Weight Change From Childhood to Early Adulthood and Diabetes Risk

Study Questions:

Does weight loss from childhood to early adulthood reduce future risk for type 2 diabetes?

Methods:

Data from the Copenhagen School Health Record Register were used for the present analysis. The database contains information (including mandatory medical exams) on almost all children who attended public or private schools in Copenhagen who were born during the period from 1930 through 1989. In 1968, this database was linked to the Danish Conscription Database, which includes men born during the period from 1939 through 1959 and includes information on height and weight during early adulthood. Height and weight were collected on participants at ages 7 and 12 years of age and again in early adulthood (ages 17-26 years). Overweight was defined in accordance with Centers for Disease Control and Prevention criteria. Data on type 2 diabetes status (at age ≥30 years, 6,710 persons) were obtained from the National Patient Register.

Results:

A total of 62,565 men were included in this study, of which 10.7% were diagnosed with type 2 diabetes during 1,969,165 person-years of follow-up. The prevalence of overweight increased from 5.4% at 7 years of age to 5.4% at age 13, and to 8.2% in early adulthood. Overweight at any age was positively associated with the risk of type 2 diabetes. These associations were stronger at older ages at overweight and at younger ages at diagnosis of type 2 diabetes. Men who had had remission of overweight before the age of 13 years had a risk of having type 2 diabetes diagnosed at 30-60 years of age that was similar to that among men who had never been overweight (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.75-1.21). As compared with men who had never been overweight, men who had been overweight at 7 and 13 years of age, but not during early adulthood had a higher risk of type 2 diabetes (HR, 1.47; 95% CI, 1.10-1.98), but their risk was lower than that among men with persistent overweight. For men persistently overweight versus never overweight, the risk of type 2 diabetes was more than fourfold (HR, 4.14; 95% CI, 3.57-4.79). An increase in body mass index between 7 years of age and early adulthood was associated with an increased risk of type 2 diabetes, even among men whose weight had been normal at 7 years of age.

Conclusions:

The authors concluded that childhood overweight at 7 years of age was associated with increased risks of adult type 2 diabetes only if it continued until puberty or later ages.

Perspective:

These data strongly support the need to prevent childhood overweight early and prior to puberty to lower the risk for type 2 diabetes in adulthood.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement

Keywords: Body Mass Index, Body Weight, Child, Diabetes Mellitus, Type 2, Metabolic Syndrome X, Overweight, Pediatric Obesity, Primary Prevention, Risk Assessment, Weight Loss


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