title: Changes in BMI, duration of overweight and obesity, and glucose metabolism: 45 years of follow-up of a birth cohort.
abstract: OBJECTIVE
  Long-term implications of childhood obesity and BMI change over the life course for risk of type 2 diabetes remain uncertain. The objective was to establish whether there are effects on adult glucose metabolism of 1) sensitive periods of BMI gain or 2) long duration of overweight and obesity.
  
  
  METHODS
  Participants in the 1958 British birth cohort with child to adult BMI and glycosylated hemoglobin (HbA(1c)) at 45 years (n = 7,855).
  
  
  RESULTS
  Prevalence of type 2 diabetes or HbA(1c) ≥7 was 2%. BMI gains in child- and adulthood were associated with higher HbA(1c): for every SD of 5-year BMI increase from 0 to 7 years, there was a 75% (95% CI 1.42-2.16) increased risk of HbA(1c) ≥7, increasing to a 4.7-fold (3.12-7.00) risk for the interval 23-33 years. Associations for BMI gain in adulthood were related to attained BMI but were independent for the longer period birth (or 7 years) to 45 years. Duration of obesity was also associated with HbA(1c); compared with the never obese, those with childhood onset had a 23.9-fold risk (13.5-42.1) of HbA(1c) ≥7%; odds ratios were 16.0 (10.6-24.2) and 2.99 (1.77-5.03), respectively, for young and midadulthood onset. Similar trends by onset age were found in mean HbA(1c) levels and for onset of overweight. Those with the earliest age of onset had higher BMI and waist circumference at 45 years, which markedly explained the associations for onset age and HbA(1c).
  
  
  CONCLUSIONS
  Excessive BMI gain across the life span and earlier onset of overweight/obesity are associated with impaired glucose metabolism, in part through attained adult BMI.
authors.affiliation: MRCCentre of Epidemiology for Child Health, University College London Institute of Child Health, London, UK. c.power@ich.ucl.ac.uk
authors.forename: Chris
authors.initials: C
authors.lastname: Power
authors.forename: Claudia
authors.initials: C
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism*; D050177:Overweight / Q000453:epidemiology* / Q000378:metabolism*; D055105:Waist Circumference / Q000502:physiology; D055815:Young Adult
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin