| Part 1 The relationship between changes of body weight status in young and middle-aged people and degree of weight loss from the maximum body weight and type 2 diabetes mellitus in middle-aged and elderly peopleObjective:To investigate the relationship between changes of body weight status after became overweight/obesity in young and middle-aged and degree of weight loss from maximum body weight and the risk of type 2 diabetes mellitus(T2DM)in middle-aged and elderly population.Methods:Participants aged≥40 years old were selected from China National Diabetes and Metabolic Disorder Study(CNDMDS)conducted in 2007-2008.The study populations were surveyed for risk factors of diabetes mellitus including the information about maximum weight and age of maximum weight.Maximum body mass index(MAXBMI)was calculated as maximum body weight(kg)/current height~2(m).The participants were divided into 5 groups based on maximum body mass index(MAXBMI),age at maximum body weight and body mass index(BMI):continuous overweight group from young adults(both MAXBMI and BMI≥24.0 kg/m~2,18 years≤age of maximum weight<40years),past overweight from young adults(MAXBMI≥24.0 kg/m2,18.5kg/m~2≤BMI<24.0kg/m~2,18 years≤age of maximum weight<40 years),continuous overweight group from middle-aged(both MAXBMI and BMI≥24.0 kg/m~2,40 years≤age of maximum weight<60 years),past overweight from middle-aged(MAXBMI≥24.0 kg/m2,18.5kg/m~2≤BMI<24.0kg/m~2,40 years≤age of maximum weight<60 years)and noramal weight group(18.5kg/m~2≤both MAXBMI and BMI<24.0kg/m~2).Weight loss ratio was calculated using the formula:(maximum weight-current weight)/maximum weight.Based on weight loss ratio,participants were divided into 3 groups:stable weight group(weight loss<5%),moderate weight loss group(5%≤weight loss<15%),heavy weight loss group(weight loss≥15%).The relationship between changes of body weight status after became overweight in young adults and middle-aged and degree of weight loss from maximum body weight and T2DM were investigated.Results:A total of 3043 cases of T2DM were diagnosed among 19878 study participants.The prevalence of T2DM in continuous overweight group from young adults,past overweight from young adults,continuous overweight group from middle aged,past overweight from middle aged and noramal weight group were 19.4%(520/2679),14.0%(225/1602),18.2%(1487/8166),21.3%(440/2064)and 6.9%(371/5367).The prevalence of T2DM of stable weight group,moderate weight loss group,heavy weight loss group were 11.6%(1189/10255),17.5%(1384/7912)and 27.5%(470/1711).After adjustment for sex,age and other potential confouding factors,overweight in stages of young adults and middle-aged were positively associated with the risk of T2DM,particularly in continuous overweight from young adults(Odds Ratios(OR)and 95%confidence interval(CI)was2.56(2.20-2.98).In overweight population(MAXBMI≥24.0 kg/m~2),compared with stable weight,moderate and heavy weight loss were associated with high risk of T2DM,the OR(95%CI)were 1.57(1.43-1.73)and 2.38(2.06-1.73).In normal weight population(18.5kg/m~2≤MAXBMI<24.0kg/m~2),the moderate and heavy weight loss were not associated with risk of T2DM,the OR(95%CI)were 1.05(0.83-1.31)and 1.14(0.64-2.01).ConclusionBeing overweight in young adults and middle-aged was associated with increased risk of T2DM in middle-aged and elderly population,particularly in continuous overweight population.Part 2 The relationship between changes of body weight status in young and middle-aged people and degree of weight loss from the maximum body weight and hypertension in middle-aged and elderly peopleObjective:To investigate the relationship between changes of body weight status after became overweight/obesity in young adults and middle-aged and degree of weight loss from maximum body weight and the risk of hypertension in middle-aged and elderly population.Methods:Participants aged ≥40 years old were selected from CNDMDS conducted in 2007-2008.The study populations were surveyed for risk factors of diabetes mellitus including the information about maximum body weight and age of maximum body weight.Maximum body mass index(MAXBMI)was calculated as maximum body weight(kg)/current height2(m).The participants were divided into 5 groups based on MAXBMI,age at maximum body weight and BMI: continuous overweight group from young adults(both MAXBMI and BMI ≥24.0 kg/m2,18 years ≤ age of maximum weight<40 years),past overweight from young adults(MAXBMI ≥24.0 kg/m2,18.5kg/m2≤ BMI <24.0kg/m2,18 years ≤ age of maximum weight<40 years),continuous overweight group from middle-aged(both MAXBMI and BMI ≥24.0 kg/m2,40 years ≤ age of maximum weight<60 years),past overweight from middle-aged(MAXBMI ≥24.0 kg/m2,18.5kg/m2≤ BMI<24.0kg/m2,40 years ≤ age of maximum weight<60 years)and noramal weight group(18.5kg/m2≤ both MAXBMI and BMI <24.0kg/m2).Weight loss ratio was calculated using the formula:(maximum weight-current weight)/maximum weight.Based on weight loss ratio,participants were divided into 3 groups: stable weight group(weight loss<5%),moderate weight loss group(5%≤weight loss<15%),heavy weight loss group(weight loss≥15%).The relationship between changes of body weight status after became overweight in young adults and middle-aged and degree of weight loss from maximum body weight and hypertension were investigated.Results:A total of 7639 cases of hypertension were diagnosed among 19852 study participants.The prevalence of hypertension in continuous overweight group from young adults,past overweight from young adults,continuous overweight group from middle-aged,past overweight from middle-aged and normal weight group were 43.5%(1170/2668),27.0%(442/1640),50.5%(4083/8078),36.6%(742/2028)and 22.2%(1202/5418).The prevalence of hypertension of stable weight group,moderate weight loss group,heavy weight loss group were 38.9%(3919/10003),38.6%(3093/8021)and 35.9%(627/1748).After adjustment for sex,age and other potential confouding factors,overweight occurring in stage of young and middle-aged were positively associated with the risk of hypertension,particularly in continuous overweight from middle-aged(OR(95% CI)was 2.78(2.56-3.03)).In normal weight population(18.5kg/m2≤MAXBMI<24.0kg/m2),the moderate and heavy weight loss were associated with low risk of hypertension,the OR(95% CI)were 0.82(0.71-0.94)and 0.38(0.24-0.58).In overweight population(MAXBMI≥24.0 kg/m2),compared with stable weight,moderate and heavy weight loss were associated with low risk of hypertension,the OR(95%CI)were 0.83(0.77-0.89)and 0.51(0.45-0.58).ConclusionBeing overweight in young adults and middle-aged was associated with increased risk of hypertension in middle-aged and elderly population,particularly in continuous overweight populaton.Weight loss of more than 5% or more from maximum body weight may be a protective factor against hypertension in normal weight and overweight population.Part 3 The relationship between changes of body weight status in young and middle-aged people and degree of weight loss from the maximum body weight and metabolic syndrome in middle-aged and elderly peopleObjective:To investigate the relationship between changes of body weight status after became overweight/obesity in young and middle-aged and degree of weight loss from maximum body weight and the risk of metabolic syndrome(MS)in middle-aged and elderly population.Methods:Participants aged ≥40 years old were selected from CNDMDS conducted in 2007-2008.The study populations were surveyed for risk factors of diabetes mellitus including the information about maximum weight and age of maximum weight.Maximum body mass index(MAXBMI)was calculated as maximum body weight(kg)/current height2(m).The participants were divided into 5 groups based on MAXBMI,age at maximum body weight and BMI: continuous overweight group from young adults(both MAXBMI and BMI ≥24.0 kg/m2,18 years ≤ age of maximum weight <40 years),past overweight from young adults(MAXBMI ≥24.0 kg/m2,18.5kg/m2≤ BMI <24.0kg/m2,18 years ≤ age of maximum weight <40 years),continuous overweight group from middle aged(both MAXBMI and BMI ≥24.0 kg/m2,40 years ≤ age of maximum weight <60 years),past overweight from middle aged(MAXBMI ≥24.0 kg/m2,18.5kg/m2≤BMI <24.0kg/m2,40 years ≤ age of maximum weight<60 years)and normal weight group(18.5kg/m2≤ both MAXBMI and BMI < 24.0kg/m2).Weight loss ratio was calculated using the formula:(maximum weight-current weight)/maximum weight.Based on weight loss ratio,participants were divided into 3 groups: stable weight group(weight loss<5%),moderate weight loss group(5%≤weight loss<15%),heavy weight loss group(weight loss≥15%).The relationship between changes of body weight status after became overweight in young adults and middle-aged and degree of weight loss from maximum body weight and MS were investigated.Results:A total of 5276 cases of MS were diagnosed among 19458 study participants.The prevalence of MS in continuous overweight group from young adults,past overweight from young adults,continuous overweight group from middle aged,past overweight from middle aged and noramal weight group were 37.3%(983/2634),9.7%(156/1604),42.4%(3348/7888),18.4%(368/1995)and 7.9%(421/5337).The prevalence of MS for stable weight group,moderate weight loss group,heavy weight loss group were 29.9%(2952/9860),25.1%(1979/7887)and 20.2%(345/1711).After adjustment for sex,age and other potential confouding factors,overweight occurring in stage of young and middle aged were still positively associated with the risk of MS,particularly in continuous overweight from young adults(OR(95% CI)was 8.05(7.21-8.99)).In normal weight population(18.5kg/m2≤MAXBMI<24.0kg/m2),the moderate and heavy weight loss were associated with decreased risk of MS,the OR(95% CI)were 0.60(0.48-0.75)and 0.14(0.05-0.38).In overweight population(MAXBMI≥24.0 kg/m2),compared with stable weight,moderate and heavy weight loss were associated with decreased risk of MS,the OR(95% CI)were 0.60(0.55-0.65)and 0.23(0.20-0.27).ConclusionBeing overweight in young adults and middle-aged was associated with increased risk of MS in middle-aged and elderly population,particularly in continuous overweight population.Weight loss of more than 5% or more from maximum body weight was associated with decreased risk of MS in normal weight and overweight population.. |
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