당뇨전단계 성인의 비만이 당뇨병 발생 위험에 미치는 영향: 전향적 코호트 자료의 활용
Incidence of Obesity-related Diabetes Mellitus in Adults with Prediabetes: Use of Data from a Prospective Cohort Study
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Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox’s proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.
Abstract
Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox’s proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.
참고문헌 (29)
- (2022)[URL]
- "Diabetes fact sheet in Korea: Diabetes & Complications in Korea" (2022)[URL]
- Korean Diabetes Association, "Clinical Practice Guidelines for Diabetes", pp.27~29 (2021), Korean Diabetes Association
- Park SW, "Complications begin in the pre-diabetes stage", Weekly Donga. 2007 June 13, ~ (2007)
- David M. Nathan, "Impaired Fasting Glucose and Impaired Glucose Tolerance", Diabetes Care, 30(3), pp.753~759 (2007), American Diabetes Association[DOI]
- JWJ Beulens, "Risk and management of pre-diabetes", European Journal of Preventive Cardiology, 26(2_suppl), pp.47~54 (2019), Oxford University Press (OUP)[DOI]
- R. M. Anjana, "Prevalence of diabetes and prediabetes (impaired fasting glucose and", or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, 2011, pp.54(12), 3022~3027[DOI]
- C. M. Buckley, "Pre‐diabetes in adults 45 years and over in Ireland: the Survey of Lifestyle, Attitudes and Nutrition in Ireland 2007", Diabetic Medicine, 30(10), pp.1198~1203 (2013), Wiley[DOI]
- M. Cullmann, "Alcohol consumption and risk of pre‐diabetes and type 2 diabetes development in a Swedish population", Diabetic Medicine, 29(4), pp.441~452 (2012), Wiley[DOI]
- Nina Grundlingh, "Assessment of prevalence and risk factors of diabetes and pre-diabetes in South Africa", Journal of Health, Population and Nutrition, 41(1) (2022), Springer Science and Business Media LLC[DOI]
- Na Li, "Factors associated with progression of different prediabetic status to Diabetes: A Community-based cohort study", Diabetes Research and Clinical Practice, 184, pp.109193~ (2022), Elsevier BV[DOI]
- 이수정, "당뇨병이 없는 성인의 비만 여부에 따른 공복혈당장애 관련 요인", 한국산학기술학회논문지, 18(6), pp.180~186 (2017), 한국산학기술학회[DOI]
- Sim JL, "Effects of waist circumference", height ratio and dyslipidemia as predictors of prediabetes in middle-aged women, 2018, ~
- Report of 2020 quick reference guideline, "Korean Society for the study of the Obesity", KSSO, ~ (2022)
- (2022)[URL]
- A. Romero-Corral, "Diagnostic performance of body mass index to detect obesity in patients with coronary artery disease", European Heart Journal, 28(17), pp.2087~2093 (2007), Oxford University Press (OUP)[DOI]
- Caroline E. Dale, "Causal Associations of Adiposity and Body Fat Distribution With Coronary Heart Disease, Stroke Subtypes, and Type 2 Diabetes Mellitus", Circulation, 135(24), pp.2373~2388 (2017), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Amy E. Rothberg, "Very-low-energy diet for type 2 diabetes: An underutilized therapy?", Journal of Diabetes and its Complications, 28(4), pp.506~510 (2014), Elsevier BV[DOI]
- Zhang P, "Prevalence of central obesity among adults with normal BMI and its association with metabolic diseases in Northeast China", PLoS One, 11(7), pp.e0160402~ (2016)[DOI]
- Meghan K. Edwards, "Physical activity, body mass index and waist circumference change, and normal-range glycated hemoglobin on incident diabetes: Jackson Heart Study", Postgraduate Medicine, 129(8), pp.842~848 (2017), Informa UK Limited[DOI]
- Fiona Bragg, "Associations of General and Central Adiposity With Incident Diabetes in Chinese Men and Women", Diabetes Care, 41(3), pp.494~502 (2018), American Diabetes Association[DOI]
- Nazari M, "Estimating transition probability of different states of type 2 diabetes and its associated factors using Markov model", Primary Care Diabetes, 12(3), pp.245~253 (2018)[DOI]
- American Diabetes Association, "Standards of medical care in diabetes—2017 abridged for primary care providers", Clinical Diabetes, 35(1), pp.5~26 (2017), American Diabetes Association[DOI]
- J. A. Bell, "Metabolically healthy obesity and risk of incident type 2 diabetes: a meta‐analysis of prospective cohort studies", Obesity Reviews, 15(6), pp.504~515 (2014), Wiley[DOI]
- Johan Ärnlöv, "Impact of BMI and the Metabolic Syndrome on the Risk of Diabetes in Middle-Aged Men", Diabetes Care, 34(1), pp.61~65 (2010), American Diabetes Association[DOI]
- Ning Kang, "Adverse associations of different obesity measures and the interactions with long-term exposure to air pollutants with prevalent type 2 diabetes mellitus: The Henan Rural Cohort study", Environmental Research, 207, pp.112640~ (2022), Elsevier BV[DOI]
- Darren K. McGuire, "Association Between Sitagliptin Use and Heart Failure Hospitalization and Related Outcomes in Type 2 Diabetes Mellitus", JAMA Cardiology, 1(2), pp.126~ (2016), American Medical Association (AMA)[DOI]
- 박선영, "한국 성인 남성 당뇨병 및 당뇨전단계 환자에서 간헐적인여가신체활동이 혈당조절에 미치는 영향", Korean Journal of Family Practice, 9(1), pp.29~35 (2019), 대한가정의학회[DOI]
- Gómez-Ambrosi J, "Body adiposity and type 2 diabetes : Increased risk with a high body fat percentage even having a normal BMI", Obesity, 19(7), pp.1439~1444 (2011)[DOI]