Effect of 3-year changes in adiposity measures on the pre-diabetes regression and progression: a community-based cohort study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Prediabetic State*/epidemiology ; Adiposity* ; Disease Progression*; Humans ; Male ; Female ; Middle Aged ; Iran/epidemiology ; Adult ; Cohort Studies ; Diabetes Mellitus, Type 2/epidemiology ; Body Mass Index ; Aged ; Waist Circumference

Aim: We assessed the impact of a 3-year change-percent in adiposity measures on regression and pre-diabetes (Pre-DM) progression among Iranian adults.
Methods: Three-year change-percent in body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and visceral adiposity index (VAI) were calculated for 1458 Pre-DM subjects (mean age of 53.0 ± 13.7, 46.8% men), participated in the third examination of the Tehran Lipid and Glucose Study (2006-2008). Multinomial logistic regression models were used to estimate relative risk ratios (RRRs) of the outcomes [i.e., regression to normal glucose regulation (NGR), persistence in Pre-DM, and progression to newly diagnosed type 2 diabetes (T2D)] across 3-year change categories of adiposity measures (i.e., ≥ 5% decrease, 0-5% decrease, increase).
Results: Over nine years of follow-up, 37.7 and 39.0% returned to NGR and progressed to T2D, respectively. Decreased BW (0-5 and ≥ 5%) was associated with regression to NGR (RRRs = 1.44, 95% CIs = 1.05-1.98, and 2.64, 1.63-4.28, respectively). Decreased BMI and WC ≥ 5% were also associated with regression to NGR (RRRs = 1.63, 95% CI = 1.01-2.64; 1.69, 1.20-2.37, respectively). Changes in WHR and VAI were not associated with Pre-DM regression or progression. Pre-DM subjects with ≥ 5% BW loss had a constant FSG level overtime and a lower overall mean of FSG (116 vs. 111 and 112 mg/dL, P = 0.023 and 0.009, respectively) and 2 h-SG (154 vs. 165 and 168 mg/dL) compared to those had 0-5% BW loss or BW gain.
Conclusion: Short-term management of adiposity measures increases the regression probability to NGR. Targeting BW loss seems a more potent predictor of Pre-DM reversion among the adiposity measures.
Competing Interests: Declarations Ethics approval and consent to participate Written informed consent was obtained from all participants. The ethics research committee of the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, approved the study protocol. The study protocol was carried out according to the relevant guidelines expressed in the Declaration of Helsinki. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)

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Keywords: Body weight; Normal glucose regulation; Pre-diabetes; Type 2 diabetes; Visceral adiposity index; Waist circumference
Local Abstract: [Publisher, French] WHAT IS ALREADY KNOWN ON THIS TOPIC?: Body weight (BW) reduction may affect the trend of prediabetes (Pre-DM) regression to normal glucose regulation (NGR) and progression to type 2 diabetes (T2D). It is not clear which adiposity measure [e.g., BW, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and visceral adiposity index (VAI)] can predict longitudinal Pre-DM outcomes better. WHAT THIS STUDY ADDS?: Decreased BW (0–5 and ≥ 5%) was associated with regression to NGR by 1.42 and 2.62-fold, respectively. Compared to 3-years BW loss, decreased BMI and WC (> 5% of initial values) moderately predicted probability of regression to NGR. Short-term change WHR and VAI were not associated with longitudinal Pre-DM outcomes. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY?: Short-term management of adiposity measures increases probability of regression to NGR, however, targeting BW loss seems to be more potent predictor of Pre-DM reversion.

Date Created: 20241113 Date Completed: 20241113 Latest Revision: 20241116

20241116

PMC11559074

10.1186/s12889-024-20680-w

39533278