BMI Trajectories as a Harbinger of Pre-Diabetes or Underdiagnosed Diabetes: an 18-Year Retrospective Cohort Study in Taiwan

Chiu, Ching Ju; Li, Siao Ling; Wu, Chih Hsing; Du, Ye

doi:10.1007/s11606-016-3750-y

Cited by 15 publications

(13 citation statements)

References 36 publications

(38 reference statements)

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“…Previous studies, including the Bogalusa Heart Study, have indicated that glucose and insulin levels during adolescence are mediated by these factors, independent of adiposity [23–25]. The findings from this and previous studies suggest that adolescence is a critical temporal window for BMI control to reduce the risk of adult hyperglycaemia [11, 13–16, 26–29]. …”

Section: Discussionsupporting

confidence: 49%

Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study

Zhang

et al. 2018

Diabetologia

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Aims/hypothesis The aim of this study was to characterise longitudinal profiles of BMI from childhood and to examine the impact of level-independent childhood BMI trajectories on adult type 2 diabetes. Methods The longitudinal cohort consisted of 2449 adults (1613 white and 836 black) who had their BMI measured between four and 15 times from childhood (4–19 years) to adulthood (20–51 years) and fasting glucose measured in adulthood. Model-estimated levels and linear slopes of BMI at childhood age points were calculated in 1-year intervals using growth-curve parameters and their first derivatives, respectively. Results BMI from childhood to adulthood fit cubic growth curves; linear and non-linear curve parameters differed significantly between race–sex groups. BMI showed race and sex differences from 15 years onwards. Individuals with hyperglycaemia had higher long-term BMI levels than those who were normoglycaemic in race–sex groups. Linear and non-linear slope parameters of BMI differed consistently and significantly between adult hyperglycaemia groups. The OR of childhood BMI levels for ages 4–19 years was 1.45–1.83 (p<0.001 for all) for adult hyperglycaemia after adjustment for confounders. Level-adjusted linear slopes of BMI at ages 10–19 years showed significantly positive associations with adult hyperglycaemia (OR 1.17–1.50, p<0.01 for all). The associations of childhood BMI linear slopes with adult hyperglycaemia were not significant during the age period 5–9 years. The trends in these associations were consistent across race–sex groups. Conclusions/interpretation These observations indicate that childhood BMI trajectories have a significant impact on adult diabetes, independent of BMI levels. The adolescence age period is a crucial window for the development of diabetes in later life, which has implications for early-life prevention. Data availability All data and materials are publicly available at the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository and can be accessed at https://biolincc.nhlbi.nih.gov/studies/bhs.

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Section: Discussionsupporting

confidence: 49%

Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study

Zhang

et al. 2018

Diabetologia

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“…For those studies directly carried out with general adults, three of them only showed the developmental trajectories of BMI before the diagnosis of diabetes, without examining the relative risk of diabetes across distinct BMI trajectories. In another study consisting of 24,875 Australian adults, Peter et al .…”

Section: Discussionmentioning

confidence: 99%

“…For those studies directly carried out with general adults, three of them [34][35][36] only showed the developmental trajectories of BMI before the diagnosis of diabetes, without examining the relative risk of diabetes across distinct BMI trajectories. In another study consisting of 24,875 Australian adults, Peter et al 37 showed that the incidence of diabetes was different across distinct BMI trajectories; however, this study did not adjust for potential covariates in the regression models.…”

Section: Discussionmentioning

confidence: 99%

Distinct developmental trajectories of body mass index and diabetes risk: A 5‐year longitudinal study of Chinese adults

Dai

Bragazzi

et al. 2019

J of Diabetes Invest

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Aims/Introduction This longitudinal study aimed to explore whether distinct developmental trajectories of body mass index (BMI) would be predictive of diabetes risk in general Chinese adults. Materials and Methods A total of 4,519 participants aged >18 years who were free of diabetes in 2011 (baseline of the current analysis) were enrolled in this study. All participants completed a medical examination every year during 2011–2016, and BMI levels were measured two to six (average 5.6) times. Group‐based trajectory modeling was applied to identify BMI trajectories over time. New‐onset diabetes was confirmed in 2016. Results During 2011–2016, four distinct BMI trajectories were identified according to BMI range and changing pattern over time: “low” (19.6%), “moderate” (33.4%), “moderate‐high” (33.4%) and “high” (13.6%). A total of 168 (3.7%) new‐onset diabetes cases were confirmed in 2016. Compared with the “low” BMI trajectory, participants in the “high” BMI trajectory were at significantly higher risk for new‐onset diabetes (adjusted relative risk 3.24, 95% confidence interval 1.27–8.24). Notably, BMI trajectories based on the first four or three annual BMI tests yielded similar results. By contrast, no significant correlation was found between categories of baseline BMI and new‐onset diabetes in 2016 after multivariate adjustment. Conclusions The present results show that distinct BMI trajectories, even identified using just four or three annual BMI tests, are significantly associated with new‐onset diabetes. Monitoring BMI trajectories over time might provide an important approach to identify subpopulations at higher risk for developing diabetes.

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“…Overaccumulation of ectopic lipids or hepatic fat causes serials of complex metabolic consequences [2–4] such as non-alcoholic fatty liver disease and insulin resistance, which will finally promote the development of diabetes. Recent studies have focused on diabetic correlations in longitudinal changes in multiple indices reflecting obesity and lipid metabolism, such as BMI [33, 34], visceral adiposity index [35], and lipids [36]. LAP combines waist measurements and fasting triglyceride (TG) levels, reflecting both the anatomic and physiological changes associated with lipid overaccumulation.…”

Section: Discussionmentioning

confidence: 99%

Association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes in Chinese adults: a cohort study

Yang

Elia

et al. 2019

Nutr Metab (Lond)

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Background Lipid accumulation product (LAP) is an index describing the overaccumulation of lipid. Baseline LAP was used for type 2 diabetes (T2D) prediction in previous studies. But the longitudinal trajectories of LAP, which reflect the efficacy of patients’ lipid-lowering treatment and lifestyle improvement, have rarely been studied. The aim of this study is to explore the association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes. Methods This cohort study included 4508 non-diabetic participants with a median age of 42 years. Using the group-based trajectory modeling (GBTM), LAP from 2011 to 2016 were determined and identified as three trajectories: low (n = 3639), moderate (n = 800), and high (n = 69). Baseline LAP was divided into groups by percentiles and tertiles respectively for the comparison of LAP trajectories. The associations between 5-year T2D incidence and LAP trajectories and baseline LAP were both assessed by generalized linear models. Results From 2011 to 2016, 169 participants developed T2D (the 5-year incidence of 3.8%). For participants with low, moderate, and high trajectories, the incidence of T2D was 2.1, 10.0, and 15.9%, respectively. A significant trend was observed in the relative risks (RRs) of 5-year incident T2D in participants with moderate (RR, 1.95; 95% CI: 1.41–2.70) and high LAP trajectory (RR, 2.20; 95% CI: 1.12–4.30) in the fully adjusted model (p for trend< 0.001). However, there were no statically significant trends in RRs in different tertiles of baseline LAP found after full adjustments. Conclusion The trajectories of LAP has an independent effect on 5-year T2D incidence beyond LAP measured at baseline.

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BMI Trajectories as a Harbinger of Pre-Diabetes or Underdiagnosed Diabetes: an 18-Year Retrospective Cohort Study in Taiwan

Cited by 15 publications

References 36 publications

Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study

Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study

Distinct developmental trajectories of body mass index and diabetes risk: A 5‐year longitudinal study of Chinese adults

Association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes in Chinese adults: a cohort study

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