Lise G. Bjerregaard
Boys with overweight at age 7 years that persists through adolescence and early adulthood are more likely to develop type 2 diabetes as adults vs. men without childhood overweight, according to findings published in The New England Journal of Medicine.
“Our findings suggest that weight loss from childhood to early adulthood can reduce the increased risks of type 2 diabetes among overweight and obese boys,” Lise G. Bjerregaard, PhD, a postdoctoral research fellow in the Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital in Copenhagen, Denmark, told Endocrine Today. “Boys who lose weight before age 13 years and maintain a normal weight until early adulthood will reduce their risk to the same levels as boys of normal weight. However, if the boys are still overweight or obese at age 13 years and then lose weight before early adulthood, their risks for developing type 2 diabetes in adulthood will only be partly reduced.”
Bjerregaard and colleagues analyzed data from 62,565 Danish men with height and weight measurements at age 7 and 13 years, as well as in early adulthood (aged 17-26 years), obtained from the Danish Conscription Database. Overweight was defined according to CDC criteria by age group. Follow-up began in 1977 or at age 30 years and ended on the date of a type 2 diabetes diagnosis, death or Dec. 31, 2015. Researchers used Cox proportional hazard models to assess the associations between overweight at each age or patterns of overweight and adult type 2 diabetes, with age used as the time scale.
Within the cohort, 6,710 (10.7%) received a diagnosis of type 2 diabetes during 1,969,165 person-years of follow-up. Prevalence of overweight increased from 5.4% at age 7 years to 8.2% in early adulthood.
Researchers found that men with overweight at age 7 years but with remission of overweight by age 13 years that persisted through early adulthood had a risk for developing type 2 diabetes that was similar to men who had never been overweight (HR = 0.96; 95% CI, 0.75-1.21). Men with overweight only at age 13 years, or with overweight only at age 7 and 13 years, but not in early adulthood, had a risk for developing type 2 diabetes in adulthood that was lower than men who had been persistently overweight, but higher than men who had never had overweight. Men with overweight at age 13 years and in early adulthood, however, had a risk for developing type 2 diabetes that was higher than men with overweight only as young adults and similar to men with overweight at all time points.
Among 2,872 men with overweight at age 7 years, 1,023 (35.6%) remained overweight or had become obese by adulthood, whereas 1,849 (64.4%) had remission of overweight.
“Among the men who had had remission, those whose BMI had decreased to below the 75th percentile in early adulthood had risks for type 2 diabetes similar to those among men whose BMI had remained in the 25th to 49th percentiles, which indicated that the effects of overweight during childhood were reversible,” the researchers wrote.
Obesity in early adulthood was associated with very high risk for type 2 diabetes, irrespective of BMI at age 7 years, according to the researchers.
“Our findings in this relatively thin population suggest that the adverse effects of childhood overweight on risks for type 2 diabetes are reversible by weight loss before puberty,” Bjerregaard said. “The findings may justify treating children with overweight at prepubertal ages, possibly even in populations with higher levels of childhood overweight, as this may greatly reduce the risks of type 2 diabetes later in life.
“It will be important to study whether these results apply to other noncommunicable diseases such as cardiovascular disease and cancer, and if they also apply to women,” Bjerregaard said. – by Regina Schaffer
Disclosures: The European Commission Horizon 2020 program, part of the DynaHEALTH Project, supported this study. The authors report no relevant financial disclosures.