Long-term weight change in adulthood and incident diabetes mellitus: MY Health Up Study

Abstract

Aim: To investigate whether long-term weight/BMI change in adulthood has a significant impact on the incidence of diabetes, independent of attained weight status.

Methods: A number of 13,700 participants (2962 men and 10,738 women) aged 36 to 55 years were followed for up to 5 years using data from annual health checkups. Incident cases of diabetes were identified from self-reports or single fasting plasma glucose measurements (≥7.0 mmol/l). Weight/BMI change was calculated from participants' weight/BMI values at age 20 years and weight/BMI values at a given point during follow-up and used as a time-dependent variable in age-stratified multivariate Cox proportional hazards models.

Results: During the 5 year follow-up, 408 participants (137 men and 271 women) developed diabetes. Even after adjusting for BMI during follow-up and other possible confounders, weight/BMI gain since age 20 years was significantly associated with an increased risk of developing diabetes. The hazard ratios were: 2.30 (95% confidence interval (CI): 1.31-4.04) for those who gained 6.0 to <10.0 kg and 3.09 (95% CI: 1.79-5.34) for those who gained ≥10.0 kg [reference: <2.0 kg change]; and 2.61 (95% CI: 1.58-4.31) for those who gained 3.0 to <5.0 kg/m(2) and 3.70 (95% CI: 2.22-6.16) for those who gained ≥5.0 kg/m(2) [reference: <1.0 kg/m(2) change].

Conclusions: The results indicate that long-term weight/BMI gain in adulthood is a significant predictor for the development of diabetes, independent of attained weight status. Because weight gain within the normal weight range could increase the risk of diabetes, non-obese people should also be warned against possible weight gain.

Keywords: Body mass index; Body weight changes; Diabetes mellitus; Obesity; Weight gain.