Abstract
PurposeTo evaluate the effect of fluctuations in waist circumference (WC), weight, and body mass index (BMI) on the incidence of diabetes in older adults.Patients and methodsA prospective cohort of 61,587 older adults (age, 60–96 years) who did not have diabetes at study initiation was examined. Data on weight, BMI, and WC were collected, and participants were followed up until 31 December 2018. The main end point was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants.ResultsDuring a mean follow-up of 3.6 years, being overweight (HR [95% CI] 1.87 [1.62–2.17]), obesity (1.41 [1.26–1.59]), abdominal obesity (1.42 [1.28–1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66–2.25]) increased the risk of diabetes onset. Compared with older adults who “maintained normal WC”, those who “remained abdominally obese” (HR = 1.66), “became abdominally obese” (HR = 1.58), or “achieved normal WC” (HR = 1.36) were at a higher risk of diabetes onset, as well as those with an increase in WC > 3 cm or > 5% compared with the baseline level. Weight gain or loss > 6 kg or weight gain > 5%, increase or decrease in BMI > 2 kg/m2, or an increase in BMI > 10% were associated with a higher diabetes risk. The diabetes risk was reduced by 19% in overweight older adults who exercised daily.ConclusionFor older adults, WC, BMI, and healthy weight maintenance reduce the diabetes risk. The findings may provide evidence for developing guidelines of proper weight and WC control for older adults.
Highlights
Diabetes is a chronic non-communicable disease, and its prevalence is rapidly increasing globally
The diabetes risk was reduced by 19% in overweight older adults who exercised daily
Characteristics of patients with newly diagnosed diabetes Compared with older individuals without diabetes, those diagnosed with diabetes were younger; had a higher prevalence of hypertension; used statins more frequently; had a higher baseline body mass index (BMI), waist circumference (WC), and TG, fasting blood glucose (FBG), alanine transaminase (ALT), and aspartate transaminase (AST) levels; had lower total bilirubin (TBIL) levels; and had a lower frequency of smoking and daily drinking (P < 0.05) (Table1)
Summary
Diabetes is a chronic non-communicable disease, and its prevalence is rapidly increasing globally. The prevalence of overweight and obesity in Chinese adults tripled, from 11.7 to 29.2%, between 1991 and 2009 [2]. Overweight, obesity, and abdominal obesity are strong risk factors for diabetes in all age groups. In a 23-year-long prospective study of British men, increased body mass index (BMI) accounted for 26% of the increased incidence of type 2 diabetes (T2DM), Wu et al Nutrition & Metabolism (2021) 18:99 suggesting a strong link between obesity and diabetes risk [3]. It has been shown that weight gain is an independent risk factor for diabetes regardless of baseline BMI levels, and the risk positively correlates with the extent of weight gain. Weight is an important factor influencing the development of diabetes
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