Abstract
It is well known that adiposity is a risk factor for insulin resistance and type 2 diabetes mellitus. In the present study, we aimed to investigate the associations of measures of adiposity with indices of glycemia and of glycemic variability over a 72-h period in non-diabetic older adults. This cross-sectional study was conducted in non-diabetic individuals from the Active and Healthy Aging Study (N = 228), Switchbox (N = 116), and the Growing Old Together Study (N = 94). Body mass index (BMI) and waist circumference were measured, and indices of glycemia and glycemic variability were derived from continuous glucose monitoring (CGM) using the Mini-Med® CGM system. Associations between adiposity and CGM were studied separately for the three cohorts, and derived estimates were subsequently meta-analyzed. After meta-analyzing the results from the separate cohorts, individuals with a higher BMI had higher levels of glycemia. Individuals with BMI between 30 and 35 kg/m2 had 0.28 mmol/L [95% confidence interval (CI): 0.12-0.44] higher 72 h-mean glucose concentration, 0.26 mmol/L (0.10-0.42) higher diurnal glucose (6:00 a.m. to 0:00 a.m.), and 0.39 mmol/L (0.19; 0.59) higher nocturnal glucose (3:00 a.m. to 6:00 a.m.) than participants with a normal weight (BMI 18.5-25 kg/m2). However, no associations were observed between higher BMI and glycemic variability. Results for glycemia and glycemic variability were similarly observed for a high waist circumference. High adiposity associates with constant higher mean glucose levels over the day in non-diabetic older adults.
Highlights
The prevalence of obesity, defined as a body mass index (BMI) above 30 kg/m2 [1, 2], is rapidly increasing worldwide, reaching pandemic proportions [3]
After meta-analyzing the data of the three cohorts (Table 3), we did not find evidence that a high adiposity level was associated with a higher intraday glycemic variability, but we found some evidence for a higher between-day glycemic variability
We observed that, based on data from three independent cohorts, the association between overweight/obesity and glycemia persists over the day, which was reflected by similar associations between overweight/obesity and diurnal, nocturnal and 72-mean glucose concentration
Summary
The prevalence of obesity, defined as a body mass index (BMI) above 30 kg/m2 [1, 2], is rapidly increasing worldwide, reaching pandemic proportions [3]. Obesity is a generally known, and causal, risk factor for the development of insulin resistance and type 2 diabetes mellitus (T2DM) [4], and weight loss is generally associated with a reduced incidence of T2DM in individuals with impaired glucose tolerance [2]. Among individuals without T2DM, indices of both glycemia and glycemic variability, measures that both reflect the dynamic aspects of glucose homeostasis, were higher in older individuals compared with younger individuals [12]. One cross-sectional study comprising 169 newly diagnosed T2DM patients of Chinese ancestry found evidence that a higher BMI was associated with a lower glycemic variability [13]. We aimed to investigate the associations of measures of adiposity with indices of glycemia and of glycemic variability over a 72-h period in non-diabetic older adults
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