Remodelling of body composition surrounding the diagnosis of type 2 diabetes in three longitudinal cohorts.

IF 10.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetologia Pub Date : 2026-10-01 Epub Date: 2026-06-30 DOI:10.1007/s00125-026-06797-0
Jiaxing Du, Kun Zeng, Fen Zhang, Yanyan Wang, Mei Liu, Jiayu Huang, Sujun Chen, Yanhan Zhao, Yan Lin
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引用次数: 0

Abstract

Aims/hypothesis: The temporal evolution of body composition surrounding type 2 diabetes diagnosis is unclear. To clarify this process, we characterised and compared the trajectories of BMI, boplledy roundness index (BRI) and handgrip strength (HGS) in the years preceding and following the diagnosis.

Methods: We analysed data from participants aged ≥50 years from the Health and Retirement Study (HRS, waves 7-14), the English Longitudinal Study of Ageing (ELSA, waves 2-6), and the Survey of Health, Ageing and Retirement in Europe (SHARE, waves 2-9). Incident diabetes cases were matched 1:4 with control participants based on age, sex and education level, with the timeline centred on the year of diagnosis. Linear mixed-effects models (LMMs) allowing for non-linear trends were employed to estimate the trajectories of BMI, BRI and HGS, and to assess the temporal evolution of differences between cases and controls.

Results: The analysis included 74,790 participants for BMI, 19,895 for BRI, and 69,560 for HGS. Over a follow-up period of up to 14 years surrounding diagnosis, BMI trajectories exhibited a distinct inverted U shape, peaking approximately 2-4 years prior to diagnosis. BRI showed an overall upward trend, but its growth in cases was accelerated during weight gain and attenuated during weight loss relative to controls. HGS declined universally; although the rates of decline were similar between groups in HRS and ELSA, cases in the SHARE cohort experienced a significantly accelerated decline compared with controls.

Conclusions/interpretation: When evaluated through multidimensional surrogate indicators, the trajectory of type 2 diabetes involves patterns that are indicative of a rise then a fall in total body mass, persistent visceral accumulation (albeit attenuated during weight loss), and probably accelerated muscle depletion. The dynamic evolution of these proxy metrics provides novel insights for capturing the full picture of body composition remodelling.

在三个纵向队列中,围绕2型糖尿病诊断的身体成分重塑。
目的/假设:2型糖尿病诊断前后身体成分的时间演变尚不清楚。为了阐明这一过程,我们在诊断前和诊断后的几年中对BMI、双侧圆度指数(BRI)和握力(HGS)的轨迹进行了表征和比较。方法:我们分析了来自健康与退休研究(HRS,波数7-14)、英国老龄化纵向研究(ELSA,波数2-6)和欧洲健康、老龄化和退休调查(SHARE,波数2-9)的年龄≥50岁参与者的数据。根据年龄、性别和教育水平,偶发糖尿病病例与对照组的比例为1:4,时间轴以诊断年份为中心。采用允许非线性趋势的线性混合效应模型(lmm)来估计BMI、BRI和HGS的轨迹,并评估病例和对照组之间差异的时间演变。结果:该分析包括74,790名BMI参与者,19,895名BRI参与者和69,560名HGS参与者。在诊断前后长达14年的随访期间,BMI轨迹表现出明显的倒U形,在诊断前约2-4年达到峰值。BRI总体呈上升趋势,但与对照组相比,病例中的增长在体重增加期间加速,在体重减轻期间减弱。HGS普遍下降;尽管HRS和ELSA组之间的下降率相似,但SHARE组的病例与对照组相比,下降速度明显加快。结论/解释:当通过多维替代指标进行评估时,2型糖尿病的发展轨迹涉及的模式表明,总体重先上升后下降,持续的内脏积累(尽管在体重减轻期间有所减弱),可能加速肌肉消耗。这些代理指标的动态演变为捕捉身体成分重塑的全貌提供了新的见解。
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来源期刊
Diabetologia
Diabetologia 医学-内分泌学与代谢
CiteScore
18.10
自引率
2.40%
发文量
193
审稿时长
1 months
期刊介绍: Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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