Abstract EP19: Obesity And Diabetes Risk According To Age Groups; An Analysis Of The National Health Screening Program For The People In Transition In Korea

Abstract

Objective: The prevalence of type 2 diabetes mellitus (DM) and obesity is increasing among young population. However, the effect of obesity on the development of diabetes in different age groups is unclear. Therefore, we assessed the risk of development of future DM in two different age groups without diabetes at baseline, according to baseline body mass index (BMI) and waist circumference (WC). Research Design and Methods: The Korean National Health Insurance Service record, a nationwide population-based cohort was used to retrospectively analyze 4,145,321 Korean adults without DM, who had national health screening in Korea between 2009 and 2014. We included participants with mean age of 40 (n=2,905,752) and 66 (n=1,239,569) years old. Participants were categorized into 5, and 6 groups based on their BMI and WC, respectively. Each participant was followed either until 2017 or until the new diagnosis of DM was made. We assessed the risk of developing DM based on BMI and WC. Obesity (O) was defined as BMI≥25. Abdominal obesity (AO) was defined as WC ≥ 90cm for men, and ≥85cm for women. Multiple confounding factors were adjusted for multivariable analysis. Results: The median duration of follow-up was 5.6 years. In a multivariable analysis, higher BMI and WC among subjects with a mean age of 40 were associated with a higher risk of developing DM in the future. There was a linear association between BMI, WC, and the risk of DM (BMI<18.5, ref; BMI≥30, HR 10.35, P trend <0.001; WC 75-80 cm, ref; WC≥100 cm, HR 3.23, P trend <0.001). A similar pattern was observed among patients with mean age 66 years old (BMI<18.5, ref; BMI≥30, HR 3.16, P trend <0.001; WC 75-80cm, ref; WC≥100, HR 1.98, P trend <0.001). When participants were categorized based on the presence of O and AO, AO had a stronger impact on the development of DM than O in the 66 years old group (O(-)/AO(-), ref; O(-)/AO(+), HR 1.55; O(+)/AO(-), HR 1.45; O(+)/AO(+), HR 2.09). At the same time, O had a stronger impact on DM development than AO in the 40 years old group. (O(-)/AO(-), ref; O(-)/AO(+), HR 2.18; O(+)/AO(-), HR 2.62; O(+)/AO(+), HR 4.94). Conclusions: Regardless of age, both obesity and abdominal obesity increase the risk of DM. Among younger people, obesity was associated with a higher impact on the risk of DM. In older adults, the presence of abdominal obesity might have a greater effect on the development of DM in the future.