Estimating the risk of type-2 diabetes using obese-years in a contemporary population of the Framingham Study.

Pubmed ID: 27369220

Pubmed Central ID: PMC4930546

Journal: Global health action

Publication Date: June 30, 2016

Affiliation: School of Health & Social Development, Deakin University, Melbourne, Australia.

Authors: Peeters A, Abdullah A, Stoelwinder J, Wong E, Amin FA, Hanum F, Tanamas S, Wolf R

Cite As: Abdullah A, Amin FA, Hanum F, Stoelwinder J, Tanamas S, Wolf R, Wong E, Peeters A. Estimating the risk of type-2 diabetes using obese-years in a contemporary population of the Framingham Study. Glob Health Action 2016 Jun 30;9:30421. doi: 10.3402/gha.v9.30421. eCollection 2016.



BACKGROUND: We have recently demonstrated that an obese-years construct is a better predictor of the risk of diabetes than the severity of body weight alone. However, these risk estimates were derived from a population cohort study initiated in 1948 that might not apply to the current population. OBJECTIVE: To validate an obese-years construct in estimating the risk of type-2 diabetes in a more contemporary cohort study. DESIGN: A total of 5,132 participants of the Framingham Offspring Study, initiated in 1972, were followed up for 45 years. Body mass index (BMI) above 29 kg/m(2) was multiplied by the number of years lived with obesity at that BMI to define the number of obese-years. Time-dependent Cox regression was used to explore the association. RESULTS: The risk of type-2 diabetes increased significantly with increase in obese-years. Adjusted hazard ratios increased by 6% (95% CI: 5-7%) per additional 10 points of obese-years. This ratio was observed to be similar in both men and women, but was 4% higher in current smokers than in never/ex-smokers. The Akaike Information Criterion confirmed that the Cox regression model with the obese-years construct was a stronger predictor of the risk of diabetes than a model including either BMI or the duration of obesity alone. CONCLUSIONS: In a contemporary cohort population, it was confirmed that the obese-years construct is strongly associated with an increased risk of type-2 diabetes. This suggests that both severity and the duration of obesity should be considered in future estimations of the burden of disease associated with obesity.