Relationship between Weight Change after 20 years of Age and the Risk of NIDDM In the Urban Area / 대한내과학회지

ABSTRACT

OBJECTIVE: The role of obesity in the pathogenesis of NIDDM has long been recognized. However, the relation between weight change and risk for diabetes has been less well defined and earlier studies have shown inconsistent results. We conducted a cross-sectional study to evaluate the relationship between weight change after 20 years of age and the risk of NIDDM in the Korean urban population. METHODS: From April 1997 to February 1998, we examined 642 subjects among a total of 776 persons aged over 30 years living in Mokdong apartment area selected using a random cluster sampling method for the survey of the prevalence of diabetes in urban area. After 75g oral glucose tolerance test, they were diagnosed with normal glucose tolerance or diabetes by WHO criteria. We excluded the subjects with impaired glucose tolerance. We obtained the data about weight change since 20 years of age and measured the current weight, height and waist-hip ratio. RESULTS: 1) Among 642 subjects, 46 were diabetic and the prevalence of diabetes was significantly increased with the increase of BMI in both men and women but with the increase of waist-hip ratio only in women. 2) The weight gain between 25 and 30 years of age was significantly greater in the subjects aged 30-39 than the older age groups. 3) In both men and women, weight gain of greater than 10 kg after 30 years of age increased the risk of diabetes. In women, weight gain greater than 20 kg between 20 years of age and the time of maximal obesity also increased the risk of diabetes. However, the significant risk factors for diabetes were age in men, whereas age and waist-hip ratio in women by multiple logistic regression analysis. 4) In women, weight gain less than 10kg after 30 years of age decreased the risk of diabetes, independent of age, BMI and family history of diabetes. CONCLUSION: Moderate weight gain after 30 years of age in women reduced the risk of diabetes. Extreme weight gain after 30 years of age in both men and women is related with high prevalence of diabetes. And in women, weight gain associated with pregnancy and otherwise after 20 years of age increased the risk of diabetes. However, the significance was disappeared after adjustment for age, BMI and family history of diabetes. The prospective study about the relationship between weight changes and the risk of diabetes would be needed.