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Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey

INTRODUCTION: This longitudinal study aims to characterize distinct body mass index (BMI) trajectories during early to mid-life adulthood and to explore the association between BMI change from young adulthood to midlife and incident diabetes. RESEARCH DESIGN AND METHODS: This study included 7289 adu...

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Autores principales: Lv, Jiali, Fan, Bingbing, Wei, Mengke, Zhou, Guangshuai, Dayimu, Alim, Wu, Zhenyu, Su, Chang, Zhang, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202728/
https://www.ncbi.nlm.nih.gov/pubmed/32327441
http://dx.doi.org/10.1136/bmjdrc-2019-000972
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author Lv, Jiali
Fan, Bingbing
Wei, Mengke
Zhou, Guangshuai
Dayimu, Alim
Wu, Zhenyu
Su, Chang
Zhang, Tao
author_facet Lv, Jiali
Fan, Bingbing
Wei, Mengke
Zhou, Guangshuai
Dayimu, Alim
Wu, Zhenyu
Su, Chang
Zhang, Tao
author_sort Lv, Jiali
collection PubMed
description INTRODUCTION: This longitudinal study aims to characterize distinct body mass index (BMI) trajectories during early to mid-life adulthood and to explore the association between BMI change from young adulthood to midlife and incident diabetes. RESEARCH DESIGN AND METHODS: This study included 7289 adults who had repeatedly measured BMI 3–9 times during 1989–2011 and information on incident diabetes. Latent class growth mixed model (LCGMM) was used to identify different BMI trajectories. Cox proportional hazard models were used to investigate the association between the trajectory group membership and incident hyperglycemia, adjusting for covariates. The hyperglycemia group included individuals with prediabetes or diabetes. The model-estimated BMI levels and slopes were calculated at each age point in 1-year intervals according to the model parameters and their first derivatives, respectively. Logistic regression analyses were used to examine the association of model-estimated levels and slopes of BMI at each age point with incident hyperglycemia. The area under the curve (AUC) was computed from longitudinal growth curve models during the follow-up for each individual. Prior to the logistic regression analyses, quartiles of total, baseline, and incremental AUC values were calculated. RESULTS: Three distinct trajectories were characterized by LCGMM, comprising of low-increasing group (n=5136), medium-increasing group (n=1914), and high-increasing group (n=239). Compared with the low-increasing group, adjusted HRs and 95% CIs were 1.21 (0.99 to 1.48) and 1.56 (1.06 to 2.30) for the medium-increasing and the high-increasing group, respectively. The adjusted standardized ORs of model-estimated BMI levels increased among 20–50 years, ranging from 0.98 (0.87 to 1.10) to 1.19 (1.08 to 1.32). The standardized ORs of level-adjusted linear slopes increased gradually from 1.30 (1.16 to 1.45) to 1.42 (1.21 to 1.67) during 20–29 years, then decreased from 1.41 (1.20 to 1.66) to 1.20 (1.08 to 1.33) during 30–43 years, and finally increased to 1.20 (1.04 to 1.38) until 50 years. The fourth quartile of incremental AUC (OR=1.31, 95% CI 1.03 to 1.66) was significant compared with the first quartile, after adjustment for covariates. CONCLUSIONS: These findings indicate that the BMI trajectories during early adulthood were significantly associated with later-life diabetes. Young adulthood is a crucial period for the development of diabetes, which has implications for early prevention.
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spelling pubmed-72027282020-05-13 Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey Lv, Jiali Fan, Bingbing Wei, Mengke Zhou, Guangshuai Dayimu, Alim Wu, Zhenyu Su, Chang Zhang, Tao BMJ Open Diabetes Res Care Obesity Studies INTRODUCTION: This longitudinal study aims to characterize distinct body mass index (BMI) trajectories during early to mid-life adulthood and to explore the association between BMI change from young adulthood to midlife and incident diabetes. RESEARCH DESIGN AND METHODS: This study included 7289 adults who had repeatedly measured BMI 3–9 times during 1989–2011 and information on incident diabetes. Latent class growth mixed model (LCGMM) was used to identify different BMI trajectories. Cox proportional hazard models were used to investigate the association between the trajectory group membership and incident hyperglycemia, adjusting for covariates. The hyperglycemia group included individuals with prediabetes or diabetes. The model-estimated BMI levels and slopes were calculated at each age point in 1-year intervals according to the model parameters and their first derivatives, respectively. Logistic regression analyses were used to examine the association of model-estimated levels and slopes of BMI at each age point with incident hyperglycemia. The area under the curve (AUC) was computed from longitudinal growth curve models during the follow-up for each individual. Prior to the logistic regression analyses, quartiles of total, baseline, and incremental AUC values were calculated. RESULTS: Three distinct trajectories were characterized by LCGMM, comprising of low-increasing group (n=5136), medium-increasing group (n=1914), and high-increasing group (n=239). Compared with the low-increasing group, adjusted HRs and 95% CIs were 1.21 (0.99 to 1.48) and 1.56 (1.06 to 2.30) for the medium-increasing and the high-increasing group, respectively. The adjusted standardized ORs of model-estimated BMI levels increased among 20–50 years, ranging from 0.98 (0.87 to 1.10) to 1.19 (1.08 to 1.32). The standardized ORs of level-adjusted linear slopes increased gradually from 1.30 (1.16 to 1.45) to 1.42 (1.21 to 1.67) during 20–29 years, then decreased from 1.41 (1.20 to 1.66) to 1.20 (1.08 to 1.33) during 30–43 years, and finally increased to 1.20 (1.04 to 1.38) until 50 years. The fourth quartile of incremental AUC (OR=1.31, 95% CI 1.03 to 1.66) was significant compared with the first quartile, after adjustment for covariates. CONCLUSIONS: These findings indicate that the BMI trajectories during early adulthood were significantly associated with later-life diabetes. Young adulthood is a crucial period for the development of diabetes, which has implications for early prevention. BMJ Publishing Group 2020-04-22 /pmc/articles/PMC7202728/ /pubmed/32327441 http://dx.doi.org/10.1136/bmjdrc-2019-000972 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Obesity Studies
Lv, Jiali
Fan, Bingbing
Wei, Mengke
Zhou, Guangshuai
Dayimu, Alim
Wu, Zhenyu
Su, Chang
Zhang, Tao
Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title_full Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title_fullStr Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title_full_unstemmed Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title_short Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
title_sort trajectories of early to mid-life adulthood bmi and incident diabetes: the china health and nutrition survey
topic Obesity Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202728/
https://www.ncbi.nlm.nih.gov/pubmed/32327441
http://dx.doi.org/10.1136/bmjdrc-2019-000972
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