科研之友
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摘要
Although adiposity is a well-known risk factor for type 2 diabetes among young and middle-aged adults, the relationship between diabetes and measures of body composition in older adults is unclear. Several measures of body composition change with aging. These changes include increased body mass index (BMI) and fat mass, loss of muscle mass, redistribution of adipose tissue, and height shrinkage. Because there is a high prevalence of obesity and diabetes in older aging adults, it is important to clarify the relationship between adiposity, changes in parameters of body composition, and diabetes risk in this population.
This prospective population-based study investigated the relationship between measures of overall body fat and fat distribution, changes in these measures, and the risk of incident type 2 diabetes in a population of 4193 men and women aged >= 65 years. This investigation is part of the Cardiovascular Health Study, a large population-based study of older ambulatory, noninstitutionalized adults. Anthropometric data on body composition measures and bioelectrical impedance data on fat mass were collected at baseline and anthropometric measurements repeated 3 years later. The presence of diabetes was defined by use of insulin or oral hypoglycemic agents, or a fasting glucose level >= 126 mg/dL. The participants were followed for a median of 12.4 years (range, 0.9-17.8 years). Of the 4193 participants, 2457 were women and 1736 were men.
Over the 12.4-year follow-up, there were 339 new cases of diabetes (7.1/1000 person-years). Comparison of the hazard ratios for women in the highest quintile of baseline measures of adiposity with those in the lowest showed that the following were strongly related to the risk of type 2 diabetes: BMI at baseline (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 2.3-6.2), BMI at 50 years of age (aHR; 3.2; 95% CI, 1.9-5.5), weight (aHR, 3.5; 95% CI, 2.1-5.7), fat mass (aHR, 3.3; 95% CI, 2.0-5.6), waist circumference (aHR, 3.6; 95% CI, 2.2-6.0), waist-hip ratio (aHR, 1.9; 95% CI, 1.1-3.2), and waist-height ratio (aHR, 3.6; 95% CI, 2.2-5.9). There was no significant statistical interaction with stratification of the data by gender or race. Stratification by age, however, showed that the HRs in participants aged >= 75 years were about half as large as those in patients aged 65 to 74 years. Compared to participants whose weight remained stable (+/- 2 kg) throughout the study period, those with the greatest weight gain (9 kg or more) from 50 years of age to baseline had a nearly 3-fold greater risk of developing type 2 diabetes during follow-up (aHR, 2.8; 95% CI, 1.9-4.3). Between baseline and the third annual visit, participants with a greater than 10-cm increase in waist size had an increased risk of developing type 2 diabetes (HR, 1.7; 95% CI, 1.1-2.8) compared to those with a gain or loss of 2 cm or less.
These findings show that measures of overall and central adiposity and weight gain are strongly associated with the risk of incident type 2 diabetes in both men and women during middle age and after the age of 65 years.
- 出版日期2010-11
- 单位西北大学
