title: Association of adiposity trajectories with insulin sensitivity and glycemic deterioration: a longitudinal study of rural Chinese twin adults.
abstract: OBJECTIVE
  To evaluate associations between adiposity trajectories over time and insulin sensitivity and glucose deterioration in a Chinese twin cohort.
  
  
  METHODS
  This study focused on 341 males and 292 females aged 20-50 years at baseline who had physical clinical examinations and oral glucose tolerance test at two time points with an average of 6 years apart. BMI, waist circumference, percent body fat (PBF), and percent trunk fat (PTF) trajectories were classified into five track groups based on age- and sex-specific tertiles at each visit. We calculated the odds of the insulin sensitivity index((0,120)) [ISI((0,120))] or glycemic deterioration at follow-up among five defined trajectories (tertile(baseline) → tertile(follow-up)) using generalized estimate equation models. Additionally, we applied structural equation models to examine genetic and environmental influences on adiposity, adiposity change over time (ACO), ISI((0,120)), and the interrelationships among them.
  
  
  RESULTS
  Participants with stable adiposity (BMI, waist circumference, PBF, and PTF) in the highest tertile or shifting to the highest tertile tended to have the lowest ISI((0,120)) at follow-up or experience glycemic deterioration. Genetic factors exerted the major influence on adiposity, but environmental factors unique to each twin contributed more strongly to ISI and ACO. Correlations between adiposity/ACO and insulin sensitivity were mainly due to environmental influences.
  
  
  CONCLUSIONS
  When adiposity stays or becomes high, insulin sensitivity falls and risk of glycemic deterioration rises. Additionally, we found that genetic factors exerted the major influence on adiposity, while environmental factors played the principal role for ACO and insulin sensitivity.
authors.affiliation: Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. rongliu606@gmail.com
authors.forename: Rong
authors.initials: R
authors.lastname: Liu
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Brickman
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Christoffel
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.forename: Guoying
authors.initials: G
authors.lastname: Wang
authors.forename: Lester
authors.initials: L
authors.lastname: Arguelles
authors.forename: Shanchun
authors.initials: S
authors.lastname: Zhang
authors.forename: Donald
authors.initials: D
authors.lastname: Zimmerman
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.forename: Xiping
authors.initials: X
authors.lastname: Xu
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Li
authors.forename: Houxun
authors.initials: H
authors.lastname: Xing
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
mesh_terms: D050154:Adiposity / Q000235:genetics*; D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004200:Diseases in Twins / Q000453:epidemiology*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics* / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D012424:Rural Population
chemical_list: D001786:Blood Glucose