title: Duration and degree of weight change and risk of incident diabetes: Japan Epidemiology Collaboration on Occupational Health Study.
abstract: We prospectively examined diabetes risk in association with a summary measure of degree and duration of weight change. The study participants were 51,777 employees from multiple companies in Japan, who were aged 30-59years, free of diabetes at baseline, and followed up for 7years (2008-2015). Exposure was cumulative body mass index (BMI)-years, which was defined as the area of BMI units above or below baseline BMI during follow-up, and was treated as a time-dependent variable in the Cox proportional hazards regression models. During the 263,539 person-years of follow-up, 3465 participants developed diabetes. The adjusted hazard ratio (HR) of diabetes for a 1-unit increase in cumulative BMI-years was 1.11 (95% confidence interval (CI): 1.09, 1.12). The association was more pronounced among overweight (HR=1.11; 95% CI: 1.08, 1.14) and obese (HR=1.12; 95% CI: 1.08, 1.15) adults compared with normal- and under-weight (HR=1.07; 95% CI: 1.03, 1.11) adults (P for interaction of cumulative BMI-years X baseline BMI-group=0.002). The association of higher cumulative BMI-years with incident diabetes did not substantially differ by metabolic phenotype. The present results emphasize the importance of avoiding additional weight gain over an extended period of time for the prevention of type 2 diabetes, especially among overweight and obese adults, irrespective of metabolic health status.
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: hu.huanhuan@yahoo.com.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Hu
authors.affiliation: All Japan Labour Welfare Foundation, Tokyo, Japan.
authors.forename: Satsue
authors.initials: S
authors.lastname: Nagahama
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanri
authors.affiliation: Mitsubishi Plastics, Inc., Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kuwahara
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Imai
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishihara
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kashino
authors.affiliation: Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogasawara
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Eguchi
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kochi
authors.affiliation: Nippon Steel & Sumitomo Metal Corporation Kimitsu Works, Chiba, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Honda
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Yamaha Corporation, Shizuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uehara
authors.affiliation: Yamaha Corporation, Shizuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Hori
authors.affiliation: Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Nishiura
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kabe
authors.affiliation: Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: National Institute of Public Health, Saitama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kunugita
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Dohi
mesh_terms: D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*
keywords: Body mass index; Diabetes; Epidemiology; Obesity