title: Extent of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation and glycated hemoglobin of 5.6-6.4.
abstract: OBJECTIVE
  Weight reduction improves glycemic control in obese men with glycated hemoglobin (HbA1c) of 5.6-6.4%, suggesting that it can prevent the development of diabetes in these patients. The aim of the present study was to quantify the amount of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation.
  
  
  METHODS
  The study participants were 482 men with an estimated visceral fat area of ≥100 cm(2), HbA1c of 5.6-6.4%, fasting plasma glucose (FPG) of <126 mg/dL or casual plasma glucose <200 mg/dL. They were divided into two groups based on weight change at the end of the 3-year follow-up period (weight gain and weight loss groups). The weight loss group was classified into quartile subgroups (lowest group, 0 to <1.2%: second lowest group, ≥1.2 to <2.5%: second highest group, ≥2.5 to <4.3%: highest group, ≥4.3% weight loss). The development of diabetes at the end-point represented a rise in HbA1c to ≥6.5% or FPG ≥126 mg/dL, or casual plasma glucose ≥200 mg/dL.
  
  
  RESULTS
  The cumulative incidence of diabetes at the end of the 3-year follow-up period was 16.2% in the weight gain group and 10.1% in the weight loss group (P not significant). The incidence of diabetes was significantly lower in the highest weight loss group (3.1%), but not in the second highest, the second lowest and the lowest weight loss groups (9.7, 10.1 and 18.3%), compared with the weight gain group.
  
  
  CONCLUSIONS
  Minimization of the risk of diabetes in Japanese men with visceral fat accumulation requires a minimum of 4-5% weight loss in those with HbA1c of 5.6-6.4%.
authors.affiliation: Departments of Metabolic Medicine, Graduate School of Medicine, Osaka University Suita, Osaka, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwahashi
authors.affiliation: Amagasaki City Office, General Affairs Bureau, Personal Department, Payroll Section, Employee Health Promotion Section Amagasaki, Hyogo, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Noguchi
authors.affiliation: Departments of Metabolic Medicine, Graduate School of Medicine, Osaka University Suita, Osaka, Japan.
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Okauchi
authors.affiliation: Amagasaki City Office, General Affairs Bureau, Personal Department, Payroll Section, Employee Health Promotion Section Amagasaki, Hyogo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Morita
authors.affiliation: Departments of Metabolic Medicine, Graduate School of Medicine, Osaka University Suita, Osaka, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Imagawa
authors.affiliation: Departments of Metabolic Medicine, Graduate School of Medicine, Osaka University Suita, Osaka, Japan.
authors.forename: Iichiro
authors.initials: I
authors.lastname: Shimomura
keywords: Diabetes prevention; Visceral fat accumulation; Weight reduction