title: Body size and shape changes and the risk of diabetes in the diabetes prevention program.
abstract: The researchers conducted this study to test the hypothesis that risk of type 2 diabetes is less following reductions in body size and central adiposity. The Diabetes Prevention Program (DPP) recruited and randomized individuals with impaired glucose tolerance to treatment with placebo, metformin, or lifestyle modification. Height, weight, waist circumference, and subcutaneous and visceral fat at L2-L3 and L4-L5 by computed tomography were measured at baseline and at 1 year. Cox proportional hazards models assessed by sex the effect of change in these variables over the 1st year of intervention upon development of diabetes over subsequent follow-up in a subset of 758 participants. Lifestyle reduced visceral fat at L2-L3 (men -24.3%, women -18.2%) and at L4-L5 (men -22.4%, women -17.8%), subcutaneous fat at L2-L3 (men -15.7%, women -11.4%) and at L4-L5 (men -16.7%, women -11.9%), weight (men -8.2%, women -7.8%), BMI (men -8.2%, women -7.8%), and waist circumference (men -7.5%, women -6.1%). Metformin reduced weight (-2.9%) and BMI (-2.9%) in men and subcutaneous fat (-3.6% at L2-L3 and -4.7% at L4-L5), weight (-3.3%), BMI (-3.3%), and waist circumference (-2.8%) in women. Decreased diabetes risk by lifestyle intervention was associated with reductions of body weight, BMI, and central body fat distribution after adjustment for age and self-reported ethnicity. Reduced diabetes risk with lifestyle intervention may have been through effects upon both overall body fat and central body fat but with metformin appeared to be independent of body fat.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA. dppmail@biostat.bsc.gwu.edu
authors.forename: Wilfred Y
authors.initials: WY
authors.lastname: Fujimoto
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Jablonski
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: Andrea
authors.initials: A
authors.lastname: Kriska
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: Steven
authors.initials: S
authors.lastname: Haffner
authors.forename: Robert
authors.initials: R
authors.lastname: Hanson
authors.forename: James O
authors.initials: JO
authors.lastname: Hill
authors.forename: Van
authors.initials: V
authors.lastname: Hubbard
authors.forename: E
authors.initials: E
authors.lastname: Stamm
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D049628:Body Size; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control*; D015444:Exercise; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014481:United States; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008687:Metformin