title: The association of maximum body weight on the development of type 2 diabetes and microvascular complications: MAXWEL study.
abstract: BACKGROUND
  Obesity precedes the development of type 2 diabetes (T2D). However, the relationship between the magnitude and rate of weight gain to T2D development and complications, especially in non-White populations, has received less attention.
  
  
  RESULTS
  We determined the association of rate and magnitude of weight gain to age at T2D diagnosis (Age(T2D)), HbA1c at T2D diagnosis (HbA1c(T2D)), microalbuminuria, and diabetic retinopathy after adjusting for sex, BMI at age 20 years, lifestyles, family history of T2D and/or blood pressure and lipids in 2164 Korean subjects aged ≥30 years and newly diagnosed with diabetes. Body weight at age 20 years (Wt(20y)) was obtained by recall or from participants' medical, school, or military records. Participants recalled their maximum weight (Wt(max)) prior to T2D diagnosis and age at maximum weight (Age(max_wt)). The rate of weight gain (Rate(max_wt)) was calculated from magnitude of weight gain (ΔWt = Wt(max)-Wt(20y)) divided by ΔTime (Age(max_wt) -20 years). The mean Age(max_wt) and Age(T2D) were 41.5±10.9 years and 50.1±10.5 years, respectively. The Wt(20y) and Wt(max) were 59.9±10.5 kg and 72.9±11.4 kg, respectively. The Rate(max_wt) was 0.56±0.50 kg/year. After adjusting for risk factors, greater ΔWt and higher Rate(max_wt) were significantly associated with earlier Age(T2D), higher HbA1c(T2D) after additional adjusting for Age(T2D), and microalbuminuria after further adjusting for HbA1c(T2D) and lipid profiles. Greater ΔWt and higher Rate(max_wt) were also significantly associated with diabetic retinopathy.
  
  
  CONCLUSIONS
  This finding supports public health recommendations to reduce the risk of T2D and its complications by preventing weight gain from early adulthood.
authors: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea ; Division of General Medicine, Harvard Medical School, Boston, Massachusetts, United States of America ; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.
authors: Soo
authors: S
authors: Lim
authors: Kyoung Min
authors: KM
authors: Kim
authors: Min Joo
authors: MJ
authors: Kim
authors: Se Joon
authors: SJ
authors: Woo
authors: Sung Hee
authors: SH
authors: Choi
authors: Kyong Soo
authors: KS
authors: Park
authors: Hak Chul
authors: HC
authors: Jang
authors: James B
authors: JB
authors: Meigs
authors: Deborah J
authors: DJ
authors: Wexler
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human