|Title||Associations of Body Mass Index and Waist Circumference in Young Adulthood with Later Life Incident Diabetes.|
|Publication Type||Journal Article|
|Year of Publication||2021|
|Authors||Nair N, Vittinghoff E, Pletcher MJ, Oelsner EC, Allen NB, Ndumele CE, West NA, Strotmeyer ES, Mukamal KJ, Siscovick DS, Biggs ML, Laferrère B, Moran AE, Zhang Y|
|Journal||J Clin Endocrinol Metab|
|Date Published||2021 Jul 24|
CONTEXT: The independent contribution of young adult exposure to overweight and obesity to later life incident diabetes is not well studied.
OBJECTIVE: To assess the associations of exposures to elevated body mass index (BMI) and waist circumference (WC) in young adulthood (ages 18 to 39 years) with incident diabetes later in life (≥40 years).
DESIGN: Pooled data from six US prospective cohorts (ARIC, CARDIA, CHS, Framingham Offspring, Health ABC, MESA).
SETTING: Population-based cohort studies.
PARTICIPANTS: 30,780 participants (56.1% female, 69.8% non-Hispanic White) without a diagnosis of diabetes by age 40.
INTERVENTIONS: We imputed BMI and WC trajectories from age 18 for every participant and estimated time-weighted average exposures to BMI or WC during young adulthood and later life.
MAIN OUTCOME MEASURE(S): Incident diabetes defined as fasting glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, or use of diabetes medications.
RESULTS: During a 9-year median follow-up, 4,323 participants developed incident diabetes. Young adult BMI and WC were associated with later life incident diabetes after controlling for later life exposures (hazard ratios [HR] 1.99 for BMI ≥30 kg/m 2 and 2.13 for WC >88cm [women]/>102cm [men] compared to normal ranges). Young adult homeostatic model of insulin resistance (HOMA-IR) mediated 49% and 44% of the association between BMI and WC with later life incident diabetes. HDL and triglycerides mediated a smaller proportion of these associations.
CONCLUSIONS: Elevated BMI and WC during young adulthood were independently associated with later life incident diabetes. Insulin resistance appears to be a key mediator.
|Alternate Journal||J Clin Endocrinol Metab|