1
|
Kan Y, Liu L, Li X, Pang J, Bi Y, Zhang L, Zhang N, Yuan Y, Gong W, Zhang Y. Association between distinct body mass index trajectories according to the group-based trajectory modeling and the risk of incident diabetes: A systematic review. Obes Rev 2022; 23:e13508. [PMID: 36269000 DOI: 10.1111/obr.13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/16/2022] [Accepted: 09/27/2022] [Indexed: 11/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yinshi Kan
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lin Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiangning Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Juan Pang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Ning Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- Department of Basic Medicine, School of Medicine, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China.,Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China
| |
Collapse
|
2
|
Gray LA, Breeze PR, Williams EA. BMI trajectories, morbidity, and mortality in England: a two-step approach to estimating consequences of changes in BMI. Obesity (Silver Spring) 2022; 30:1898-1907. [PMID: 35920148 PMCID: PMC9546036 DOI: 10.1002/oby.23510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/03/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE BMI is known to have an association with morbidities and mortality. Many studies have argued that identifying health risks using single BMI measures has limitations, particularly in older adults, and that changes in BMI can help to identify risks. This study identifies distinct BMI trajectories and their association with the risks of a range of morbidities and mortality. METHODS The English Longitudinal Study of Aging provides data on BMI, mortality, and morbidities between 1998 and 2015, sampled from adults over 50 years of age. This study uses a growth-mixture model and discrete-time survival analysis, combined using a two-step approach, which is novel in this setting, to the authors' knowledge. RESULTS This study identified four trajectories: "stable overweight," "elevated BMI," "increasing BMI," and "decreasing BMI." No differences in mortality, cancer, or stroke risk were found between these trajectories. BMI trajectories were significantly associated with the risks of diabetes, asthma, arthritis, and heart problems. CONCLUSIONS These results emphasize the importance of looking at change in BMI alongside most recent BMI; BMI trajectories should be considered where possible when assessing health risks. The results suggest that established BMI thresholds should not be used in isolation to identify health risks, particularly in older adults.
Collapse
Affiliation(s)
- Laura A. Gray
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Penny R. Breeze
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Elizabeth A. Williams
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| |
Collapse
|
3
|
Vázquez-Bourgon J, Gómez-Revuelta M, Mayoral-van Son J, Labad J, Ortiz-García de la Foz V, Setién-Suero E, Ayesa-Arriola R, Tordesillas-Gutiérrez D, Juncal-Ruiz M, Crespo-Facorro B. Pattern of long-term weight and metabolic changes after a first episode of psychosis: Results from a 10-year prospective follow-up of the PAFIP program for early intervention in psychosis cohort. Eur Psychiatry 2022; 65:e48. [PMID: 35971658 PMCID: PMC9486831 DOI: 10.1192/j.eurpsy.2022.2308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background People with psychosis are at higher risk of cardiovascular events, partly explained by a higher predisposition to gain weight. This has been observed in studies on individuals with a first-episode psychosis (FEP) at short and long term (mainly up to 1 year) and transversally at longer term in people with chronic schizophrenia. However, there is scarcity of data regarding longer-term (above 3-year follow-up) weight progression in FEP from longitudinal studies. The aim of this study is to evaluate the longer-term (10 years) progression of weight changes and related metabolic disturbances in people with FEP. Methods Two hundred and nine people with FEP and 57 healthy participants (controls) were evaluated at study entry and prospectively at 10-year follow-up. Anthropometric, clinical, and sociodemographic data were collected. Results People with FEP presented a significant and rapid increase in mean body weight during the first year of treatment, followed by less pronounced but sustained weight gain over the study period (Δ15.2 kg; SD 12.3 kg). This early increment in weight predicted longer-term changes, which were significantly greater than in healthy controls (Δ2.9 kg; SD 7.3 kg). Weight gain correlated with alterations in lipid and glycemic variables, leading to clinical repercussion such as increments in the rates of obesity and metabolic disturbances. Sex differences were observed, with women presenting higher increments in body mass index than men. Conclusions This study confirms that the first year after initiating antipsychotic treatment is the critical one for weight gain in psychosis. Besides, it provides evidence that weight gain keep progressing even in the longer term (10 years), causing relevant metabolic disturbances.
Collapse
|
4
|
The Association between Trajectories of Anthropometric Variables and Risk of Diabetes among Prediabetic Chinese. Nutrients 2021; 13:nu13124356. [PMID: 34959908 PMCID: PMC8706558 DOI: 10.3390/nu13124356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 11/17/2022] Open
Abstract
In order to explore the association between trajectories of body mass index (BMI) and mid-upper arm circumference (MUAC) and diabetes and to assess the effectiveness of the models to predict diabetes among Chinese prediabetic people, we conducted this study. Using a national longitudinal study, 1529 cases were involved for analyzing the association between diabetes and BMI trajectories or MUAC trajectories. Growth mixture modeling was conducted among the prediabetic Chinese population to explore the trajectories of BMI and MUAC, and logistic regression was applied to evaluate the association between these trajectories and the risk of diabetes. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were applied to assess the feasibility of prediction. BMI and MUAC were categorized into 4-class trajectories, respectively. Statistically significant associations were observed between diabetes in certain BMI and MUAC trajectories. The AUC for trajectories of BMI and MUAC to predict diabetes was 0.752 (95% CI: 0.690-0.814). A simple cross-validation using logistic regression indicated an acceptable efficiency of the prediction. Diabetes prevention programs should emphasize the significance of body weight control and maintaining skeletal muscle mass and resistance training should be recommended for prediabetes.
Collapse
|
5
|
Luo J, Hodge A, Hendryx M, Byles JE. BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women. Nutr Metab Cardiovasc Dis 2021; 31:1063-1070. [PMID: 33612383 PMCID: PMC8005471 DOI: 10.1016/j.numecd.2020.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 01/04/2023]
Abstract
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.
Collapse
Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, USA.
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, USA
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
6
|
Cheng YJ, Chen ZG, Wu SH, Mei WY, Yao FJ, Zhang M, Luo DL. Body mass index trajectories during mid to late life and risks of mortality and cardiovascular outcomes: Results from four prospective cohorts. EClinicalMedicine 2021; 33:100790. [PMID: 33778436 PMCID: PMC7985466 DOI: 10.1016/j.eclinm.2021.100790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Our understanding of the weight-outcome association mainly comes from single-time body mass index (BMI) measurement. However, data on long-term trajectories of within-person changes in BMI on diverse study outcomes are sparse. Therefore, this study is to determine the associations of individual BMI trajectories and cardiovascular outcomes. METHODS The present analysis was based on data from 4 large prospective cohorts and restricted to participants aged ≥45 years with at least two BMI measurements. Hazard ratios (HR) and 95% confidence intervals(95%CI) for each outcome according to different BMI trajectories were calculated in Cox regression models. FINDINGS The final sample comprised 29,311 individuals (mean age 58.31 years, and 77.31% were white), with a median 4 BMI measurements used in this study. During a median follow-up of 21.16 years, there were a total of 10,192 major adverse cardiovascular events (MACE) and 11,589 deaths. A U-shaped relation was seen with all study outcomes. Compared with maintaining stable weight, the multivariate adjusted HR for MACE were 1.53 (95%CI 1.40-1.66), 1.26 (95%CI 1.16-1.37) and 1.08 (95%CI 1.02-1.15) respectively for rapid, moderate and slow weight loss; 1.01 (95%CI 0.95-1.07), 1.13 (95%CI 1.05-1.21) and 1.29 (95%CI 1.20-1.40) respectively for slow, moderate and rapid weight gain. Identical patterns of association were observed for all other outcomes. The development of BMI differed markedly between the outcome-free individuals and those who went on to experience adverse events, generally beginning to diverge 10 years before the occurrence of the events. INTERPRETATION Our findings may signal an underlying high-risk population and inspire future studies on weight management. FUNDING National Natural Science Foundation of China, Guangdong Natural Science Foundation.
Collapse
Affiliation(s)
- Yun-Jiu Cheng
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
- Corresponding authors.
| | - Zhen-Guang Chen
- From the Department of Thoracic Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Su-Hua Wu
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Wei-Yi Mei
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Feng-Juan Yao
- From the Department of Medical Ultrasonics, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ming Zhang
- From the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dong-Ling Luo
- From the Department of Cardiology, the Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518033, China
- Corresponding authors.
| |
Collapse
|
7
|
Reges O, Dicker D, Haase CL, Finer N, Karpati T, Leibowitz M, Satylganova A, Feldman B. Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database. Obes Sci Pract 2020; 7:148-158. [PMID: 33841884 PMCID: PMC8019279 DOI: 10.1002/osp4.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/28/2020] [Indexed: 11/10/2022] Open
Abstract
Objective Previous studies using longitudinal weight data to characterize obesity are based on populations of limited size and mostly include individuals of all body mass index (BMI) levels, without focusing on weight changes among people with obesity. This study aimed to identify BMI trajectories over 5 years in a large population with obesity, and to determine the trajectories' association with mortality. Methods For inclusion, individuals aged 30–74 years at index date (1 January 2013) with continuous membership in Clalit Health Services from 2008 to 2012 were required to have ≥1 BMI measurement per year in ≥3 calendar years during this period, of which at least one was ≥30 kg/m2. Latent class analysis was used to generate BMI trajectories over 5 years (2008–2012). Cox proportional hazards models were used to assess the association between BMI trajectories and all‐cause mortality during follow‐up (2013–2017). Results In total, 367,141 individuals met all inclusion criteria. Mean age was 57.2 years; 41% were men. The optimal model was a quadratic model with four classes of BMI clusters. Most individuals (90.0%) had stable high BMI over time. Individuals in this cluster had significantly lower mortality than individuals in the other trajectory clusters (p < 0.01), including clusters of people with dynamic weight trajectories. Conclusions The results of the current study show that people with stable high weight had the lowest mortality of all four BMI trajectories identified. These findings help to expand the scientific understanding of the impact that weight trajectories have on health outcomes, while demonstrating the challenges of discerning the cumulative effects of obesity and weight change, and suggest that dynamic historical measures of BMI should be considered when assessing patients' future risk of obesity‐related morbidity and mortality, and when choosing a treatment strategy.
Collapse
Affiliation(s)
- Orna Reges
- Clalit Research Institute Clalit Health Services Ramat Gan Israel.,Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago Illinois USA
| | - Dror Dicker
- Internal Medicine D Department and EASO Collaborating Center for Obesity Management Rabin Medical Center Hasharon Hospital Petach Tikva Israel.,Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | | | | | - Tomas Karpati
- Clalit Research Institute Clalit Health Services Ramat Gan Israel.,Holon Institute of Technology Holon Israel
| | - Morton Leibowitz
- Clalit Research Institute Clalit Health Services Ramat Gan Israel
| | | | - Becca Feldman
- Clalit Research Institute Clalit Health Services Ramat Gan Israel
| |
Collapse
|
8
|
Nano J, Dhana K, Asllanaj E, Sijbrands E, Ikram MA, Dehghan A, Muka T, Franco OH. Trajectories of BMI Before Diagnosis of Type 2 Diabetes: The Rotterdam Study. Obesity (Silver Spring) 2020; 28:1149-1156. [PMID: 32379398 PMCID: PMC7317538 DOI: 10.1002/oby.22802] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/22/2020] [Accepted: 03/05/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE People with diabetes show great variability in weight gain and duration of obesity at the time of diagnosis. BMI trajectories and other cardiometabolic risk factors prior to type 2 diabetes were investigated. METHODS A total of 6,223 participants from the Rotterdam Study cohort were included. BMI patterns before diagnosis of diabetes were identified through latent class trajectories. RESULTS During a mean follow-up of 13.7 years, 565 participants developed type 2 diabetes. Three distinct trajectories of BMI were identified, including the "progressive overweight" group (n = 481, 85.1%), "progressive weight loss" group (n = 59, 10.4%), and "persistently high BMI" group (n = 25, 4.4%). The majority, the progressive overweight group, was characterized by a steady increase of BMI in the overweight range 10 years before diabetes diagnosis. The progressive weight loss group had fluctuations of glucose and marked beta cell function loss. The persistently high BMI group was characterized by a slight increase in insulin levels and sharp increase of insulin resistance accompanied by a rapid decrease of beta cell function. CONCLUSIONS Heterogeneity of BMI changes prior to type 2 diabetes was found in a middle-aged and elderly white population. Prevention strategies should be tailored rather than focusing only on high-risk individuals.
Collapse
Affiliation(s)
- Jana Nano
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Institute of EpidemiologyHelmholtz Zentrum MunichGerman Research Center for
Environmental HealthNeuherbergGermany
- German Diabetes Center (DZD)Munich
Germany
| | - Klodian Dhana
- Department of Internal MedicineDivision of Geriatrics and Palliative MedicineRush Medical
CollegeChicagoIllinoisUSA
| | - Eralda Asllanaj
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Institute for
Community MedicineUniversity Medicine GreifswaldGreifswaldGermany
| | - Eric Sijbrands
- Department of
Internal MedicineErasmus University Medical CenterRotterdamThe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Abbas Dehghan
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of
Biostatistics and EpidemiologyMRC‐PHE Centre for Environment and HealthSchool of Public
HealthImperial College LondonLondonUK
- UK Dementia
Research Institute (UK DRI), Imperial College LondonLondonUK
| | - Taulant Muka
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Institute of
Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Oscar H. Franco
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Institute of
Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| |
Collapse
|
9
|
Dai H, Li F, Bragazzi NL, Wang J, Chen Z, Yuan H, Lu Y. Distinct developmental trajectories of body mass index and diabetes risk: A 5-year longitudinal study of Chinese adults. J Diabetes Investig 2020; 11:466-474. [PMID: 31454166 PMCID: PMC7078171 DOI: 10.1111/jdi.13133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/08/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022] Open
Abstract
AIMS/INTRODUCTION This longitudinal study aimed to explore whether distinct developmental trajectories of body mass index (BMI) would be predictive of diabetes risk in general Chinese adults. MATERIALS AND METHODS A total of 4,519 participants aged >18 years who were free of diabetes in 2011 (baseline of the current analysis) were enrolled in this study. All participants completed a medical examination every year during 2011-2016, and BMI levels were measured two to six (average 5.6) times. Group-based trajectory modeling was applied to identify BMI trajectories over time. New-onset diabetes was confirmed in 2016. RESULTS During 2011-2016, four distinct BMI trajectories were identified according to BMI range and changing pattern over time: "low" (19.6%), "moderate" (33.4%), "moderate-high" (33.4%) and "high" (13.6%). A total of 168 (3.7%) new-onset diabetes cases were confirmed in 2016. Compared with the "low" BMI trajectory, participants in the "high" BMI trajectory were at significantly higher risk for new-onset diabetes (adjusted relative risk 3.24, 95% confidence interval 1.27-8.24). Notably, BMI trajectories based on the first four or three annual BMI tests yielded similar results. By contrast, no significant correlation was found between categories of baseline BMI and new-onset diabetes in 2016 after multivariate adjustment. CONCLUSIONS The present results show that distinct BMI trajectories, even identified using just four or three annual BMI tests, are significantly associated with new-onset diabetes. Monitoring BMI trajectories over time might provide an important approach to identify subpopulations at higher risk for developing diabetes.
Collapse
Affiliation(s)
- Haijiang Dai
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
- Center for Disease ModelingDepartment of Mathematics and StatisticsYork UniversityTorontoOntarioCanada
| | - Fei Li
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Nicola Luigi Bragazzi
- Center for Disease ModelingDepartment of Mathematics and StatisticsYork UniversityTorontoOntarioCanada
| | - Jiangang Wang
- Department of Health ManagementThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Zhiheng Chen
- Department of Health ManagementThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Hong Yuan
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Yao Lu
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| |
Collapse
|
10
|
Luo J, Hodge A, Hendryx M, Byles JE. Age of obesity onset, cumulative obesity exposure over early adulthood and risk of type 2 diabetes. Diabetologia 2020; 63:519-527. [PMID: 31858184 DOI: 10.1007/s00125-019-05058-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/31/2019] [Indexed: 02/08/2023]
Abstract
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.
Collapse
Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th Street, Bloomington, IN, 47405, USA.
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
11
|
Yan G, Li F, Elia C, Zhao Y, Wang J, Chen Z, Yuan H, Lu Y. Association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes in Chinese adults: a cohort study. Nutr Metab (Lond) 2019; 16:72. [PMID: 31641369 PMCID: PMC6802349 DOI: 10.1186/s12986-019-0399-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/24/2019] [Indexed: 12/12/2022] Open
Abstract
Background Lipid accumulation product (LAP) is an index describing the overaccumulation of lipid. Baseline LAP was used for type 2 diabetes (T2D) prediction in previous studies. But the longitudinal trajectories of LAP, which reflect the efficacy of patients' lipid-lowering treatment and lifestyle improvement, have rarely been studied. The aim of this study is to explore the association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes. Methods This cohort study included 4508 non-diabetic participants with a median age of 42 years. Using the group-based trajectory modeling (GBTM), LAP from 2011 to 2016 were determined and identified as three trajectories: low (n = 3639), moderate (n = 800), and high (n = 69). Baseline LAP was divided into groups by percentiles and tertiles respectively for the comparison of LAP trajectories. The associations between 5-year T2D incidence and LAP trajectories and baseline LAP were both assessed by generalized linear models. Results From 2011 to 2016, 169 participants developed T2D (the 5-year incidence of 3.8%). For participants with low, moderate, and high trajectories, the incidence of T2D was 2.1, 10.0, and 15.9%, respectively. A significant trend was observed in the relative risks (RRs) of 5-year incident T2D in participants with moderate (RR, 1.95; 95% CI: 1.41-2.70) and high LAP trajectory (RR, 2.20; 95% CI: 1.12-4.30) in the fully adjusted model (p for trend< 0.001). However, there were no statically significant trends in RRs in different tertiles of baseline LAP found after full adjustments. Conclusion The trajectories of LAP has an independent effect on 5-year T2D incidence beyond LAP measured at baseline.
Collapse
Affiliation(s)
- Guangyu Yan
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Fei Li
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Christelle Elia
- 2Department of Life Science and Medicine, King's College London, WC2R 2LS, London, UK
| | - Yating Zhao
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Jiangguang Wang
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Zhiheng Chen
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Hong Yuan
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Yao Lu
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China.,2Department of Life Science and Medicine, King's College London, WC2R 2LS, London, UK
| |
Collapse
|
12
|
Ho HE, Yeh CJ, Chu WM, Lee MC. Midlife Body Mass Index Trajectory and Risk of Frailty 8 Years Later in Taiwan. J Nutr Health Aging 2019; 23:849-855. [PMID: 31641735 DOI: 10.1007/s12603-019-1226-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Few studies have focused on weight change and frailty, especially in Asia. This research aimed to evaluate midlife body mass index (BMI) trajectory and assess its relationship with frailty 8 years later in Taiwan. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS Data were retrieved from the Taiwan Longitudinal Study on Aging conducted from 1999 to 2007. The analysis was restricted to respondents aged between 50 to 69 years old, who were not frail in 1999 and were alive in 2007 (n=1609). MEASUREMENTS Frailty was defined using the Fried criteria. The group-based model of trajectory was used to estimate BMI trajectories among elderly participants. Logistic regression analysis was used to examine the association between BMI change and frailty. RESULTS Four trajectory classes were identified and each remained stable during the 8-year follow-up. There were 316 participants (20.3%) in the low-normal weight group (baseline BMI=20.38 kg/m2), 737 participants (44.7%) in the high-normal weight group (baseline BMI=23.22 kg/m2), 449 participants (28.4%) in the overweight group (baseline BMI=26.24 kg/m2), and 107 participants (6.6%) in the obesity group (baseline BMI=30.65 kg/m2). After adjustment for confounding factors, the low-normal weight group and obesity group were associated with increased frailty compared with the high-normal weight group. CONCLUSION Our results showed that the BMI trajectories of midlife individuals tended to be constant and those in both the low-normal weight group and obesity group had an increased risk of developing frailty in later life. Therefore, an optimal weight-targeting strategy should be considered for Asian elderly individuals.
Collapse
Affiliation(s)
- H-E Ho
- Meng-Chih Lee, Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Sec. 1, Sanmin Rd., West Dist., Taichung City 403, Taiwan, Phone No: 886-4-22294411, Fax No: 886-4-22229517, Email Address:
| | | | | | | |
Collapse
|
13
|
Sheikh Rezaei S, Weisshaar S, Litschauer B, Gouya G, Ohrenberger G, Wolzt M. ADMA and NT pro-BNP are associated with overall mortality in elderly. Eur J Clin Invest 2019; 49:e13041. [PMID: 30365159 PMCID: PMC6587535 DOI: 10.1111/eci.13041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/20/2018] [Accepted: 10/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Increased asymmetrical dimethylarginine (ADMA) and NT pro-BNP concentrations have been associated with mortality in patients with cardiovascular (CV) disease and the general population. The use of these prognostic markers in an older population is not established yet. The aim of the present study was to investigate the prognostic value of age, sex, BMI, co-medication and CV laboratory risk markers in geriatric care patients. MATERIALS AND METHODS In this prospective observational single-centre cohort study data of long-term geriatric care patients were collected. Blood samples were collected between 14.09.2009 and 16.12.2009, and mortality was recorded up to 90 months. ADMA, its symmetric isomer SDMA, L-arginine, NT pro-BNP and CRP were determined at study entry. Simple associations of risk factors for survival period were explored by Spearman correlation coefficient. Significant univariate predictors for survival period were used in the Cox proportional hazard model. RESULTS A total of 481 patients were screened, and data from 449 patients were analysed. A total of 381 patients died during the observation period. Full data sets from 344 patients were used for Cox regression analysis. Male sex, older age, lower BMI, use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA, NT pro-BNP, and CRP were significant predictors of mortality. CONCLUSION The concentration of ADMA and NT pro-BNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with increased mortality in this population.
Collapse
Affiliation(s)
| | - Stefan Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Brigitte Litschauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Ghazaleh Gouya
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
14
|
Rock AK, Opalak CF, Workman KG, Broaddus WC. Safety Outcomes Following Spine and Cranial Neurosurgery: Evidence From the National Surgical Quality Improvement Program. J Neurosurg Anesthesiol 2018; 30:328-336. [PMID: 29135700 DOI: 10.1097/ana.0000000000000474] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery. RESULTS There were 175,313 neurosurgical cases (137,029 spine, 38,284 cranial) identified. A total of 23,723 (13.5%) patients developed a complication and 2588 (1.5%) patients died. Compared with spine surgery, cranial surgery had higher likelihood of any complication (22.2% vs. 11.1%; P<0.001) and mortality (4.8% vs. 0.5%; P<0.001). In multivariable analysis, cranial surgery had 2.73 times higher likelihood for mortality compared with spine surgery (95% confidence interval, 2.46-3.03; P<0.001), but demonstrated lower odds of any complication (odds ratio, 0.93; 95% confidence interval, 0.90-0.97; P<0.001). There were 6 predictors (race, tobacco use, dyspnea, chronic obstructive pulmonary disease, chronic heart failure, and wound classification) significantly associated with any complication, but not mortality. Paradoxically, tobacco use had an unexplained protective effect on at least one complication or any complication. Similarly, increasing body mass index was protective for any complication and mortality, which suggests there may be a newly observed "obesity paradox" in neurosurgery. CONCLUSIONS After controlling for demographic characteristics, preoperative comorbidities, and perioperative factors, cranial surgery had higher risk for mortality compared with spine surgery despite lower risk for other complications. These findings highlight a discrepancy in the risk for postoperative complications following neurosurgical procedures that requires emphasis within quality improvement initiatives.
Collapse
Affiliation(s)
- Andrew K Rock
- Departments of Neurosurgery
- Physiology and Biophysics, Virginia Commonwealth University, Richmond, VA
| | | | | | - William C Broaddus
- Departments of Neurosurgery
- Physiology and Biophysics, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
15
|
Furer A, Afek A, Orr O, Gershovitz L, Landau Rabbi M, Derazne E, Pinhas-Hamiel O, Fink N, Leiba A, Tirosh A, Kark JD, Twig G. Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife. Cardiovasc Diabetol 2018; 17:80. [PMID: 29871640 PMCID: PMC5989357 DOI: 10.1186/s12933-018-0727-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/28/2018] [Indexed: 02/08/2023] Open
Abstract
Context Most studies linking long-term consequences of adolescent underweight and obesity are limited to men. Objective To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife. Setting A nationwide cohort. Participants 927,868 women, 1,366,271 men. Interventions Medical examination data at age 17, including BMI, were linked to the national death registry. Main outcomes Death attributed to cardiovascular (CVD) and non-CVD causes. Results During 17,346,230 women-years and 28,367,431 men-years of follow-up, there were 451 and 3208 CVD deaths, respectively, and 6235 and 22,223 non-CVD deaths, respectively. Compared to low-normal BMI (18.5–22.0 kg/m2), underweight women had a lower adjusted risk for CVD mortality (Cox hazard ratio (HR) = 0.68; 95% CI 0.46–0.98) in contrast to underweight men (HR = 0.99; 0.88–1.13). The latter were at higher risk for non-CVD mortality (HR = 1.04; 1.00–1.09), unlike underweight women (HR = 1.01; 0.93–1.10). Findings, which persisted when the study sample was limited to those with unimpaired health, were accentuated for the obese with ≥ 30 years follow-up. Both sexes exhibited similarly higher risk estimates already in the high-normal BMI range (22.0 ≤ BMI < 25.0 kg/m2) with overall no interaction between sex and BMI (p = 0.62). Adjusted spline models suggested lower BMI values for minimal mortality risk among women (16.8 and 18.2 kg/m2) than men (18.8 and 20.0 kg/m2), for CVD and non-CVD death, respectively. Conclusions Underweight adolescent females have favorable cardiovascular outcomes in adulthood. Otherwise the risk patterns were similar between the sexes. The optimal BMI value for women and men with respect to future CVD outcomes is within or below the currently accepted low-normal BMI range. Electronic supplementary material The online version of this article (10.1186/s12933-018-0727-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ariel Furer
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omri Orr
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Liron Gershovitz
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Moran Landau Rabbi
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Estela Derazne
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orit Pinhas-Hamiel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
| | - Noam Fink
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Adi Leiba
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel.,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat-Gan, Israel.,Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.,The Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeremy D Kark
- Hebrew University-Hadassah School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel
| | - Gilad Twig
- The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel. .,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel. .,The Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Medicine, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.
| |
Collapse
|