previous epidemiologic studies debated the association of body mass index (BMI) trends with cardiovascular disease and mortality. This study aimed to evaluate the association of BMI variability and slope with the incidence of Type 2 diabetes mellitus (T2DM) in a sex-stratified 15.8-year follow-up in the population-based Tehran Lipid and Glucose Study (TLGS). Of 10,911 individuals aged 20-60 years, 4981 subjects were included and followed for 15.8-years. The slope coefficient of BMI in the linear regression model represented individuals' BMI trends up to the incidence of DM. The root mean squared error (RMSE) of the BMI linear trend was selected to reflect BMI variability through six follow-ups. Cox proportional hazards regression was used to investigate the association of the baseline BMI, BMI slope and RMSE with the incidence of T2DM among men and women. Multivariable-adjusted HRs of T2DM for each SD increment in BMI slope was 1.18 (95% CI: 0.94-1.48, p = 0.161) in normal weight men and 1.26 (95% CI: 1.10-1.44, p = 0.001) in overweight and obese men. However, in women, each SD increment in BMI slope increased the risk of T2DM with a HR of 1.19 (95% CI: 1.01-1.40, p = 0.039) in normal weight, and 1.14 (95% CI: 1.08-1.19, p < 0.001) in women with BMI ≥ 25 kg/m². In men with a baseline BMI ≥ 25 kg/m², BMI-RMSE was associated with a decreased risk of T2DM (HR: 0.71, 95% CI: 0.53-0.93, p = 0.015). Baseline BMI was not associated with the risk of diabetes in men and women. Positive BMI slope is associated with the development of diabetes in both sexes. The association of BMI variability with incident T2DM differs according to sex and baseline BMI. BMI variability is associated with a lower risk of T2DM in overweight and obese men. BMI variability in women and baseline BMI in both gender are not related to the risk of T2DM.

Long-term variability and change trend of systolic blood pressure and risk of type 2 diabetes mellitus in middle-aged Japanese individuals: findings of the Aichi Workers' Cohort Study

Studies have reported that short-term blood pressure (BP) variability (BPV) is associated with type 2 diabetes mellitus (T2DM) incidence, but the association with long-term BPV remains unclear. The present study investigated the associations of long-term BPV as well as the time trend of BP changes over time with the incidence of T2DM. This study followed a cohort of 3017 Japanese individuals (2446 male, 571 female) aged 36-65 years from 2007 through March 31, 2019. The root-mean-square error (RMSE) and the slope of systolic BP (SBP) change regressed on year were calculated individually using SBP values obtained from 2003 to baseline (2007). A multivariable Cox proportional hazard model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for tertiles of SBP RMSE and continuous SBP slopes adjusted for age, sex, smoking status, regular exercise, sodium intake, family history of diabetes, sleep disorder, body mass index (BMI), SBP, and fasting blood glucose (FBG) at baseline, and BMI slope from 2003 to 2007. The highest RMSE tertile compared to the lowest was associated with a significantly higher incidence of T2DM after adjusting for covariates (HR: 1.79, 95% CI: 1.15, 2.78). The slope was also significantly associated with T2DM incidence until baseline SBP and FBG were adjusted (HR: 1.03, 95% CI: 0.99, 1.07). In conclusion, long-term SBP variability was significantly associated with an increased incidence of T2DM independent of baseline age, sex, BMI, SBP, FBG, lifestyle factors and BMI slope from 2003 until baseline.

The association between diabetes and hypertension with the number and extent of weight cycles determined from 6 million participants

The purpose of this study was to elucidate the association between weight cycling and clinical outcomes such as type 2 diabetes and hypertension with differential effects of baseline age and obesity. Nationwide data from 6,132,569 healthy adults who underwent five or more health screenings between 2002 and 2011 were analyzed and followed until December 2019 for type 2 diabetes and hypertension. Weight cycling was defined as a change in body weight followed by another change in the opposite direction. Through the Cox proportional hazards model, the number and degree of weight cycles were positively associated with increased risk of type 2 diabetes and hypertension. The hazard ratios (HRs) of weight cycling for type 2 diabetes and hypertension were as high as 1.263 (1.213-1.315) and 1.175 (1.144-1.207) at two or more weight cycles of 10% of body weight (BW), respectively. The association was stronger for females, individuals with normal body weight/BMI, and older individuals. Weight cycling was significantly associated with an increased risk of adverse health outcomes and was stronger in individuals with normal BMI and females, indicating that these people should be informed about the potential risk of weight cycling.

Beyond emotion: online takeaway food consumption is associated with emotional overeating among Chinese college students

BACKGROUND

Online takeaway food has become very popular in China. However, the potential effects of online takeaway food consumption on eating behaviours among individuals during the transition stage from adolescence to young adulthood have not yet been assessed.

OBJECTIVE

This study aimed to examine the effects of takeaway food consumption on emotional overeating behaviour among college students.

METHODS

Data were collected from 1450 college students from six universities in Anhui, China. The frequency of emotional overeating during the past 4 weeks was assessed by the emotional overeating questionnaire (EOQ). Data on the frequency of online takeaway food consumption and other potential risk factors at the individual, interpersonal, physical environment, and macro-system levels were assessed by questionnaire. Multilevel linear regression analyses were employed to explore the association between takeaway food consumption and emotional overeating behaviour.

RESULTS

Compared to those who consumed online takeaway food less than 1 day per week, participants who consumed this food 4-5 days per week and participants who consumed this food 6-7 days per week had significantly higher EOQ scores (β = 0.14, p < 0.05 and β = 0.67, p < 0.001, respectively). More frequent consumption was associated with higher EOQ scores (p for trend < 0.001).

CONCLUSION

A higher frequency of takeaway food consumption was associated with an elevated risk of emotional overeating among college students independent of personal emotional status and other potential confounders at the interpersonal, physical environmental and macro-system levels.

LEVEL OF EVIDENCE

Level V; cross-sectional descriptive study.

Body weight fluctuation is associated with rapid kidney function decline

OBJECTIVE

This study aimed to evaluate the effects of body weight fluctuations on kidney function deterioration in a prospective cohort of individuals with normal kidney function.

METHODS

Data were obtained from the Korean Genome and Epidemiology Study. Body weight fluctuations were determined using average successive variability (ASV), which was defined as the average absolute body weight change using repeated measurements for all participants. The decline of the estimated glomerular filtration rate (eGFR) over time was calculated using linear regression analysis of serial eGFR measurements for each patient. Rapid eGFR decline was defined as an average eGFR decline > 3 mL/min/1.73 m² per year.

RESULTS

A total of 6,790 participants were analyzed. During a median follow-up of 11.7 years, rapid eGFR decline was observed in 913 (13.4%) participants. When the participants were categorized into tertiles according to ASV, rapid eGFR decline was more prevalent in the highest ASV tertile group than in the lowest. Analyses using multiple logistic regression models revealed that the risk of rapid eGFR decline was increased in the highest ASV tertile group compared with the lowest (odds ratio: 1.66).

CONCLUSIONS

Body weight fluctuations were significantly associated with an increased risk of rapid kidney function decline in participants with normal kidney function.

Do Weight trajectories influence diabetes control? A prospective study in Switzerland (CoLaus study)

OBJECTIVE

Identify anthropometric trajectories among subjects with type 2 diabetes mellitus (T2DM), and associate them with glycaemic control.

METHODS

Prospective study including 268 community-dwelling participants with T2DM (34% women, mean age 68.7 ± 8.9 years) followed for 10.7 years (range: 8.8-13.6 years). T2DM control was considered for 1) fasting plasma glucose (FPG) < 7.0 mmol/L, or 2) HbA1c < 7.0% (53 nmol/mol). Changes in weight or waist and weight variability were considered.

RESULTS

One half (FPG) and one third (HbA1c) of participants presented with uncontrolled T2DM. Half of the participants presented with obesity and 75% with abdominal obesity. During follow-up, half of the participants maintained their weight, 25% gained > 5 kg, and 25% lost < 5 kg; almost half increased their waist by > 5 cm. Using FPG as criterion, participants who lost > 5 cm waist were more likely to be controlled: multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI): 3.10 (1.23-7.78). Participants with controlled T2DM also presented with a higher weight variability: multivariable adjusted mean ± standard error 4.8 ± 0.3 vs. 3.9 ± 0.3 kg, p = 0.028. Using HbA1c as criterion, participants who lost > 5 kg were less likely to be controlled: OR and (95% CI): 0.35 (0.18-0.66). Similar findings were obtained when restricting the analysis to participants who were diabetic throughout the whole study period.

CONCLUSION

In a Swiss community-based sample of participants with T2DM, T2DM control rates could be implemented. Neither weight nor waist variability was significantly and consistently associated with T2DM control.

Long-term body mass trajectories and hypertension by sex among Chinese adults: a 24-year open cohort study

Evidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension. We aimed to evaluate their association by sex in large-scale study. Data were obtained from the China Health and Nutrition Survey (CHNS) from 1991 to 2015. Latent class trajectory analysis (LCTA) was used to capture BMI change trajectories. Hazard risks (HRs) were estimated from Cox proportion hazard regression. Among 14,262 participants (mean age, 38.8; 47.8% men), 5138 hypertension occurred (2687 men and 2451 women) occurred during a mean follow-up 9.6 years. Four body mass trajectory groups were identified as BMI loss, stable, moderate and substantial gain. Appropriately half of participants (48.0%) followed 1 of the 2 BMI gain trajectories, where BMI increased at least 3 kg/m2 overtime. Compared with participants with stable BMI, those gaining BMI substantially had higher risk of hypertension by 65% (HR 1.65, 95% CI 1.45-1.86) in male and 83% (HR 1.83, 95% CI 1.58-2.12) in female. The HRs in BMI loss patterns were 0.74 (0.62-0.89) in men and 0.87 (0.75-1.00) in women. Our findings imply that majority of Chinese adults transited up to a higher BMI level during follow-up. Avoiding excessive weight gain and maintaining stable weight might be important for hypertension prevention.

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women

BACKGROUND AND AIMS

Little is known about how weight trajectories among women during menopausal transition and beyond may be related to risk of type 2 diabetes mellitus (T2DM). The aim of this study was to examine associations between body mass index (BMI) trajectories over 20 years, age of obesity onset, cumulative obese-years and incidence of T2DM among middle-aged women.

METHODS AND RESULTS

12,302 women enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed in 1996 (Survey 1, age 45-50), 1998 and then every three years to 2016. Self-reported weight and height were collected for up to eight time points. Incident diabetes was assessed via validated self-report of physician-diagnosed diabetes. Growth mixture models were used to identify distinct BMI trajectories. A total of 1380 (11.2%) women newly developed T2DM over an average 16 years of follow-up. Seven distinct BMI trajectories were identified with differential risk of developing T2DM. Initial BMI was positively associated with T2DM risk. We also observed that risk of T2DM was positively associated with rapid weight increase, early age of obesity onset and greater obese-years.

CONCLUSION

Slowing down weight increases, delaying the onset of obesity, or reducing cumulative exposure to obesity may substantially lower the risk of developing T2DM.

Body-weight fluctuation and risk of diabetes in older adults: The China Health and Retirement Longitudinal Study (CHARLS)

AIMS

Body-weight fluctuation is associated with an increased risk of all-cause mortality. Yet no studies investigate its association with risk of diabetes in adults aged ≥ 60 years. This study aimed to address this issue.

METHODS

A total of 1,565 participants free of diabetes at baseline in the CHARLS were followed for 4-year. Body-weight was collected at baseline and every 2-year. Body-weight fluctuation was primarily calculated as the root-mean-square-error deviation from the regression line of body-weights against years. The risk of diabetes was estimated using logistic regression analysis.

RESULTS

During the 4-year follow-up, 153 participants developed diabetes. The risk of diabetes was increased by 23% (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.06 to 1.43) per every 1-standard deviation higher of body-weight fluctuation after controlling for cardiovascular risk factors. The association appeared pronounced among participants with poor physical performance (both P < 0.03). Participants with overweight/obesity and a high body-weight fluctuation had the largest increase in the risk for diabetes (OR 3.03). Body-weight fluctuation correlated with hemoglobin A1c and white blood cells at follow-up or their change scores from baseline, especially in females (all P < 0.02).

CONCLUSIONS

Body-weight fluctuation led to an increased risk of diabetes in adults aged ≥ 60 years.

Association between weight cycling and risk of developing diabetes in adults: A systematic review and meta-analysis

AIMS/INTRODUCTION

In this meta-analysis, we aimed to explore the association between bodyweight cycling (weight fluctuation) and the risk of developing diabetes.

MATERIALS AND METHODS

We analyzed data from eligible cohort studies that assessed the association between weight cycling in adults and the risk of developing diabetes from online databases PubMed, Cochrane Library and EMBASE databases (1966 to April 2020). We pooled data using relative risks (RRs) with a random effects model.

RESULTS

A total of 14 studies involving 253,766 participants, including 8,904 diabetes events, were included. One study included eight independent reports, resulting in 21 reports in 14 studies. Summary analysis showed that individuals who suffered weight cycling had a higher risk of diabetes (RR 1.23. 95% confidence interval 1.07-1.41; P = 0.003). However, the association between weight cycling and the risk of developing diabetes was not observed in obese participants (body mass index ≥30 kg/m² ; P = 0.08).

CONCLUSIONS

The present meta-analysis showed that weight cycling was a strong independent predictor of new-onset diabetes. Future studies are required to detect the causal links between weight cycling and the risk of developing diabetes.

Long-term BMI change trajectories in Chinese adults and its association with the hazard of type 2 diabetes: evidence from a 20-year China Health and Nutrition Survey

INTRODUCTION

To investigate the relationship between long-term change trajectory in body mass index (BMI) and the hazard of type 2 diabetes among Chinese adults.

RESEARCH DESIGN AND METHODS

Data were obtained from the China Health and Nutrition Survey (CHNS). Type 2 diabetes was reported by participants themselves in each survey wave. The duration of follow-up was defined as the period from the first visit to the first time self-reported type 2 diabetes, death, or other loss to follow-up from CHNS. The patterns of change trajectories in BMI were derived by latent class trajectory analysis method. The Fine and Gray regression model was used to estimate HRs with corresponding 95% CIs for type 2 diabetes.

RESULTS

Four patterns of the trajectories of change in BMI were identified among Chinese adults, 42.7% of participants had stable BMI change, 40.8% for moderate BMI gain, 8.9% for substantial BMI gain and 7.7% for weight loss. During the follow-up with mean 11.2 years (158 637 person-years contributed by 14 185 participants), 498 people with type 2 diabetes (3.7%) occurred. Risk of type 2 diabetes was increased by 47% among people who gained BMI more substantially and rapidly (HR: 1.47, 95% CI 1.08 to 2.02, p=0.016) and increased by 20% among those in people with the moderate BMI gain (HR: 1.20, 95% CI 0.98 to 1.48, p=0.078), compared with those with stable BMI change.

CONCLUSIONS

Long-term substantial gain of BMI was significantly associated with an increased risk of type 2 diabetes in the Chinese adults.

Age of obesity onset, cumulative obesity exposure over early adulthood and risk of type 2 diabetes

AIMS/HYPOTHESIS

Obesity is a risk factor for type 2 diabetes, yet little is known about how timing and cumulative exposure of obesity are related to disease risk. The aim of this study was to examine the associations between BMI trajectories, age of onset of obesity and obese-years (a product of degree and duration of obesity) over early adulthood and subsequent risk of type 2 diabetes.

METHODS

Women aged 18-23 years at baseline (n = 11,192) enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) in 1996 were followed up about every 3 years via surveys for up to 19 years. Self-reported weights were collected up to seven times. Incident type 2 diabetes was self-reported. A growth mixture model was used to identify distinct BMI trajectories over the early adult life course. Cox proportional hazards regression models were used to examine the associations between trajectories and risk of diabetes.

RESULTS

One hundred and sixty-two (1.5%) women were newly diagnosed with type 2 diabetes during a mean of 16 years of follow-up. Six distinct BMI trajectories were identified, varying by different initial BMI and different slopes of increase. Initial BMI was positively associated with risk of diabetes. We also observed that age at onset of obesity was negatively associated with risk of diabetes (HR 0.87 [95% CI 0.79, 0.96] per 1 year increment), and number of obese-years was positively associated with diabetes (p for trend <0.0001).

CONCLUSIONS/INTERPRETATION

Our data revealed the importance of timing of obesity, and cumulative exposure to obesity in the development of type 2 diabetes in young women, suggesting that preventing or delaying the onset of obesity and reducing cumulative exposure to obesity may substantially lower the risk of developing diabetes.

Body Weight Fluctuation as a Risk Factor for Type 2 Diabetes: Results from a Nationwide Cohort Study

We aimed to investigate how body weight fluctuation affects the risk of developing type 2 diabetes by conducting a nationwide cohort study. A total of 3,855,884 participants from the National Health Insurance System health check-up data from 2012 were included in this study, and follow-up continued until 2016. Body weight was measured at least thrice between 2009 and 2012. Body weight variability (BWV) was estimated using average successive variability (ASV) indices. Cox proportional hazards regression models were used to evaluate the association of BWV with the risk of type 2 diabetes using hazard ratios (HRs) and 95% confidence intervals (CIs). Body weight fluctuation was associated with a higher risk of incident diabetes after adjustment for confounders (HR 1.10, 95% CI 1.07, 1.12 in the highest BWV quartile compared to the lowest). Regardless of the weight change status, the highest ASV quartile of BWV increased the risk for diabetes. Even subjects with a normal glucose tolerance status and those aged under 65 years had a higher risk of diabetes if their body weight highly fluctuated during the follow-up years. Our results suggest that body weight variability is an independent risk factor for diabetes. It is important to pay attention to frequent body weight fluctuations.

Impact of weight cycling on CTRP3 expression, adipose tissue inflammation and insulin sensitivity in C57BL/6J mice

Impacts of weight cycling on C1q/tumor necrosis factor (TNF)-related protein-3 (CTRP3) expression, adipose tissue inflammation and insulin sensitivity in C57BL/6J mice were evaluated in the current study. A total of 30 male C57Bl/6J mice were divided randomly into three groups; normal control (n=10), high-fat diet (OB, n=10) and weight cycling (WC, n=10), which were fed with high-fat diet in the first and last 8 weeks and regular chow in between. Systemic glucose metabolic status and insulin sensitivity were detected by intraperitoneal glucose tolerance test and hyperinsulinemic-euglycemic clamp, respectively. Blood levels of interleukin (IL)-6 and TNF-α were determined using ELISA. Relative CTRP3, IL-6, TNF-α and glucose transporter (GLUT)4 mRNA expression in adipose tissue was detected using reverse transcription-quantitative polymerase chain reaction assays. Relative CTRP3, phosphatidylinositide 3-kinases (PI3K) and protein kinase B (PKB; Ser473) protein expression were detected by western blot analysis. Area under the curve of glucose and glucose infusion rate of the WC group were significantly increased compared with the OB group (P<0.01). CTRP3 mRNA and protein levels of the WC group were significantly decreased by 20.3 and 23.1%, respectively, compared with the OB group (P<0.01). IL-6 and TNF-α protein plasma levels and gene expression in adipose tissue of the WC group were significantly increased compared with the OB group (P<0.01). Expression and phosphorylation of insulin signaling molecules PI3K and PKB (Ser473), respectively and GLUT4 gene expression in adipose tissue of the WC group were significantly decreased compared with the OB group (P<0.01). In conclusion, weight cycling impaired glucose metabolism and insulin sensitivity by decreasing CTRP3, PI3K, phosphorylated-PKB (Ser473) and GLUT4 expression, and increasing IL-6 and TNF-α levels.