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Timing and duration of obesity in relation to diabetes: Findings from an ethnically diverse, nationally representative sample

机译：与糖尿病相关的肥胖症的发生时间和持续时间：来自具有种族差异，具有全国代表性的样本的发现

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OBJECTIVE-The influence on diabetes of the timing and duration of obesity across the highrisk period of adolescence to young adulthood has not been investigated in a population-based, ethnically diverse sample. RESEARCH DESIGN AND METHODS-A cohort of 10,481 individuals aged 12-21 years enrolled in the U.S. National Longitudinal Study of Adolescent Health (1996) was followed over two visits during young adulthood (18-27 years, 2001-2002; 24-33 years, 2007-2009). Separate logistic regression models were used to examine the associations of diabetes (A1C ??6.5% or diagnosis by a health care provider) in young adulthood with 1) obesity timing (never obese, onset <16 years, onset 16 to <18 years, onset ??18 years) and 2) obesity duration over time (never obese, incident obesity, fluctuating obesity, and persistent obesity), testing differences by sex and race/ethnicity. RESULTS-Among 24- to 33-year-old participants, 4.4% had diabetes (approximately half were undiagnosed), with a higher prevalence in blacks and Hispanics than whites. In multivariable analyses, women who became obese before age 16 were more likely to have diabetes than women who became obese at or after age 18 (odds ratio 2.77 [95% CI 1.39-5.52]), even after accounting for current BMI, waist circumference, and age at menarche. Persistent (vs. adult onset) obesity was associated with increased likelihood of diabetes in men (2.27 [1.41-3.64]) and women (2.08 [1.34-3.24]). CONCLUSIONS-Diabetes risk is particularly high in individuals who were obese as adolescents relative to those with adult-onset obesity, thus highlighting the need for diabetes prevention efforts to address pediatric obesity. ? 2013 by the American Diabetes Association.
机译：目的-在以人群为基础，种族不同的样本中，未研究过肥胖的时机和持续时间，从青春期的高风险时期到年轻的成年期对糖尿病的影响。研究设计和方法-纳入了10481名年龄在12-21岁之间的美国队列青少年队列研究（1996年），在成年期（18-27岁，2001-2002年; 24-33岁）中进行了两次随访，2007-2009）。 （1）肥胖时机（从未肥胖，发病<16岁，发病16至<18岁，从未肥胖），年轻成年糖尿病的相关性（Logistic回归模型）用于检查糖尿病的相关性（A1C≥6.5％或由医疗保健提供者诊断）发病年龄为18岁）和2）肥胖随时间变化的持续时间（从不肥胖，偶然性肥胖，波动性肥胖和持续性肥胖），按性别和种族/族裔测试差异。结果-在24至33岁的参与者中，有4.4％患有糖尿病（大约一半未得到诊断），黑人和西班牙裔的患病率高于白人。在多变量分析中，即使考虑了当前的BMI，腰围，在18岁之前或之后肥胖的女性比在18岁或之后肥胖的女性更容易患糖尿病（优势比2.77 [95％CI 1.39-5.52]）。和初潮年龄。持续肥胖（相对于成人发病）与男性（2.27 [1.41-3.64]）和女性（2.08 [1.34-3.24]）患糖尿病的可能性增加相关。结论相对于成年肥胖者，青少年时期肥胖的糖尿病风险尤其高，因此强调了预防糖尿病以解决儿童肥胖的必要性。 ？ 2013年由美国糖尿病协会颁发。

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