Abstract
Little is known about the associations between long-term weight change and the natural history of impaired fasting glucose (IFG) in young adults. We investigated the association between long-term body mass index (BMI) change and the risk of IFG using data of 24,930 20- to 40-year-old participants from the Vorarlberg Health Monitoring and Promotion Program (VHM&PP) cohort. Poisson models were applied to estimate the 10-year risk for new development of IFG (≥5.6 mmol/L), and persistence of IFG. Over 10 years, most men (68.2%) and women (70.0%) stayed within their initial BMI category. The risk for incident IFG was highest for men and women with persisting obesity (37.4% and 24.1%) and lowest with persisting normal weight (15.7% and 9.3%). Men transitioning from normal to overweight increased their risk of incident IFG by factor 1.45 (95%-CI: 1.31, 1.62), women by 1.70 (95%-CI: 1.50, 1.93), whereas transitioning from overweight to normal weight decreased the risk in men by 0.69 (95%-CI: 0.53, 0.90) and 0.94 (95%-CI: 0.66, 1.33) in women. Relative risks for men and women transitioning from obesity to overweight were 0.58 and 0.44, respectively. In conclusion, 10 year weight increase was associated with an increased IFG risk, weight decrease with a decreased risk of IFG in young adults.
Highlights
In Austria the prevalence of overweight or obesity among adults is high and has been increasing during the past decades [1]
We modeled the risks for the development or persistence of impaired fasting glucose (IFG) associated with baseline body mass index (BMI) and BMI change using Poisson models with robust variance estimation
Adams et al found that subjects from Health-AARP Diet and Health Study were lean until the age of 18 years, but gained considerable weight until the age of 50 years [2]
Summary
In Austria the prevalence of overweight or obesity among adults is high (male: 50.0%, female: 39.6%) and has been increasing during the past decades [1]. Recent reports showed an increase of adiposity prevalence in young adults in Germany and Austria [3,4]. There is evidence that an early onset of overweight or obesity is associated with an augmented risk for developing the metabolic syndrome [7], type two diabetes mellitus (T2DM) [8] and vascular disease [9]. There is evidence that the age of onset of T2DM is falling [10] and that the risk due to obesity in young adults persists independently of later weight changes [11,12]
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