[Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population].

Objective: To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 28 736 residents aged ≥50 years were included in Guangzhou. Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population. Adjustments on age, smoking, alcohol consumption, physical activity, education level, occupation, district of residence and body mass index etc., were made. Results: The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women, with the prevalence rates of diabetes as 13.1% and 13.7% in men and women, respectively. Compared to those with stable body weight, the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend<0.01). Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83, 95%CI:1.99-4.02) and women (OR=3.13, 95%CI: 2.47-3.96). Compared to those who reached the highest weight at age 20, those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes, with OR being 5.32 (95%CI: 1.92-14.8) in men and 3.41 (95%CI: 2.49-4.67) in women, respectively. Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women. Conclusion: Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population. The detrimental effect of obesity on diabetes might become significantly visible in the next decades.目的： 探讨成年早、中期体重变化与中老年糖尿病的相关性。 方法： 基于"广州生物库队列研究"（GBCS）平台，选取其中28 736例≥50岁广州市中老年人为研究对象，采用多因素logistic回归模型，分析调整年龄、吸烟、饮酒、体力活动、教育程度、职业、居住地、BMI后成年早中期体重变化、达到最重体重时的年龄等与糖尿病的关系。 结果： 研究对象年龄男性（64.3±6.7）岁，女性（61.0±7.0）岁，糖尿病患病率男、女性（13.1%和13.7%）基本一致。与体重基本不变组相比，男女性糖尿病患病风险均随其成年早、中期体重增加而增加（趋势检验P<0.01），以体重增加>20 kg组患糖尿病风险最高，男女性OR值分别为2.83（95%CI：1.99~4.02）和3.13（2.47~3.96）。与在20岁时已达到最高体重者相比，以40~49岁达到最重体重组糖尿病患病风险最高，男性OR=5.32（95%CI：1.92~14.8），女性OR=3.41（95%CI：2.49~4.67）。男女性成年后体重减少仅与中老年自报糖尿病有关，与新诊断糖尿病无关。 结论： 成年早、中期体重增加可增加中老年糖尿病患病风险，体重明显增重到发生糖尿病相隔时间可能为10~20年。.