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Ke P, Xu M, Feng J, Tian Q, He Y, Lu K, Lu Z. Association between weight change and risk of liver fibrosis in adults with type 2 diabetes. J Glob Health 2023; 13:04138. [PMID: 37856776 PMCID: PMC10586795 DOI: 10.7189/jogh.13.04138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Liver fibrosis plays a key role in the progression of non-alcoholic fatty liver disease to cirrhosis. Considering weight change is known to be closely associated with increased risk of liver fibrosis, we aimed to address a gap in evidence regarding the existence of this association in patients with type 2 diabetes (T2D). Methods We included data on 622 T2D patients and 1618 non-T2D participants from the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES). We assessed liver fibrosis by the median values of liver stiffness measurement (LSM). According to the participants' body mass index (BMI) at age 25 (early adulthood), 10 years prior (middle adulthood), and at the 2017-2018 cycle (late adulthood), we categorised weight change patterns into stable non-obese, weight loss, weight gain, and stable obese. We applied logistic regression to association analysis and used population attributable fraction (PAF) to analyses hypothetical prevention regimens. Results The prevalence of liver fibrosis was higher in T2D patients (23.04%) than in non-T2D participants (6.70%), while weight change was associated with a greater risk of fibrosis in the former compared to the latter group. Compared with T2D patients in the stable non-obese group, stable obese individuals from 10 years prior to the 2017-2018 cycle had the highest risk of developing liver fibrosis, corresponding to an adjusted odds ratio (aOR) of 3.13 (95% confidence interval = 1.84-5.48). Absolute weight change patterns showed that the risk of liver fibrosis was highest (aOR = 2.94) when T2D patients gained at least 20 kg of weight from 10 years prior to 2017-2018 cycle. Conclusions Obesity in middle and late adulthood is associated with an increased risk of T2D complicated with liver fibrosis.
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Affiliation(s)
- Pan Ke
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minzhi Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qingfeng Tian
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan He
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Kai Lu
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Jung YM, Oh GC, Noh E, Lee HY, Oh MJ, Park JS, Jun JK, Lee SM, Cho GJ. Pre-pregnancy blood pressure and pregnancy outcomes: a nationwide population-based study. BMC Pregnancy Childbirth 2022; 22:226. [PMID: 35305601 PMCID: PMC8934452 DOI: 10.1186/s12884-022-04573-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 03/02/2022] [Indexed: 01/21/2023] Open
Abstract
Background Hypertension has been known to increase the risk of obstetric complications. Recently, the American College of Cardiology endorsed lower thresholds for hypertension as systolic blood pressure of 130-139 mmHg or diastolic blood pressure 80-89 mmHg. However, there is a paucity of information regarding the impact of pre-pregnancy blood pressure on pregnancy outcomes. We aimed to evaluate the effect of pre-pregnancy blood pressure on maternal and neonatal complications. Methods In this nationwide, population based study, pregnant women without history of hypertension and pre-pregnancy blood pressure < 140/90 mmHg were enrolled. The primary outcome of composite morbidity was defined as any of the followings: preeclampsia, placental abruption, stillbirth, preterm birth, or low birth weight. Results A total of 375,305 pregnant women were included. After adjusting for covariates, the risk of composite morbidity was greater in those with stage I hypertension in comparison with the normotensive group (systolic blood pressure, odds ratio = 1.68, 95% CI: 1.59 – 1.78; diastolic blood pressure, odds ratio = 1.56, 95% CI: 1.42 – 1.72). There was a linear association between pre-pregnancy blood pressure and the primary outcome, with risk maximizing at newly defined stage I hypertension and with risk decreasing at lower blood pressure ranges. Conclusions ‘The lower, the better’ phenomenon was still valid for both maternal and neonatal outcomes. Our results suggest that the recent changes in diagnostic thresholds for hypertension may also apply to pregnant women. Therefore, women with stage I hypertension prior to pregnancy should be carefully observed for adverse outcomes.
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Knop MR, Geng TT, Gorny AW, Ding R, Li C, Ley SH, Huang T. Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta-Analysis of 7 646 267 Participants From 135 Studies. J Am Heart Assoc 2019; 7:e008870. [PMID: 30486715 PMCID: PMC6405546 DOI: 10.1161/jaha.118.008870] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Low birth weight has been associated with increased risk of type 2 diabetes mellitus, cardiovascular disease, and hypertension, but the risk at high birth weight levels remains uncertain. This systematic review and meta-analysis aimed to clarify the shape of associations between birth weight and aforementioned diseases in adults and assessed sex-specific risks. Methods and Results We systematically searched PubMed, EMBASE , and Web of Science for studies published between 1980 and October 2016. Studies of birth weight and type 2 diabetes mellitus (T2 DM ), cardiovascular disease ( CVD ), and hypertension were included. Random-effects models were used to derive the summary relative risks and corresponding 95% confidence intervals.We identified 49 studies with 4 053 367 participants assessing the association between birth weight and T2 DM , 33 studies with 5 949 477 participants for CVD , and 53 studies with 4 335 149 participants for hypertension and high blood pressure. Sex-specific binary analyses showed that only females had an increased risk of T2 DM and CVD at the upper tail of the birth weight distribution. While categorical analyses of 6 birth weight groups and dose-response analyses showed J-shaped associations of birth weight with T2 DM and CVD , the association was inverse with hypertension. The lowest risks for T2 DM , CVD , and hypertension were observed at 3.5 to 4.0, 4.0 to 4.5, and 4.0 to 4.5 kg, respectively. Conclusions These findings indicate that birth weight is associated with risk of T2 DM and CVD in a J-shaped manner and that this is more pronounced among females.
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Affiliation(s)
- Marianne Ravn Knop
- 1 Epidemiology Domain Saw Swee Hock School of Public Health National University of Singapore
| | - Ting-Ting Geng
- 1 Epidemiology Domain Saw Swee Hock School of Public Health National University of Singapore
| | - Alexander Wilhelm Gorny
- 1 Epidemiology Domain Saw Swee Hock School of Public Health National University of Singapore
| | - Renyu Ding
- 2 Department of Otolaryngology The First Hospital of China Medical University Shenyang China
| | - Changwei Li
- 3 Department of Epidemiology & Biostatistics College of Public Health University of Georgia Athens GA
| | - Sylvia H Ley
- 4 Department of Nutrition Harvard School of Public Health Boston MA
| | - Tao Huang
- 5 Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China
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Matsui M, Yoshikawa T, Mizushima R, Tanahashi K, Myoenzono K, Tanaka K, Maeda S. Association between duration of excessive weight and arterial stiffness in middle-aged and older adults. Clin Exp Hypertens 2019; 42:213-217. [DOI: 10.1080/10641963.2019.1619752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Masahiro Matsui
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Toru Yoshikawa
- Faculty of Sports and Health Sciences, Ryutsu Keizai University, Ryugasaki, Japan
| | - Ryoko Mizushima
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Koichiro Tanahashi
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kanae Myoenzono
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Nguyen Duc N, Bui Van N, Vo HL, Nam KD, Si Anh HN, Minh HT, Tuan NT, Duy TM, Thi Thu HT, Chu-Dinh T, Chu DT. Impact of body mass index and waist circumference on blood pressure: A cross-sectional survey in a population living in the Vietnam northern mountainous. Diabetes Metab Syndr 2019; 13:1399-1404. [PMID: 31336499 DOI: 10.1016/j.dsx.2019.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/04/2019] [Indexed: 01/12/2023]
Abstract
AIMS Several epidemiological studies have indicated that elevated blood pressure (BP) is associated with the surfeit of body weight. Body fat accumulation is considered as be a significant factor contributing to the nexus between obesity and hypertension. Two of the most common indicators used to characterize the associations of BP are body mass index (BMI) and waist circumference (WC). This study was aimed to describe the differences in some characteristics among people aged 20 and above in three communes of a district in Vietnam and analyze the correlation between BMI and WC, and BP. MATERIALS AND METHODS We conducted a survey with a cross-sectional design of 734 subjects in three communes in Chiem Hoa district of the Vietnam northern mountainous region. RESULTS It was found that except for BMI, there were significant differences in some physical characteristics between genders (p < 0.05). Particularly, the effects on Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP) of WC were more significant than that of BMI in genders. The impacts of WC on SBP as well as DBP were also stronger than that of BMI in age groups with the cut-off point 60 than BMI. CONCLUSIONS This study provides the science evidence in support of public and preventive health interventions to the locals residing in studied area. We recommend the existing correlations in subjects belonging to different ethnicities and continents.
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Affiliation(s)
- Nghia Nguyen Duc
- Department of Anatomy, Hanoi Medical University, Hanoi, Viet Nam
| | - Nhon Bui Van
- Department of Science and Technology, Hanoi Medical University, Hanoi, Viet Nam.
| | - Hoang Long Vo
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Khanh Do Nam
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hao Nguyen Si Anh
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hien Tran Minh
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Ngo Tri Tuan
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Ton Mai Duy
- Department of Emergency, Bach Mai Hospital, Hanoi, Viet Nam
| | | | - Thien Chu-Dinh
- Institute for Research and Development, Duy Tan University, Danang, Viet Nam.
| | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam; School of Odonto Stomatology, Hanoi Medical University, Hanoi, Viet Nam.
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Adane AA, Tooth LR, Mishra GD. Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study. Diabetes Res Clin Pract 2017; 124:72-80. [PMID: 28110238 DOI: 10.1016/j.diabres.2016.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/09/2016] [Accepted: 12/22/2016] [Indexed: 11/23/2022]
Abstract
AIMS In a population-based cohort study we examined the associations between early adult pre-pregnancy weight change and the risk of gestational diabetes mellitus (GDM). METHODS The study included 3111 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. These women have been surveyed regularly since 1996. Women without diabetes and GDM were followed-up between 2003 and 2012. Generalized estimating equations were used to assess the effect of baseline (1996, mean age 20years) and pre-pregnancy body mass index (BMI) and the pre-pregnancy weight changes on the incidence of GDM. The full models were adjusted for sociodemographic and lifestyle factors. RESULTS From 2003 to 2012, 229GDM cases (4.4%) were reported in 5242 pregnancies. Relative to normal BMI women, obese women at baseline (RR: 1.8, 95% CI: 1.1, 2.8) and prior to pregnancy (RR: 2.7, 95% CI: 2.0, 3.6) were at greater risk of GDM. Weight gains prior to each study pregnancy were strongly associated with increased GDM risk with an adjusted RR ranging from 2.0 to 2.9. Within under/normal range of BMI, women with a moderate/high (>2.5%/year) weight gain had 2.7 (95% CI: 1.3, 5.5) times the risk of GDM compared with women with stable weight. CONCLUSIONS Early adult weight gain, even within normal BMI range, is an important risk factor for the development of GDM. Weight gain prevention from early adulthood to prior to pregnancy appears to be the main strategy to prevent the incidence of GDM.
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Affiliation(s)
- Akilew Awoke Adane
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia.
| | - Leigh R Tooth
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia
| | - Gita D Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia
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Thearle MS, Votruba SB, Piaggi P, Muller YL, Hanson RL, Baier LJ, Knowler W, Krakoff J. The effect of differing patterns of childhood body mass index gain on adult physiology in American Indians. Obesity (Silver Spring) 2015; 23:1872-80. [PMID: 26308479 PMCID: PMC4552081 DOI: 10.1002/oby.21162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/01/2015] [Accepted: 04/28/2015] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Identifying groups of individuals with similar patterns of body mass index (BMI) change during childhood may increase understanding of the relationship between childhood BMI and adult health. METHODS Discrete classes of BMI z-score change were determined in 1,920 American Indian children with at least four non diabetic health examinations between the ages of 2 and 18 years using latent class trajectory analysis. In subsets of subjects, data were available for melanocortin-4 receptor (MC4R) sequencing; in utero exposure to type 2 diabetes (T2D); or, as adults, oral glucose tolerance tests, onset of T2D, or body composition. RESULTS Six separate groups were identified. Individuals with a more modern birth year, an MC4R mutation, or in utero exposure to T2D were clustered in the two groups with high increasing and chronic overweight z-scores (P < 0.0001). The z-score classes predicted adult percent fat (P < 0.0001, partial r(2) = 0.18 adjusted for covariates). There was a greater risk for T2D, independent from adult BMI, in three classes (lean increasing to overweight, high increasing, and chronic overweight z-scores) compared to the two leanest groups (respectively: HRR= 3.2, P = 0.01; 6.0, P = 0.0003; 11.6, P < 0.0001). CONCLUSIONS Distinct patterns of childhood BMI z-score change associate with adult adiposity and may impact risk of T2D.
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Affiliation(s)
- Marie S Thearle
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Susanne B Votruba
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Paolo Piaggi
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Yunhua L Muller
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Leslie J Baier
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - William Knowler
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
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Heianza Y, Arase Y, Kodama S, Tsuji H, Tanaka S, Saito K, Hara S, Sone H. Trajectory of body mass index before the development of type 2 diabetes in Japanese men: Toranomon Hospital Health Management Center Study 15. J Diabetes Investig 2015; 6:289-94. [PMID: 25969713 PMCID: PMC4420560 DOI: 10.1111/jdi.12308] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/07/2014] [Accepted: 10/31/2014] [Indexed: 12/27/2022] Open
Abstract
Aims/Introduction We aimed to investigate the long-term trajectory of general adiposity assessed by the body mass index (BMI) before the onset of type 2 diabetes in Japanese individuals. Materials and Methods We retrospectively examined data on 1,553 Japanese men without diabetes. Mean BMI and incident cases of diabetes (diabetes indicated by fasting glucose concentrations ≥7.0 mmol/L, a self-reported history of clinician-diagnosed diabetes, or glycated hemoglobin ≥6.5% (≥48 mmol/mol) were assessed on an annual basis over a 10-year period after the baseline examination. Results Mean (standard deviation) BMI at the time of diagnosis was 24.4 kg/m2 (3.1 kg/m2) among cases of diabetes (n = 191). An increasingly high BMI was associated with the early stage of the disease development, such as an 8- to 10-year prediagnosis period; individuals who developed diabetes experienced a prolonged and stable elevated BMI of ≥24.4 kg/m2 over the 8 years before the diagnosis of diabetes. The mean BMI among the non-cases of diabetes did not exceed 23.2 kg/m2 throughout the period. Conclusions These results suggested that Japanese men who eventually developed diabetes during the 10-year observation period were not characterized as obese, but had stable high-normal BMIs before the onset of diabetes. Previous evidence showed that values for glycemic markers rapidly increased before the development of diabetes; however, the present study showed a slight gain in BMI in the earlier stage of the natural history of diabetes followed by a prolonged period of overweight.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine Niigata, Japan ; Health Management Center, Toranomon Hospital Minato-ku, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital Minato-ku, Japan ; Okinaka Memorial Institute for Medical Research Tokyo, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine Niigata, Japan ; Health Management Center, Toranomon Hospital Minato-ku, Japan
| | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital Minato-ku, Japan ; Okinaka Memorial Institute for Medical Research Tokyo, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University Kyoto, Japan
| | - Kazumi Saito
- Department of Internal Medicine, Niigata University Faculty of Medicine Niigata, Japan ; Health Management Center, Toranomon Hospital Minato-ku, Japan
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital Minato-ku, Japan ; Okinaka Memorial Institute for Medical Research Tokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine Niigata, Japan ; Health Management Center, Toranomon Hospital Minato-ku, Japan
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Valadares ALR, Machado VSS, Costa-Paiva LS, de Sousa MH, Pinto-Neto AM. Factors associated with the age of the onset of diabetes in women aged 50 years or more: a population-based study. BMJ Open 2014; 4:e004838. [PMID: 25428628 PMCID: PMC4248098 DOI: 10.1136/bmjopen-2014-004838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Investigate factors associated with the onset of diabetes in women aged more than 49 years. DESIGN AND METHODS Cross-sectional, population-based study using self-reports with 622 women. The dependent variable was the age of occurrence of diabetes using the life table method. Cox multiple regression models were adjusted to analyse the onset of diabetes according to predictor variables. Sociodemographic, clinical and behavioural factors were evaluated. RESULTS Of the 622 women interviewed, 22.7% had diabetes. The mean age at onset was 56 years. The factors associated with the age of occurrence of diabetes were self-rated health (very good, good) (coefficient=-0.792; SE of the coefficient=0.215; p=0.0001), more than two individuals living in the household (coefficient=0.656, SE of the coefficient=0.223; p=0.003), and body mass index (BMI) (kg/m(2)) at 20-30 years of age (coefficient= 0.056, SE of the coefficient=0.023; p=0.014). CONCLUSIONS Self-rated health considered good or very good was associated with a higher rate of survival without diabetes. Sharing a home with two or more other people and a weight increase at 20-30 years of age was associated with the onset of type 2 diabetes.
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Affiliation(s)
- Ana L R Valadares
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Vanessa S S Machado
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Lúcia S Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Maria H de Sousa
- Department of Statistics, Campinas Center for Research in Reproductive Health (CEMICAMP), UNICAMP, Campinas, Brazil
| | - Aarão M Pinto-Neto
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
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Abstract
OBJECTIVE Weight changes may be an important indicator of an ongoing pathological process. Retrospective self-report might be the only possibility to capture prior weight. The objective of the study was to evaluate the accuracy of retrospective recall of body weight in old age and factors that might predict accuracy. DESIGN AND METHODS In 2007, 646 participants (mean age, 71.6 years) of the Swedish Adoption/Twin Study of Aging (SATSA) answered questions about their present weight and how much they weighed 20-years ago. Of these, 436 had self-reported their weight twenty years earlier and among these 134 had also had their weight assessed at this time point. RESULTS Twenty year retrospectively recalled weight underestimated the prior assessed weight by -1.89 ± 5.9 kg and underestimated prior self-reported weight by -0.55 ± 5.2 kg. Moreover, 82.4% of the sample were accurate within 10%, and 45.8% were accurate within 5% of their prior assessed weights; similarly, 84.2% and 58.0% were accurate within 10% and 5% respectively, for prior self-reported weight. Current higher body mass index and preferences of reporting weights ending with zero or five was associated with an underestimation of prior weight, while greater weight change over 20 years, and low Mini-Mental State Scores (MMSE) (<25) led to an overestimation of prior weight. CONCLUSIONS Recalled weight comes close to the assessed population mean, but at the individual level there is a large variation. The accuracy is affected by current BMI, changes in weight, end-digit preferences, and current cognitive ability. Recalled weight should be used with caution.
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Affiliation(s)
- Anna K Dahl
- Deparment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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The NS, Richardson AS, Gordon-Larsen P. Timing and duration of obesity in relation to diabetes: findings from an ethnically diverse, nationally representative sample. Diabetes Care 2013; 36:865-72. [PMID: 23223352 PMCID: PMC3609525 DOI: 10.2337/dc12-0536] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The influence on diabetes of the timing and duration of obesity across the high-risk period of adolescence to young adulthood has not been investigated in a population-based, ethnically diverse sample. RESEARCH DESIGN AND METHODS A cohort of 10,481 individuals aged 12-21 years enrolled in the U.S. National Longitudinal Study of Adolescent Health (1996) was followed over two visits during young adulthood (18-27 years, 2001-2002; 24-33 years, 2007-2009). Separate logistic regression models were used to examine the associations of diabetes (A1C ≥6.5% or diagnosis by a health care provider) in young adulthood with 1) obesity timing (never obese, onset <16 years, onset 16 to <18 years, onset ≥18 years) and 2) obesity duration over time (never obese, incident obesity, fluctuating obesity, and persistent obesity), testing differences by sex and race/ethnicity. RESULTS Among 24- to 33-year-old participants, 4.4% had diabetes (approximately half were undiagnosed), with a higher prevalence in blacks and Hispanics than whites. In multivariable analyses, women who became obese before age 16 were more likely to have diabetes than women who became obese at or after age 18 (odds ratio 2.77 [95% CI 1.39-5.52]), even after accounting for current BMI, waist circumference, and age at menarche. Persistent (vs. adult onset) obesity was associated with increased likelihood of diabetes in men (2.27 [1.41-3.64]) and women (2.08 [1.34-3.24]). CONCLUSIONS Diabetes risk is particularly high in individuals who were obese as adolescents relative to those with adult-onset obesity, thus highlighting the need for diabetes prevention efforts to address pediatric obesity.
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Affiliation(s)
- Natalie S The
- Department of Health Sciences, Furman University, Greenville, South Carolina, USA
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Dahl AK, Hassing LB, Fransson EI, Gatz M, Reynolds CA, Pedersen NL. Body mass index across midlife and cognitive change in late life. Int J Obes (Lond) 2013; 37:296-302. [PMID: 22450854 PMCID: PMC3387354 DOI: 10.1038/ijo.2012.37] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND High midlife body mass index (BMI) has been linked to a greater risk of dementia in late life, but few have studied the effect of BMI across midlife on cognitive abilities and cognitive change in a dementia-free sample. METHODS We investigated the association between BMI, measured twice across midlife (mean age 40 and 61 years, respectively), and cognitive change in four domains across two decades in the Swedish Adoption/Twin Study of Aging. RESULTS Latent growth curve models fitted to data from 657 non-demented participants showed that persons who were overweight/obese in early midlife had significantly lower cognitive performance across domains in late life and significantly steeper decline in perceptual speed, adjusting for cardio-metabolic factors. Both underweight and overweight/obesity in late midlife were associated with lower cognitive abilities in late life. However, the association between underweight and low cognitive abilities did not remain significant when weight decline between early and late midlife was controlled for. CONCLUSION There is a negative effect on cognitive abilities later in life related to being overweight/obese across midlife. Moreover, weight decline across midlife rather than low weight in late midlife per se was associated with low cognitive abilities. Weight patterns across midlife may be prodromal markers of late life cognitive health.
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Affiliation(s)
- A K Dahl
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Patel S, Henderson J, Jeffreys M, Davey Smith G, Galobardes B. Associations between socioeconomic position and asthma: findings from a historical cohort. Eur J Epidemiol 2012; 27:623-31. [PMID: 22696048 PMCID: PMC3444704 DOI: 10.1007/s10654-012-9703-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 05/29/2012] [Indexed: 11/21/2022]
Abstract
Understanding the association between asthma and socioeconomic position (SEP) is key to identify preventable exposures to prevent inequalities and lessen overall disease burden. We aim to assess the variation in asthma across SEP groups in a historical cohort before the rise in asthma prevalence. Male students participating in a health survey at Glasgow University from 1948 to 1968 (n = 11,274) completed medical history of bronchitis, asthma, hay fever, eczema/urticaria, and reported father’s occupation. A subsample responded to postal follow-up in adulthood (n = 4,101) that collected data on respiratory diseases, early life and adult SEP. Lower father’s occupational class was associated with higher odds of asthma only (asthma without eczema/urticaria or hay fever) (trend adjusted multinomial odds ratio (aMOR) = 1.23, 95 % CI 1.03–1.47) but with lower odds of asthma with atopy (asthma with eczema/urticaria or hay fever) (trend aMOR = 0.66, 95 % CI 0.52–0.83) and atopy alone (trend aMOR = 0.84, 95 % CI 0.75–0.93). Household amenities (<3), in early life was associated with higher odds of adult-onset asthma (onset > 30 years) (OR = 1.48, 95 % CI 1.07–2.05) though this association attenuated after adjusting for age. Adult SEP (household crowding, occupation, income and car ownership) was not associated with adult-onset asthma. Lower father’s occupational class in early life was associated with higher odds of asthma alone but lower odds of asthma with atopy in a cohort that preceded the 1960s rise in asthma prevalence. Different environmental exposures and/or disease awareness may explain this opposed socioeconomic patterning, but it is important to highlight that such patterning was already present before rises in the prevalence of asthma and atopy.
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Affiliation(s)
- Sumaiya Patel
- MRC Causal Analyses in Translational Epidemiology Centre, School of Social and Community Medicine, University of Bristol, Bristol, UK.
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15
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Kang HM, Kim DJ. Body mass index and waist circumference according to glucose tolerance status in Korea: the 2005 Korean Health and Nutrition Examination Survey. J Korean Med Sci 2012; 27:518-24. [PMID: 22563217 PMCID: PMC3342543 DOI: 10.3346/jkms.2012.27.5.518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 02/02/2012] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to investigate the stage of glucose intolerance in which persons showed a maximum obesity in Korea. A total of 4,479 participants, who were involved in the 2005 Korean National Health and Nutrition Examination Survey, was examined. The participants were divided into 5 groups by fasting plasma glucose (FPG); normal fasting glucose (NFG)1, FPG < 90 mg/dL; NFG2, FPG 90-99 mg/dL; impaired fasting glucose (IFG)1, FPG 100-109 mg/dL; IFG2, FPG 110-125 mg/dL; and diabetes mellitus, FPG ≥ 126 mg/dL or with anti-diabetes drugs. In those with FPG < 110 mg/dL, body mass index (BMI) and waist circumference (WC) were increased with increase of FPG (BMI in men; NFG1, 23.3 ± 0.1; NFG2, 24.4 ± 0.1; IFG1, 25.0 ± 0.2 kg/m(2), in women; NFG1, 23.0 ± 0.1; NFG2, 24.0 ± 0.1; IFG1, 24.8 ± 0.2 kg/m(2), WC in men; NFG1, 82.1 ± 0.3; NFG2, 85.3 ± 0.3; IFG1, 86.7 ± 0.5 cm, in women; NFG1, 77.1 ± 0.2; NFG2, 79.4 ± 0.3; IFG1, 81.8 ± 0.6 cm). In IFG2 and diabetes range, there was no more increase of BMI and WC with increase of FPG in each sex. The data suggest that degree of obesity increases with an increase of FPG in range of FPG < 100 mg/dL, peaked in FPG of 100-109 mg/dL, and then plateaus in higher FPG range in general Korean population.
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Affiliation(s)
- Hye Mi Kang
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea
| | - Dong-Jun Kim
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea
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Bombelli M, Facchetti R, Sega R, Carugo S, Fodri D, Brambilla G, Giannattasio C, Grassi G, Mancia G. Impact of Body Mass Index and Waist Circumference on the Long-Term Risk of Diabetes Mellitus, Hypertension, and Cardiac Organ Damage. Hypertension 2011; 58:1029-35. [DOI: 10.1161/hypertensionaha.111.175125] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity is associated with a higher risk of developing diabetes mellitus (DM), hypertension (HT), and left ventricular hypertrophy (LVH). The present study assessed in the general population the impact of body weight and visceral obesity on the development of alterations in glucose metabolism and cardiac structure, as well as of elevation in blood pressure. In 1412 subjects randomly selected and representative of the general population of Monza, we assessed twice (in 1990/1991 and 2000/2001) body mass index (BMI); waist circumference; office, home, and 24-hour ambulatory (24-hour) blood pressure, fasting glycemia, and left ventricular mass (echocardiography). New-onset high-risk conditions were DM; impaired fasting glucose; office, home, and 24-hour HT; and LVH. The incidence of new-onset DM; impaired fasting glucose; office, home, and 24-hour HT; and LVH increased progressively from the quintile with the lowest to the quintile with the highest BMI values. Adjusting for confounders, the risk of developing new-onset DM; impaired fasting glucose; office, home, and 24-hour HT; and LVH increased significantly for an increase of 1 kg/m
2
of BMI and 1 cm of waist circumference (respectively, 8.4% [
P
<0.01], 9.5% [
P
<0.0001], 4.2% [
P
<0.0001], 3.9% [
P
<0.001], 2.5% [
P
<0.05], and 5.1% [
P
<0.001] for BMI and 3.2% [
P
<0.001], 3.5% [
P
<0.0001], 1.8% [
P
<0.0001], 1.5% [
P
<0.0001], 1.4% [
P
<0.001], and 2.6% [
P
<0.0001]). These data provide evidence that an increase in BMI and waist circumference is associated with a linearly increased adjusted risk of developing conditions with high cardiovascular risk, such as DM, impaired fasting glucose, in- and out-of-office HT, and LVH.
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Affiliation(s)
- Michele Bombelli
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Rita Facchetti
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Roberto Sega
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Stefano Carugo
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Danilo Fodri
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Gianmaria Brambilla
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Cristina Giannattasio
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Guido Grassi
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
| | - Giuseppe Mancia
- From the Clinica Medica (M.B., R.F., R.S., G.B., C.G., G.G., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy; Centro Interuniversitario di Fisiologia Clinica e Ipertensione (S.C.), Università di Milano, Milan, Italy; Istituto Scientifico Multimedica (D.F.), Istituto Di Ricovero e Cura a Carattere Scientifico, Sesto San Giovanni, Italy
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17
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Maleki-Fischbach M, Jordan JM. New developments in osteoarthritis. Sex differences in magnetic resonance imaging-based biomarkers and in those of joint metabolism. Arthritis Res Ther 2010; 12:212. [PMID: 20701741 PMCID: PMC2945043 DOI: 10.1186/ar3091] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Sex differences in the prevalence, incidence, and severity of osteoarthritis (OA) have long been known. Some differences in the evaluation of this issue across studies may be related to differences in study design, sampling, study size, study populations, targeted joint sites, and definitions of OA. This report highlights recent studies of sex differences in individual joint components imaged by magnetic resonance imaging and in systemic biomarkers of joint metabolism. Particularly important are those studies that examine this issue in young unaffected adults and children before the development of disease. Despite some variation across studies, women appear for the most part to have a thinner and more reduced volume of cartilage in the knee than men, and this may occur from early childhood. It is not clear whether women have a more accelerated rate of cartilage volume loss than men. Few data exist on sex differences in systemic biomarkers of joint metabolism. In these studies, it is critically important to characterize the total body burden of OA and the presence of comorbid conditions likely to influence a given biomarker. Lastly, future research should dovetail studies of sex differences in imaging and biochemical biomarkers with genetics to maximize insight into the mechanisms behind observed sex differences.
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18
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Merten MJ. Weight status continuity and change from adolescence to young adulthood: examining disease and health risk conditions. Obesity (Silver Spring) 2010; 18:1423-8. [PMID: 19851300 DOI: 10.1038/oby.2009.365] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study examined weight status during adolescence and young adulthood, and young adult health condition diagnosis. Data are from 10,439 African-American, Hispanic, and white men and women participating in the National Longitudinal Study of Adolescent Health during Waves 1 (adolescence: ages 12-19) and 3 (young adulthood: ages 19-26). Categories were created differentiating individuals based on their weight status during adolescence and young adulthood: (i) obese during adolescence and young adulthood (i.e., continuously obese), (ii) obese during adolescence only, (iii) obese during young adulthood only, and (iv) never obese. Multilevel random intercept regression models were used to examine the impact of obesity category, sex, and race/ethnicity on young adult asthma, diabetes, high cholesterol, and high blood pressure. Continuous obesity increased the likelihood for young adult disease and health risk conditions compared to individuals who were never obese. Obesity isolated to adolescence (Wave 1) increased the likelihood for high cholesterol and high blood pressure, whereas obesity isolated to young adulthood (Wave 3) also increased the likelihood for diabetes--all increases were relative to nonobese weight status during both periods. Associations varied in direction and degree when sex and race/ethnicity were considered. Findings clarify some of the mixed understandings regarding the associations between age of onset and stability of obesity, and health outcomes with important public health implications. Although results indicate obesity isolated to a single developmental period does have health repercussions, obesity experienced continuously during adolescence and young adulthood greatly intensified risk across all health conditions.
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Affiliation(s)
- Michael J Merten
- Department of Human Development and Family Science, Oklahoma State University, Tulsa, Oklahoma, USA.
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19
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Yeung EH, Hu FB, Solomon CG, Chen L, Louis GM, Schisterman E, Willett WC, Zhang C. Life-course weight characteristics and the risk of gestational diabetes. Diabetologia 2010; 53:668-78. [PMID: 20043144 PMCID: PMC2901841 DOI: 10.1007/s00125-009-1634-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 11/26/2009] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS We prospectively determined the risk of gestational diabetes mellitus in association with life-course weight characteristics and adult abdominal adiposity. METHODS We investigated the joint and independent impact of birthweight, childhood size by somatotypes, adolescent and adult BMI, and abdominal adiposity on gestational diabetes mellitus risk among the 21,647 women in the Nurses' Health Study II who reported a singleton pregnancy between 1989 and 2001. A total of 1,386 incident cases of gestational diabetes mellitus were reported. Relative risk was estimated by pooled logistic regression adjusting for age, prematurity, race, smoking status, parental history of diabetes, age of first birth, parity and physical activity. RESULTS Birthweight was inversely associated with gestational diabetes mellitus risk (p = 0.02 for trend). Childhood somatotypes at ages 5 and 10 years were not associated with risk. U-shaped associations were found for BMI at age 18 years and somatotype at age 20 years. Weight gain between adolescence and adulthood, pre-gravid BMI and abdominal adiposity were positively associated with risk (p < 0.01 for all trends). Multivariate adjusted RRs for gestational diabetes from lowest to highest quintile of WHR were 1.00, 1.50, 1.51, 2.03, 2.12 (p = 0.0003 for trend). Lower birthweight (<7 lb) without adulthood overweight (BMI > 25 kg/m(2)) was associated with a 20% increased risk (95% CI 1.02-1.41). However, adulthood overweight alone was related to a 2.36 times greater risk (95% CI 2.12-3.77). CONCLUSIONS/INTERPRETATION Although lower birthweight is an independent risk factor for gestational diabetes mellitus, weight gain since early adulthood, and overall and central obesity in adulthood were more strongly associated with elevated risk of the condition independently of other known risk factors.
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Affiliation(s)
- E H Yeung
- Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd, 7B03, Bethesda, MD 20892, USA.
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20
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de Lauzon-Guillain B, Balkau B, Charles MA, Romieu I, Boutron-Ruault MC, Clavel-Chapelon F. Birth weight, body silhouette over the life course, and incident diabetes in 91,453 middle-aged women from the French Etude Epidemiologique de Femmes de la Mutuelle Generale de l'Education Nationale (E3N) Cohort. Diabetes Care 2010; 33:298-303. [PMID: 19918011 PMCID: PMC2809270 DOI: 10.2337/dc09-1304] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obesity and increases in body weight in adults are considered to be among the most important risk factors for type 2 diabetes. Low birth weight is also associated with a higher diabetes incidence. We aimed to examine to what extent the evolution of body shape, from childhood to adulthood, is related to incident diabetes in late adulthood. RESEARCH DESIGN AND METHODS Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a cohort study of French women born in 1925-1950 and followed by questionnaire every 2 years. At baseline, in 1990, women were asked to report their current weight, height, and body silhouette at various ages. Birth weight was recorded in 2002. Cases of diabetes were self-reported or obtained by drug reimbursement record linkage and further validated. RESULTS Of the 91,453 women who were nondiabetic at baseline, 2,534 developed diabetes over the 15 years of follow-up. Birth weight and body silhouette at 8 years, at menarche, and in young adulthood (20-25 years) were inversely associated with the risk of diabetes, independently of adult BMI during follow-up (all P(trend) < 0.001). In mid-adulthood (35-40 years), the association was reversed, with an increase in risk related to a larger body silhouette. An increase in body silhouette from childhood to mid-adulthood amplified the risk of diabetes. CONCLUSIONS Low birth weight and thinness until young adulthood may increase the risk of diabetes, independently of adult BMI during follow-up. Young women who were lean children should be especially warned against weight gain.
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21
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Al Mamun A, Cramb SM, O'Callaghan MJ, Williams GM, Najman JM. Childhood overweight status predicts diabetes at age 21 years: a follow-up study. Obesity (Silver Spring) 2009; 17:1255-61. [PMID: 19214172 DOI: 10.1038/oby.2008.660] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We examined the prospective association of childhood BMI z-score and BMI categories (normal or overweight) with young adult diabetes, controlling for early life, childhood, and adolescence factors. A subsample of 2,639 young adults from the Mater-University study of pregnancy (MUSP) and its outcomes, a prospective birth cohort who were born in Brisbane, Australia and for whom we had measured height and weight at 5 years and self-reported diabetes at age 21 years. The risk of developing diabetes by age 21 years was greater among young adults who had greater BMI z-score or were overweight at age 5 years than those who had normal BMI at age 5 years. Young adults who were overweight at age 5 years had an increased odds ratio of 2.60 (95% confidence interval (CI): 1.29, 5.22, in age- and sex-adjusted model) of experiencing diabetes by age 21 years. Adjustment for potential confounders and mediators including intrauterine environmental factors, childhood dietary patterns, television watching, participation in sports and exercise, and current weight, did not substantively alter these associations. Overweight and increasing BMI z-score at childhood is an independent predictor of young adult's type 1 and type 2 diabetes. Findings of this study suggest that childhood BMI may be central to the development and rising incidence of all diabetes.
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Affiliation(s)
- Abdullah Al Mamun
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
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22
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Influence of birth weight and adult body composition on 17β-estradiol levels in young women. Cancer Causes Control 2008; 20:233-42. [DOI: 10.1007/s10552-008-9238-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 09/12/2008] [Indexed: 11/25/2022]
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23
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Lapidus L, Andersson SW, Bengtsson C, Björkelund C, Rossander-Hulthén L, Lissner L. Weight and length at birth and their relationship to diabetes incidence and all-cause mortality--a 32-year follow-up of the population study of women in Gothenburg, Sweden. Prim Care Diabetes 2008; 2:127-133. [PMID: 18779036 DOI: 10.1016/j.pcd.2008.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 04/28/2008] [Accepted: 05/01/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of the study was to explore the relationship of weight and length at birth to diabetes in adult life and to all-cause mortality. Special attention was taken to potential confounding factors as age, family history, education, socio-economic group, physical inactivity, smoking, blood pressure, serum lipids and obesity. RESEARCH DESIGN AND METHODS A longitudinal population study consisting of a representative sample of 1381 women aged 38-54 started in Gothenburg, Sweden, in 1968-1969 monitoring for diabetes mellitus and overall mortality over 32 years. Original delivery records were retrieved for 61.2% of the women. Death certificates were obtained for 99.3% the women who died during the 32-year follow-up period. RESULTS We observed an inverse statistically significant relationship between birth weight and 32-year diabetes incidence independent of age, the highest incidence 16.3% in the lowest quartile of birth weight compared to 9.2% in the highest quartile. The relationship remained when controlling for the following covariates: education, socio-economic group, physical activity, smoking, systolic blood pressure, adult body mass index (BMI), waist-hip ratio, serum triglycerides and cholesterol. When overweight women (BMI> or =25) were excluded from the statistical analyses birth weight was even stronger related to the incidence of diabetes, 12.8% in lowest quartile and 5.7% in the highest quartile of birth weight independent of birth length, education, socio-economic group, physical activity, smoking, systolic blood pressure, body mass index, waist-hip ratio, blood glucose, serum triglycerides and cholesterol. Length at birth was a predictor for diabetes independent of age plus adult body mass index (BMI) and smoking but not independent of age only. No significant associations were observed between birth factors as birth weight and birth length and overall mortality during the 32-year of follow-up. CONCLUSIONS A low birth weight seems to be a risk factor for diabetes in adult women independent of age and most of the established risk factors for diabetes.
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Affiliation(s)
- Leif Lapidus
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
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24
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Maty SC, Lynch JW, Raghunathan TE, Kaplan GA. Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. Am J Public Health 2008; 98:1486-94. [PMID: 18556612 DOI: 10.2105/ajph.2007.123653] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES We examined the association between childhood socioeconomic position and incidence of type 2 diabetes and the effects of gender and adult body mass index (BMI). METHODS We studied 5913 participants in the Alameda County Study from 1965 to 1999 who were diabetes free at baseline (1965). Cox proportional hazards models estimated diabetes risk associated with childhood socioeconomic position and combined childhood socioeconomic position-adult BMI categories in pooled and gender-stratified samples. Demographic confounders and potential pathway components (physical inactivity, smoking, alcohol consumption, hypertension, depression, health care access) were included as covariates. RESULTS Low childhood socioeconomic position was associated with excess diabetes risk, especially among women. Race and body composition accounted for some of this excess risk. The association between childhood socioeconomic position and diabetes incidence differed by adult BMI category in the pooled and women-only groups. Adjustment for race and behaviors attenuated the risk attributable to low childhood socioeconomic position among the obese group only. CONCLUSIONS Childhood socioeconomic position was a robust predictor of incident diabetes, especially among women. A cumulative risk effect was observed for both childhood socioeconomic position and adult BMI, especially among women.
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Affiliation(s)
- Siobhan C Maty
- School of Community Health, Portland State University, PO Box 751, Portland, OR 97207-0751, USA.
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25
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Changes of cardiovascular risk factors and their implications in subsequent birth cohorts of older adults in Germany: a life course approach. ACTA ACUST UNITED AC 2008; 14:809-14. [PMID: 18043304 DOI: 10.1097/hjr.0b013e3282eeb308] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To examine lifetime patterns of cardiovascular risk factors and their implications in subsequent birth cohorts of older adults in Germany, who experienced very different political and socioeconomic conditions at various phases of their lives. DESIGN AND METHODS Participants of the ESTHER study, a statewide cohort study conducted in Saarland, Germany, were categorized into four birth cohorts: 1925-1934, 1935-1939, 1940-1944, 1945-1952. At baseline, lifetime history of body weight, physical activity, smoking and drinking habits, and of physician-diagnosed diabetes mellitus were documented. The average BMI, the average number of hours of physical activity, prevalence of smoking and alcohol consumption between ages 20 and 50 years were assessed. The relative risks of a first diagnosis of diabetes mellitus before or at the age of 50 years by birth cohorts were assessed by multiple logistic regressions controlling for education and BMI at the age of 20. RESULTS For both men and women, later birth cohorts had considerably worse lifestyle profiles. The frequency of diabetes mellitus up to the age of 50 years was much higher in the later than in the earlier cohorts. The increase was more pronounced among men than among women. CONCLUSION Women and men reaching old age in the forthcoming years have more unfavourable lifetime risk factor profiles than earlier birth cohorts. These patterns might have substantial implications for the future burden of chronic disease.
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Abstract
The present paper reviews the development of life course epidemiology since its origins during the 1990s from biological programming, birth cohort research and the study of health inequalities. Methods of studying the life course are examined, including birth cohort studies, linked register datasets and epidemiological archaeology. Three models of life course epidemiology are described: critical periods, accumulation, and pathways. Their conceptual and empirical differentiation can be difficult, but it is argued that accumulation is the underlying social process driving life course trajectories, while the critical period and pathway models are distinguished by their concern with specific types of aetiological process. Among the advantages of the accumulation model are predictive power, aetiological insights, contributions to health inequality debates and social policy implications. It is emphasised that the life course approach is not opposed to, or an alternative to, a concern with cross-sectional and current effects; major social disruption can have a large and immediate impact on health. Other limitations of the life course approach include a spectrum of impact (life course effects can be strong in relation to physiology, but often are weaker in relation to behaviour and psychological reactions to everyday life) and, more speculatively, the possibility that life course effects are diluted in the older age groups where morbidity and mortality are highest. Three issues for the future of life course epidemiology are identified. Many life course data are collected retrospectively. We need to know which items of information are recalled with what degree of accuracy over how many decades; and what methods of collecting these retrospective data maximise accuracy and duration. Second, the two partners in life course research need to take more seriously each other's disciplines. Social scientists need to be more critical of such measures as self-assessed health, which lacks an aetiology and hence biological plausibility. Natural scientists need to be more critical of such concepts as socio-economic status, which lacks social plausibility because it fails to distinguish between social location and social prestige. Finally, European comparative studies can play an important part in the future development of life course epidemiology if they build on the emerging infrastructure of European comparative research.
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Affiliation(s)
- D Blane
- Department of Primary Care and Social Medicine, Imperial College, London W6 8RP, UK.
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Stenholm S, Rantanen T, Alanen E, Reunanen A, Sainio P, Koskinen S. Obesity history as a predictor of walking limitation at old age. Obesity (Silver Spring) 2007; 15:929-38. [PMID: 17426328 DOI: 10.1038/oby.2007.583] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To study whether walking limitation at old age is determined by obesity history. RESEARCH METHODS AND PROCEDURES In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed<1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded. RESULTS Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4-fold higher risk of walking limitation compared to non-obese. Obesity duration increased the age- and gender-adjusted risk of walking limitation among those who had been obese since the age of 50 (odds ratio, 4.33; 95% confidence interval, 2.59 to 7.23, n=114), among the obese since the age of 40 [6.01 (2.55 to 14.14), n=39], and among the obese since the age of 30 [8.97 (3.06 to 26.29), n=14]. The risk remained elevated even among those who had previously been obese but lost weight during their midlife or late adulthood [3.15 (1.63 to 6.11), n=71]. DISCUSSION Early onset of obesity and obesity duration increased the risk of walking limitation, and the effect was only partially mediated through current BMI and higher risk of obesity-related diseases. Preventing excess weight gain throughout one's life course is an important goal in order to promote good health and functioning in older age.
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Affiliation(s)
- Sari Stenholm
- Department of Health and Functional Capacity, National Public Health Institute, Peltolantie 3, FI-20720 Turku, Finland.
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