Dataset Information

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women.

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.

SUBMITTER: Luo J

PROVIDER: S-EPMC8005471 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women.

Luo Juhua J Hodge Allison A Hendryx Michael M Byles Julie E JE

Nutrition, metabolism, and cardiovascular diseases : NMCD 20201226 4

<h4>Background and aims</h4>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.<h4>Methods and results</h4>12,302 women enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) wer ...[more]

PMID: 33612383

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Project description:BackgroundThe prevalence of type 2 diabetes has been growing among younger and middle-aged adults in the United States. A portion of this increase for this age group may be attributable to shared type 2 diabetes risks with family members. How family history of type 2 diabetes history is associated with type 2 diabetes risk among younger and middle-aged adults is not well understood.MethodsThis population-based retrospective cohort study uses administrative, genealogical, and electronic medical records from the Utah Population Database. The study population comprises offspring born between 1970 and 1990 and living in the four urban Utah counties in the United States between 1990 and 2015. The sample comprises 360,907 individuals without a type 2 diabetes diagnosis and 14,817 with a diagnosis. Using multivariate logistic regressions, we estimate the relative risk (RR) of type 2 diabetes associated with the number of affected first- (FDRs), second- (SDRs), and third-degree (first cousin) relatives for the full sample and for Hispanic-specific and sex-specific subsets.ResultsIndividuals with 2+ FDRs with type 2 diabetes have a significant risk of type 2 diabetes in relation to those with no affected FDRs (RR = 3.31 [3.16, 3.48]). Individuals with 2+ versus no SDRs with type 2 diabetes have significant but lower risks (RR = 1.32 [1.25, 1.39]). Those with 2+ versus no affected first cousins have a similarly low risk (RR = 1.28 [1.21, 1.35]). Larger RRs are experienced by males (2+ vs. 0 FDRs, RR = 3.55) than females (2+ vs. 0 FDRs, RR = 3.18) (p < 0.05 for the interaction). These familial associations are partly mediated by the individual's own obesity.ConclusionsThe risks of type 2 diabetes are significantly associated with having affected first-, second-, and third-degree relatives, especially for men. One of the forces contributing to the rising patterns of type 2 diabetes among young and middle-aged adults is their connection to affected, often older, kin.

Project description:BackgroundExposure to persistent organic pollutants (POPs) may predispose to the development of type 2 diabetes (T2D), but prospective human evidence is scarce.ObjectivesWe investigated the association between plasma-POP concentrations in the late 1990s and incident T2D over 11 years of follow-up in the Nurses' Health Study II.DiscussionThree organochlorine pesticides and 20 polychlorinated biphenyls (PCBs) were measured in banked plasma from 793 case-control pairs of T2D. In a multiviarate-adjusted model, T2D ORs (95%CIs) comparing extreme POP tertiles (high vs. low) were 1.67 (1.24, 2.23; Ptrend < 0.001) for hexachlorobenzene (HCB), 3.62 (2.57, 5.11; Ptrend < 0.001) for β-hexachlorocyclohexane (β-HCH), 1.55 (1.13, 2.13; Ptrend = 0.05) for p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), and 1.95 (1.42, 2.69; Ptrend < 0.001) for total dioxin-like PCBs (DL-PCBs) which included 5 mono-ortho congeners, PCB-105, 118, 156, 157, and 167. Adjustment for previous weight change and body mass index (BMI) at blood draw attenuated these associations, but that for DL-PCBs remained (OR[95% CI] = 1.78[1.14, 2.76]; Ptrend = 0.006). Age, breastfeeding history, previous weight change and BMI at blood draw were significant predictors of plasma POP concentrations. In addition, we found significant interactions of POPs and weight change before blood draw on T2D risk. ORs (95%CIs) of T2D comparing extreme (high vs. low) POP groups were 2.00 (1.02, 3.92; Ptrend = 0.01) for HCB, 2.69 (1.34, 5.40; Ptrend < 0.001) for β-HCH, and 2.41 (1.22, 4.77; Ptrend < 0.001) for DL-PCBs in the lowest weight gain group, whereas these values were 1.29 (0.73, 2.28; Ptrend = 0.46; Pinteraction = 0.04) for HCB, 1.41 (0.77, 2.60; Ptrend = 0.24; Pinteraction = 0.003) for β-HCH, and 0.90 (0.50, 1.63; Ptrend = 0.61; Pinteraction = 0.01) for DL-PCBs in the highest weight-gain group.ConclusionsOur findings suggest that elevated POP exposure may have diabetogenic potential. These data also highlight the impact of lifestyle factors, especially history of weight gain, on circulating POP concentrations and their associations with subsequent T2D risk.

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Dataset Information

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women.

Background and aims

Methods and results

Conclusion

Publications

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women.

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