Risk of Type 2 Diabetes Among Individuals with Excess Weight: Weight Trajectory Effects.

IF 5.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Arthur H Owora, David B Allison, Xuan Zhang, Nana Gletsu-Miller, Kishore M Gadde
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引用次数: 0

Abstract

Purpose of review: Increased risk of type 2 diabetes mellitus (T2D) among individuals with overweight or obesity is well-established; however, questions remain about the temporal dynamics of weight change (gain or loss) on the natural course of T2D in this at-risk population. Existing epidemiologic evidence is limited to studies that discretely sample and assess excess weight and T2D risk at different ages with limited follow-up, yet changes in weight may have time-varying and possibly non-linear effects on T2D risk. Predicting the impact of weight change on the risk of T2D is key to informing primary prevention. We critically review the relationship between weight change, trajectory groups (i.e., distinct weight change patterns), and T2D risk among individuals with excess weight in recently published T2D prevention randomized controlled trials (RCTs) and longitudinal cohort studies.

Recent findings: Overall, weight trajectory groups have been shown to differ by age of onset, sex, and patterns of insulin resistance or beta-cell function biomarkers. Lifestyle (diet and physical activity), pharmacological, and surgical interventions can modify an individual's weight trajectory. Adolescence is a critical etiologically relevant window during which onset of excess weight may be associated with higher risk of T2D. Changes in insulin resistance and beta-cell function biomarkers are distinct but related correlates of weight trajectory groups that evolve contemporaneously over time. These multi-trajectory markers are differentially associated with T2D risk. T2D risk may differ by the age of onset and duration of excess body weight, and the type of weight loss intervention. A better understanding of the changes in weight, insulin sensitivity, and beta-cell function as distinct but related correlates of T2D risk that evolve contemporaneously over time has important implications for designing and targeting primary prevention efforts.

Abstract Image

超重个体的2型糖尿病风险:体重轨迹效应
综述目的:超重或肥胖人群患2型糖尿病(T2D)的风险增加已得到证实;然而,在这些高危人群中,体重变化(增加或减少)对T2D自然过程的时间动态影响仍然存在疑问。现有的流行病学证据仅限于对不同年龄的超重和T2D风险进行离散抽样和评估的研究,随访时间有限,但体重变化可能对T2D风险具有时变和非线性的影响。预测体重变化对T2D风险的影响是告知初级预防的关键。我们在最近发表的T2D预防随机对照试验(RCTs)和纵向队列研究中,对超重个体的体重变化、轨迹组(即不同的体重变化模式)和T2D风险之间的关系进行了批判性回顾。最新发现:总体而言,体重轨迹组在发病年龄、性别、胰岛素抵抗模式或β细胞功能生物标志物方面存在差异。生活方式(饮食和身体活动)、药物和手术干预可以改变个体的体重轨迹。青春期是一个关键的病因相关窗口期,在此期间,体重超重可能与T2D的高风险相关。胰岛素抵抗和β细胞功能生物标志物的变化是不同的,但随着时间的推移同时进化的体重轨迹组相关。这些多轨迹标记与T2D风险有不同的相关性。T2D风险可能因发病年龄、超重持续时间和减肥干预类型而异。更好地了解体重、胰岛素敏感性和β细胞功能的变化作为t2dm风险的不同但相关的相关因素,随着时间的推移同时演变,对设计和靶向一级预防工作具有重要意义。
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来源期刊
CiteScore
9.80
自引率
0.00%
发文量
52
审稿时长
6-12 weeks
期刊介绍: The goal of this journal is to publish cutting-edge reviews on subjects pertinent to all aspects of diabetes epidemiology, pathophysiology, and management. We aim to provide incisive, insightful, and balanced contributions from leading experts in each relevant domain that will be of immediate interest to a wide readership of clinicians, basic scientists, and translational investigators. We accomplish this aim by appointing major authorities to serve as Section Editors in key subject areas across the discipline. Section Editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year on their topics, in a crisp and readable format. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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