title: Comparison of different aspects of BMI history to identify undiagnosed diabetes in Japanese men and women: Toranomon Hospital Health Management Center Study 12 (TOPICS 12).
abstract: OBJECTIVE
  To examine current BMI and various aspects of BMI history as pre-screening tools for undiagnosed diabetes in Japanese individuals.
  
  
  METHODS
  This cross-sectional study included 16 226 men and 7026 women aged 30-75 years without a self-reported history of clinician-diagnosed diabetes. We estimated the probability of having undiagnosed diabetes (fasting glucose ≥ 7.0 mmol/l and/or HbA1c ≥ 48 mmol⁄mol (≥ 6.5%) for the following variables: current BMI, BMI in the early 20s (BMI(20y)), lifetime maximum BMI (BMI(max)), change between BMI in the early 20s and current BMI (ΔBMI(20y-cur)), change between BMI in the early 20s and maximum BMI (ΔBMI(20y-max)), and change between lifetime maximum and current BMI (ΔBMI(max-cur)).
  
  
  RESULTS
  The prevalence of undiagnosed diabetes was 3.3% (771/23252) among participants. BMI(max) , ΔBMI(20y-max) and current BMI (1-sd increments) were more strongly associated with diabetes than the other factors (multivariate odds ratio 1.58 [95% CI 1.47-1.70] in men and 1.65 [95% CI 1.43-1.90] in women for BMI(max) ; multivariate odds ratio 1.47 [95% CI 1.37-1.58] in men and 1.61 [95% CI 1.41-1.84] in women for ΔBMI(20y-max) ; multivariate odds ratio 1.47 [95% CI 1.36-1.58] in men and 1.63 [95% CI 1.40-1.89] in women for current BMI). The probability of having diabetes was markedly higher in those with both the highest tertile of BMI(max) and greatest ΔBMI(20y-max) ; however, a substantially lower likelihood of diabetes was observed among individuals with the lowest and middle tertiles of current BMI (< 24.62 kg/m² in men and < 22.54 kg/m² in women).
  
  
  CONCLUSIONS
  Lifetime maximum BMI and BMI changes from early adulthood were strongly associated with undiagnosed diabetes. Adding BMI history to people's current BMI would improve the identification of individuals with a markedly higher probability of having undiagnosed diabetes.
authors.affiliation: Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yoshizawa
authors.forename: Y
authors.initials: Y
authors.lastname: Heianza
authors.forename: Y
authors.initials: Y
authors.lastname: Arase
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: S D
authors.initials: SD
authors.lastname: Hsieh
authors.forename: H
authors.initials: H
authors.lastname: Tsuji
authors.forename: O
authors.initials: O
authors.lastname: Hanyu
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: S
authors.initials: S
authors.lastname: Kodama
authors.forename: H
authors.initials: H
authors.lastname: Shimano
authors.forename: S
authors.initials: S
authors.lastname: Hara
authors.forename: H
authors.initials: H
authors.lastname: Sone
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006786:Hospitals, Urban; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000628:therapy; D050177:Overweight / Q000150:complications* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human