246543 Change in body size during early adulthood and prevalence of diabetes mellitus

Monday, October 31, 2011: 10:50 AM

Asieh Golozar, MD, MPH , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Arash Etemadi, MD, PhD , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Hooman Khademi, MD, MPH , Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
Farin Kamangar, MD, PhD , Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
Hossein Poustchi, MD , Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
Farhad Islami, MD, PhD , Genetic epidemiology, International Agency for Research on Cancer, Lyon, France
Neal Freedman, PhD, MPH , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Philip Taylor, MD, ScD , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Paul Pharoah, DP , Cancer Research UK, Dept Oncology, Cambridge University, Cambridge, United Kingdom
Paulo Boffetta, MD, MPH , The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, NY
Paul Brennan, PhD , Genetic epidemiology, International Agency for Research on Cancer, Lyon, France
Christian Abnet, PhD, MPH , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Sanford Dawsey, MD , Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Reza Malekzadeh, MD , Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
To study the role of childhood and early adulthood obesity on diabetes mellitus (DM) using a life course approach, we analyzed data on 3811 participants (median age=54) in the Golestan Cohort study in Iran. At baseline, we collected individuals' self-assessed body size at ages 15 and 30, using validated pictograms from 1 (very lean) to 7 in men and 9 in women (very obese). Obesity was defined as pictogram≥5. DM diagnosis was based on fasting blood glucose (>126 mg/dl), or antidiabetes treatment 5 years after recruitment. We used Poisson regression with robust variance estimator adjusted for confounders to estimate prevalence ratios (PR) using pictogram 2 as the reference. The age-standardized prevalence of diabetes was 10.24%, and 61.50% of the diabetics were aware of their disease. Body size at age 30 was positively associated with DM (P for trend<.001); PR in very obese men and women was 2.71 (CI: 1.01-7.32) and 3.25 (1.79-5.88), respectively. At age 15, both extreme leanness (PR: 1.87; 1.23-2.82) and obesity (PR: 1.52; 1.01-2.31) were associated with increased prevalence of DM only in women. From age 15 to 30, prominent increase (≥2) in body size increased DM prevalence both in men (PR: 2.59; 1.59-4.23) and women (PR: 1.49; 1.05-2.11). Among women who were obese at 15, decrease in body size was associated with a 72% reduction in DM prevalence (PR: 0.28; 0.17-0.49). While diabetes prevalence is high, awareness is relatively low in this population. Early lifestyle modification should be emphasized in preventive strategies.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Epidemiology

Learning Objectives:
Describe the role of childhood obesity on the prevalence of diabetes

Keywords: Diabetes, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published journal articles and presented study results at different meetings about chronic diseases epidemiology, especially diabetes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Obesity and Nutrition
See more of: Epidemiology