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从儿童期至成年早期超重的变化与2型糖尿病风险的关系
Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes


Lise G. Bjerregaard ... 糖尿病 妇产科和儿科 • 2018.04.05
相关阅读
• 儿童和青少年的心脏代谢风险与肥胖严重程度 • 儿童期体重减轻与2型糖尿病风险降低相关 • 新发2型糖尿病成年患者的体质指数与死亡率

摘要


背景

儿童期超重与成年期2型糖尿病风险增加相关。我们研究了在成年早期之前消除超重是否可以降低这种风险。

 

方法

我们在7岁、13岁和成年早期(17~26岁)测量了体重和身高的62,565名丹麦男性中开展了一项研究。根据美国疾病预防控制中心的标准定义超重。从一个全国性卫生登记系统获得关于2型糖尿病状态(在年龄≥30岁时,6,710人)的数据。

 

结果

在7岁(62,565人中的3,373人;5.4%)、13岁(62,565人中的3,418人;5.5%)或成年早期(62,565人中的5,108人;8.2%)时超重与2型糖尿病风险呈正相关;当超重时年龄大、诊断2型糖尿病时年龄小时,相关性更强。在13岁之前消除超重的男性中,在30~60岁被诊断为2型糖尿病的风险与从未超重的男性相似(风险比,0.96;95%置信区间[CI],0.75~1.21)。与从未超重的男性相比,在7岁和13岁时超重但在成年早期不超重的男性患2型糖尿病的风险较高(风险比,1.47;95% CI,1.10~1.98),但他们的风险低于持续超重的男性(风险比,4.14;95% CI,3.57~4.79)。从7岁至成年早期的体质指数增加与2型糖尿病风险增加相关,即使7岁时体重正常的男性亦如此。

 

结论

只有当超重持续至青春期或更大年龄时,7岁时的儿童期超重才与成年2型糖尿病风险增加相关(由欧盟资助)。





作者信息

Lise G. Bjerregaard, Ph.D., Britt W. Jensen, Ph.D., Lars Ängquist, Ph.D., Merete Osler, D.M.Sc., Thorkild I.A. Sørensen, D.M.Sc., and Jennifer L. Baker, Ph.D.
From the Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital (L.G.B., B.W.J., L.Ä, M.O., J.L.B.), and the Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, Faculty of Health and Medical Sciences (T.I.A.S., J.L.B.), and the Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences (T.I.A.S.), University of Copenhagen — all in Copenhagen. Address reprint requests to Dr. Bjerregaard at the Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark, or at lise.geisler.bjerregaard@regionh.dk.

 

参考文献

1. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343-1350.

2. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.

3. Zimmermann E, Bjerregaard LG, Gamborg M, Vaag AA, Sørensen TIA, Baker JL. Childhood body mass index and development of type 2 diabetes throughout adult life — a large-scale Danish cohort study. Obesity (Silver Spring) 2017;25:965-971.

4. Yeung EH, Zhang C, Louis GM, Willett WC, Hu FB. Childhood size and life course weight characteristics in association with the risk of incident type 2 diabetes. Diabetes Care 2010;33:1364-1369.

5. Park MH, Sovio U, Viner RM, Hardy RJ, Kinra S. Overweight in childhood, adolescence and adulthood and cardiovascular risk in later life: pooled analysis of three British birth cohorts. PLoS One 2013;8(7):e70684-e70684.

6. Juonala M, Magnussen CG, Berenson GS, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011;365:1876-1885.

7. Merten MJ. Weight status continuity and change from adolescence to young adulthood: examining disease and health risk conditions. Obesity (Silver Spring) 2010;18:1423-1428.

8. Power C, Thomas C. Changes in BMI, duration of overweight and obesity, and glucose metabolism: 45 years of follow-up of a birth cohort. Diabetes Care 2011;34:1986-1991.

9. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:766-781.

10. Kelsey MM, Zeitler PS. Insulin resistance of puberty. Curr Diab Rep 2016;16:64-64.

11. Stringhini S, Tabak AG, Akbaraly TN, et al. Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study. BMJ 2012;345:e5452-e5452.

12. Stringhini S, Batty GD, Bovet P, et al. Association of lifecourse socioeconomic status with chronic inflammation and type 2 diabetes risk: the Whitehall II prospective cohort study. PLoS Med 2013;10(7):e1001479-e1001479.

13. Shrewsbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity (Silver Spring) 2008;16:275-284.

14. Baker JL, Olsen LW, Andersen I, Pearson S, Hansen B, Sørensen TIA. Cohort profile: the Copenhagen School Health Records Register. Int J Epidemiol 2009;38:656-662.

15. Christensen GT, Molbo D, Ängquist LH, et al. Cohort profile: the Danish Conscription Database (DCD): a cohort of 728,160 men born from 1939 through 1959. Int J Epidemiol 2015;44:432-440.

16. Mortensen EL, Reinisch JM, Teasdale TW. Intelligence as measured by the WAIS and a military draft board group test. Scand J Psychol 1989;30:315-318.

17. Pedersen CB. The Danish Civil Registration System. Scand J Public Health 2011;39:Suppl:22-25.

18. Andersen TF, Madsen M, Jørgensen J, Mellemkjoer L, Olsen JH. The Danish National Hospital Register: a valuable source of data for modern health sciences. Dan Med Bull 1999;46:263-268.

19. Diabetes Foreningen. Diabetes in Denmark (http://diabetes.dk/presse/diabetes-i-tal/diabetes-i-danmark.aspx).

20. Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11 2002;2002:1-190.

21. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999;94:496-509.

22. Tirosh A, Shai I, Afek A, et al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011;364:1315-1325.

23. Hyppönen E, Power C, Smith GD. Prenatal growth, BMI, and risk of type 2 diabetes by early midlife. Diabetes Care 2003;26:2512-2517.

24. Lawlor DA, Davey Smith G, Clark H, Leon DA. The associations of birthweight, gestational age and childhood BMI with type 2 diabetes: findings from the Aberdeen Children of the 1950s cohort. Diabetologia 2006;49:2614-2617.

25. de Lauzon-Guillain B, Balkau B, Charles MA, Romieu I, Boutron-Ruault MC, Clavel-Chapelon F. Birth weight, body silhouette over the life course, and incident diabetes in 91,453 middle-aged women from the French Etude Epidemiologique de Femmes de la Mutuelle Generale de l’Education Nationale (E3N) Cohort. Diabetes Care 2010;33:298-303.

26. Bhargava SK, Singh Sachdev H, Fall CH, et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004;350:865-875.

27. Eriksson JG, Osmond C, Kajantie E, Forsén TJ, Barker DJ. Patterns of growth among children who later develop type 2 diabetes or its risk factors. Diabetologia 2006;49:2853-2858.

28. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-2374.

29. Aarestrup J, Bjerregaard LG, Gamborg M, et al. Tracking of body mass index from 7 to 69 years of age. Int J Obes (Lond) 2016;40:1376-1383.

30. Must A, Willett WC, Dietz WH. Remote recall of childhood height, weight, and body build by elderly subjects. Am J Epidemiol 1993;138:56-64.

31. Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health 2005;59:134-139.

32. Kristensen JK, Drivsholm TB, Carstensen B, Steding-Jensen M, Green A. Validation of methods to identify known diabetes on the basis of health registers. Ugeskr Laeger 2007;169:1687-1692. (In Danish.)

33. Svendsen OL. Should measurement of body composition influence therapy for obesity? Acta Diabetol 2003;40:Suppl 1:S250-S253.

34. Andersen LG, Baker JL, Sørensen TIA. Contributions of incidence and persistence to the prevalence of childhood obesity during the emerging epidemic in Denmark. PLoS One 2012;7(8):e42521-e42521.

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