Body Size and Shape Changes and the Risk of Diabetes in the Diabetes Prevention Program

Abstract

The researchers conducted this study to test the hypothesis that risk of type 2 diabetes is less following reductions in body size and central adiposity. The Diabetes Prevention Program (DPP) recruited and randomized individuals with impaired glucose tolerance to treatment with placebo, metformin, or lifestyle modification. Height, weight, waist circumference, and subcutaneous and visceral fat at L2-L3 and L4-L5 by computed tomography were measured at baseline and at 1 year. Cox proportional hazards models assessed by sex the effect of change in these variables over the 1st year of intervention upon development of diabetes over subsequent follow-up in a subset of 758 participants. Lifestyle reduced visceral fat at L2-L3 (men ؊24.3%, women ؊18.2%) and at L4-L5 (men ؊22.4%, women ؊17.8%), subcutaneous fat at L2-L3 (men ؊15.7%, women ؊11.4%) and at L4-L5 (men ؊16.7%, women ؊11.9%), weight (men ؊8.2%, women ؊7.8%), BMI (men ؊8.2%, women ؊7.8%), and waist circumference (men ؊7.5%, women ؊6.1%). Metformin reduced weight (؊2.9%) and BMI (؊2.9%) in men and subcutaneous fat (؊3.6% at L2-L3 and ؊4.7% at L4-L5), weight (؊3.3%), BMI (؊3.3%), and waist circumference (؊2.8%) in women. Decreased diabetes risk by lifestyle intervention was associated with reductions of body weight, BMI, and central body fat distribution after adjustment for age and self-reported ethnicity. Reduced diabetes risk with lifestyle intervention may have been through effects upon both overall body fat and central body fat but with metformin appeared to be independent of body fat. Diabetes 56:1680-1685, 2007 T ype 2 diabetes has rapidly become a global health problem (1). Moreover, diabetes is a major cause of morbidity and mortality from coronary artery, cerebrovascular, retinal, neurological, and renal complications (2,3). One solution may be to prevent or delay diabetes in at-risk populations (4 -6). The Diabetes Prevention Program (DPP), a multicenter randomized clinical trial, showed that this could be accomplished with lifestyle intervention or metformin among individuals with impaired glucose tolerance. At the end of 3.2 years, diabetes incidence rates were 10.8, 7.7, and 5.0 per 100 person-years in the placebo, metformin, and lifestyle intervention groups, respectively (this average duration of follow-up is 4 months longer than that reported in the primary outcome report [6]). Treatment effects were consistent by sex and race/ethnicity. Individuals who have type 2 diabetes are usually overweight or obese. Moreover, a central pattern of body fat distribution, particularly an increased amount of intraabdominal or visceral fat, is an independent risk factor for type 2 diabetes (7-17). The effect of lifestyle modification and metformin on body size and central obesity was assessed in the DPP by both anthropometric measurements and computed tomography (CT).In this article, we tested the hypothesis that reductions in body size and central adiposity over the 1st year are associated with a decreased risk in developing type 2 diabetes over subsequent fo...

The Pro12Ala variant at the peroxisome proliferator-activated receptor γ gene and change in obesity-related traits in the Diabetes Prevention Program

“…The CT instruments used included GE High Speed Advantage (GE Medical Systems, Waukesha, WI, USA; five centres), Picker PQ 5000 (TransAmerican Medical Imaging, Lindon, UT, USA; five centres), Siemens and Siemens Somatom Plus (Siemens, New York, NY, USA; two centres), GE 9800 (GE Medical Systems; three centres) and GE Highlite (GE Medical Systems; two centres). Two 10 mm thick axial images were obtained at the L2-3 and L4-5 disc spaces and used to define the different adipose compartments and areas by trained staff at a central reading facility (Health Sciences Centre, University of Colorado, Denver, CO, USA) as described previously [21].…”

Diabetes Risk Factor Screening in Adults Using Perkeni Questionnaire and Oral Glucose Tolerance Test in Socah County, Bangkalan

“…Higher fatty acids content in the body increases Resistin and Adiponectin, which in turn decreases the sensitivity of insulin receptors. Hence, they increase insulin resistance (Fujimoto et al 2007). Reduced abdominal circumference and BMI correlates with lower risk and occurrences of diabetes (Fujimoto et al 2007, Ndraha 2014.…”

“…Hence, they increase insulin resistance (Fujimoto et al 2007). Reduced abdominal circumference and BMI correlates with lower risk and occurrences of diabetes (Fujimoto et al 2007, Ndraha 2014. Out of 91 participants, more than 50% had increased risks for diabetes.…”

“…IGT is a transitional state between normal function and diabetes. People with IGT had increased risk of developing diabetes (Fujimoto et al 2007, PERKENI 2011. Risk factor screening and OGTT should be done as an early detection on high risk population to have early interventions such as lifestyle changes and pharmacological intervention (The Diabetes Prevention Program Research Group 2012).…”

“…Out of 91 participants, more than 50% had increased risks for diabetes. The risk factor screening test was used as a method of early recognition of increased risks and hopefully as a prevention method of diabetes (Fujimoto et al 2007, Hoerger et al 2007.…”