Impact of body mass index, metabolic health and weight change on incident diabetes in a Korean population.
OBJECTIVE
The aim of this study was to examine an impact of body mass index (BMI) and weight change on the risk of diabetes according to metabolic health status.


METHODS
Cohort study of 34,999 Korean men and women 30-59 years of age free of diabetes at baseline were followed-up annually or biennially for an average of 5.1 years. Being metabolically healthy was defined as not having any metabolic syndrome component.


RESULTS
During 176,878.6 person-years of follow-up, 889 participants developed diabetes (incidence rate 5.0 per 1000 person-years). Compared to metabolically healthy normal-weight individuals, the adjusted hazard ratios for diabetes in metabolically unhealthy obese and in metabolically healthy obese were 13.7 (95% confidence interval [CI] 9.8-19.0) and 2.7 (95% CI: 1.7-4.3), respectively. The aHR (95% CI) for incident diabetes for weight changes of <-0.9, 0.5 to 2.0, and ≥2.1 kg compared to a weight change of -0.9 to 0.4 kg (reference) were 0.80 (0.66-0.97), 0.99 (0.82-1.20), and 1.24 (1.02-1.49), respectively (P-trend<0.001).


CONCLUSIONS
In this large cohort of young and middle age Koreans, metabolic health status, obesity, and weight change were all independently associated with increased incidence of diabetes over 5 years of follow-up.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Hyun-Suk
HS
Jung
Yoosoo
Y
Chang
Kyung
K
Eun Yun
Chan-Won
CW
Kim
Eun-Suk
ES
Choi
Min-Jung
MJ
Kwon
Juhee
J
Cho
Yiyi
Y
Zhang
Sanjay
S
Rampal
Di
D
Zhao
Hyun
H
Soo Kim
Hocheol
H
Shin
Eliseo
E
Guallar
Seungho
S
Ryu
D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology