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Effect of changes in anthropometric measurements on the remission and progression of prediabetes: a community-based cohort study

  • Author Footnotes
    1 Siyu Chen and Yebei Liang contributed equally to this work.
    Siyu Chen
    Footnotes
    1 Siyu Chen and Yebei Liang contributed equally to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China

    Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
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  • Author Footnotes
    1 Siyu Chen and Yebei Liang contributed equally to this work.
    Yebei Liang
    Footnotes
    1 Siyu Chen and Yebei Liang contributed equally to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
    Search for articles by this author
  • Xiaoqi Ye
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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  • Zhijun Zhu
    Affiliations
    General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
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  • Keqing Dong
    Affiliations
    General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
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  • Yuexing Liu
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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  • Fusong Jiang
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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  • Li Wei
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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  • Yuqian Bao
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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  • Xuhong Hou
    Correspondence
    Corresponding author at: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 Siyu Chen and Yebei Liang contributed equally to this work.
Published:November 16, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110163

      Abstract

      Aims

      We assessed the impact of changes in body mass index (BMI), body fat percentage (BF%), and waist circumference (WC) on prediabetes among Chinese middle-aged and elderly adults.
      Subjects, Materials and Methods: 2.5-year changes in BMI, BF%, and WC were calculated by subtracting baseline levels from follow-up, based on a cohort of 3,632 participants with prediabetes, and outcomes were defined as remission to normal glucose regulation (NGR), persistence in prediabetes, and progression to newly diagnosed diabetes mellitus (NDM).

      Results

      Among participants with prediabetes, 16.9% returned to NGR and 24.6% progressed to NDM. Changes in BMI, BF%, but not WC were associated with remission and progression of prediabetes (risk ratio per standard deviation increase of BMI: 0.86 [0.79-0.93] and 1.15 [1.08-1.23]; BF%: 0.91 [0.84-0.98] and 1.11 [1.03-1.19]). Among participants with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), only BF% change was significantly associated with remission of prediabetes.

      Conclusion

      Short-term management of BMI and BF% should be stressed to promote the remission and prevent the progression of prediabetes, regardless of whether someone is obese. Moreover, it is of particular clinical importance to monitor BF% among people with combined IFG and IGT.

      Keywords

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      References

      1. International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: International Diabetes Federation, 2021.

        • Garber A.
        • Handelsman Y.
        • Einhorn D.
        • et al.
        Diagnosis and Management of Prediabetes in the Continuum of Hyperglycemia—When do the Risks of Diabetes Begin? A Consensus Statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists.
        Endocrine Practice. 2008; 14: 933-946
        • Tabák A.G.
        • Herder C.
        • Rathmann W.
        • et al.
        Prediabetes: a high-risk state for diabetes development.
        Lancet. 2012; 379: 2279-2290
        • Li Y.
        • Teng D.
        • Shi X.
        • et al.
        Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study.
        BMJ. 2020; 369m997
        • Ligthart S.
        • van Herpt T.T.
        • Leening M.J.
        • et al.
        Lifetime risk of developing impaired glucose metabolism and eventual progression from prediabetes to type 2 diabetes: a prospective cohort study.
        Lancet Diabetes Endocrinol. 2016; 4: 44-51
        • Fujimoto W.Y.
        • Jablonski K.A.
        • Bray G.A.
        • et al.
        Body size and shape changes and the risk of diabetes in the diabetes prevention program.
        Diabetes. 2007; 56: 1680-1685
        • Li G.
        • Zhang P.
        • Wang J.
        • et al.
        Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study.
        The Lancet Diabetes & Endocrinology. 2014; 2: 474-480
        • Lindström J.
        • Ilanne-Parikka P.
        • Peltonen M.
        • et al.
        Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study.
        The Lancet. 2006; 368: 1673-1679
        • Shimizu S.
        • Kawata Y.
        • Kawakami N.
        • et al.
        Effects of changes in obesity and exercise on the development of diabetes and return to normal fasting plasma glucose levels at one-year follow-up in middle-aged subjects with impaired fasting glucose.
        Environ Health Prev Med. 2001; 6: 127-131
        • Kowall B.
        • Rathmann W.
        • Heier M.
        • et al.
        Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study.
        International Journal Of Obesity. 2011; 36: 826
        • Gautier A.
        • Roussel R.
        • Ducluzeau P.H.
        • et al.
        Increases in waist circumference and weight as predictors of type 2 diabetes in individuals with impaired fasting glucose: influence of baseline BMI: data from the DESIR study.
        Diabetes care. 2010; 33: 1850-1852
        • Bodicoat D.H.
        • Khunti K.
        • Srinivasan B.T.
        • et al.
        Incident Type 2 diabetes and the effect of early regression to normoglycaemia in a population with impaired glucose regulation.
        Diabetic Medicine. 2017; 34: 396-404
        • Nakasone Y.
        • Miyakoshi T.
        • Sato Y.
        • et al.
        Impact of weight gain on the evolution and regression of prediabetes: a quantitative analysis.
        European Journal Of Clinical Nutrition. 2016; 71: 206
        • Kowall B.
        • Rathmann W.
        • Kuss O.
        • et al.
        Reversion from prediabetes to normoglycaemia after weight change in older persons: The KORA F4/FF4 study.
        Nutr Metab Cardiovasc Dis. 2021; 31: 429-438
        • Kim E.S.
        • Jeong J.S.
        • Han K.
        • et al.
        Impact of weight changes on the incidence of diabetes mellitus: a Korean nationwide cohort study.
        Sci Rep. 2018; 8: 3735
        • Caleyachetty R.
        • Barber T.M.
        • Mohammed N.I.
        • et al.
        Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study.
        The Lancet Diabetes & Endocrinology. 2021; 9: 419-426
        • Chen P.
        • Hou X.
        • Hu G.
        • et al.
        Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?.
        Cardiovasc Diabetol. 2018;17:93-.;
      2. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.

        • Li L.
        • Wang C.
        • Bao Y.
        • et al.
        Optimal body fat percentage cut-offs for obesity in Chinese adults.
        Clinical and Experimental Pharmacology and Physiology. 2012; 39: 393-398
        • Bao Y.
        • Lu J.
        • Wang C.
        • et al.
        Optimal waist circumference cutoffs for abdominal obesity in Chinese.
        Atherosclerosis. 2008; 201: 378-384
        • Jia W.
        • Weng J.
        • Zhu D.
        • et al.
        Standards of medical care for type 2 diabetes in China 2019.
        Diabetes Metab Res Rev. 2019; 35: e3158
        • Gerstein H.C.
        • Santaguida P.
        • Raina P.
        • et al.
        Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: A systematic overview and meta-analysis of prospective studies.
        Diabetes Research and Clinical Practice. 2007; 78: 305-312
        • Dunkley A.J.
        • Bodicoat D.H.
        • Greaves C.J.
        • et al.
        Diabetes Prevention in the Real World: Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes and of the Impact of Adherence to Guideline Recommendations.
        Diabetes Care. 2014; 37: 922
        • Aziz Z.
        • Absetz P.
        • Oldroyd J.
        • et al.
        A systematic review of real-world diabetes prevention programs: learnings from the last 15 years.
        Implement Sci. 2015;10:172-.;
        • Wat N.M.S.
        • Lam T.H.
        • Janus E.D.
        • et al.
        Central obesity predicts the worsening of glycemia in southern Chinese.
        International Journal of Obesity. 2001; 25: 1789-1793
        • Ko G.T.
        • Chan J.C.
        • Tsang L.W.
        • et al.
        Combined use of fasting plasma glucose and HbA1c predicts the progression to diabetes in Chinese subjects.
        Diabetes Care. 2000; 23: 1770
        • Ko G.T.C.
        • Chan J.C.N.
        • Cockram C.S.
        Change of glycaemic status in Chinese subjects with impaired fasting glycaemia.
        Diabetic Medicine. 2001; 18: 745-748
      3. Yuan Y, Liu K, Zheng M, et al. Analysis of Changes in Weight, Waist Circumference, or Both, and All-Cause Mortality in Chinese Adults. JAMA Netw Open. 2022;5:e2225876.

        • Stephan Y.
        • Sutin A.R.
        • Terracciano A.
        Change in weight and personality in middle-aged and older adults.
        Psychol Health. 2020; 35: 872-886
        • Vlassopoulos A.
        • Combet E.
        • Lean M.E.
        Changing distributions of body size and adiposity with age.
        Int J Obes (Lond). 2014; 38: 857-864
        • Rimm E.B.
        • Stampfer M.J.
        • Giovannucci E.
        • et al.
        Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men.
        Am J Epidemiol. 1995; 141: 1117-1127
        • Litwin S.E.
        Which measures of obesity best predict cardiovascular risk?.
        J Am Coll Cardiol. 2008; 52: 616-619
        • Lee J.
        • Cho Y.K.
        • Kang Y.M.
        • et al.
        The Impact of NAFLD and Waist Circumference Changes on Diabetes Development in Prediabetes Subjects.
        Sci Rep. 2019; 9: 17258
        • Beaufrère B.
        • Morio B.
        Fat and protein redistribution with aging: metabolic considerations.
        European Journal of Clinical Nutrition. 2000; 54: S48-S53
        • Toth M.J.
        • Tchernof A.
        • Sites C.K.
        • et al.
        Effect of menopausal status on body composition and abdominal fat distribution.
        International Journal of Obesity. 2000; 24: 226-231
        • Gómez-Ambrosi J.
        • Silva C.
        • Galofré J.C.
        • et al.
        Body adiposity and type 2 diabetes: increased risk with a high body fat percentage even having a normal BMI.
        Obesity (Silver Spring). 2011; 19: 1439-1444
        • Taylor R.
        Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause.
        Diabetologia. 2008; 51: 1781-1789
        • Akindele M.O.
        • Phillips J.S.
        • Igumbor E.U.
        The Relationship Between Body Fat Percentage and Body Mass Index in Overweight and Obese Individuals in an Urban African Setting.
        J Public Health Afr. 2016;7:515-.;
        • Resnick H.E.
        • Valsania P.
        • Halter J.B.
        • et al.
        Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults.
        J Epidemiol Community Health. 2000; 54: 596-602
      4. Sherwani SI, Khan HA, Ekhzaimy A, et al. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker Insights. 2016;11:BMI.S38440.

        • Vasold K.L.
        • Parks A.C.
        • Phelan D.M.L.
        • et al.
        Reliability and Validity of Commercially Available Low-Cost Bioelectrical Impedance Analysis.
        Int J Sport Nutr Exerc Metab. 2019; 29: 406-410
        • Kyle U.G.
        • Bosaeus I.
        • De Lorenzo A.D.
        • et al.
        Bioelectrical impedance analysis-part II: utilization in clinical practice.
        Clin Nutr. 2004; 23: 1430-1453