| ObjectiveDiabetes is one of the common chronic diseases in the elderly and obesity is a risk factors of diabetes.At present,few studies had focused on the effects of weight,BMI,WC and their changes on the onset of diabetes.In our study,a total of 61,587 elderly people from Binhai New Area were followed up from 2015 to 2018.We made cross-sectional analysis on their BMI,WC,blood tests and lifestyle year by year.We also analyzed the risk factors of diabetes and the impact of weight,BMI,WC and their changes on the incidence of diabetes.The main purpose of our study is to explore a more reasonable individualized weight management strategy for the elderly.ParticipantsThe participants were from a prospective cohort containing 61587 aged 60 or older permanent residents living in Tianjin Binhai New Area without diabetes at the start of our study(27,211 men and 34,376 women,aged 60-96 years),with a median follow-up of 3.6 years.The main observation endpoint was new-onset diabetes.MethodsThe cohort from Binhai New Area was followed up from 2015 to 2018.The BMI,WC,blood tests and lifestyle of the elderly were described and analyzed year by year.The Cox regression model was used to assess the impact of weight,BMI,WC and their changes on the risk of new-onset diabetes in the elderly.Results1.The overweight rates of the elderly from 2015 to 2018 were 41.0%,41.2%,41.8%and 41.6%,respectively,and the rate was higher in men than in women;the obesity rates were 13.7%,14.8%,15.7%and 15.8%,respectively,and the rate was higher in women than in men;the elderly of 60-69 years old were the main group of overweight and obesity;the abdominal obesity rates were 38.1%,38.8%,41.1%and43.0%,respectively,and the rate was higher in women than in men;the elderly of60-79 years old were the main group of abdominal obesity;the proportion of obese elderly with abdominal obesity were 12.5%,13.7%,14.6%and 15.1%,respectively.2.The level of SBP and WC of the elderly increased year by year from 2015 to2018;the level of DBP,BMI,TC,TG,FBG and the proportion of smoking,drinking,occasional exercise,daily exercise all presented an upward trend.The elderly with higher baseline BMI or WC in 2015 generally had lower mean age and higher levels of SBP,DBP,TG,ALT,HGB and PLT;the proportion of smoking was lower and the proportion of people who prefer animal food was higher.3.After a median follow-up of 3.6 years(ranged from 0.3 to 4.0 years),a total of1414 new cases of diabetics were diagnosed(6.4 cases per 1000 person-years),and the average annual incidence of diabetes was 0.76%.The increased levels of BMI,FBG,ALT and the use of statins were independent risk factors of diabetes.4.The elderly who were overweight,obese,abdominal obese or obese combined with abdominal obesity at baseline had an increased risk of developing diabetes,the HR(95%CI)were 1.87(1.62,2.17),1.41(1.26,1.59),1.42(1.28,1.58)and 1.93(1.66,2.25),respectively.5.During the follow-up period,compared with those who maintained underweight or normal weight,the elderly who became overweight or obese had the highest risk of diabetes,followed by those who remained overweight or obese and who became underweight or normal weight,the HR(95%CI)were 1.96(1.62,2.37),1.88(1.65,2.14),and 1.72(1.38,2.15),respectively.Compared with those who maintained normal WC,the elderly who maintained abdominal obesity had the highest risk of diabetes,followed by those who became abdominal obesity and who became normal WC,the HR(95%CI)were 1.66(1.48,1.88),1.58(1.36,1.85)and1.36(1.11,1.65),respectively.During follow-up,weight gained or decreased over6kg,or weight gained over 5%;BMI increased or decreased over 2kg/m~2,or BMI increased over 10%;or WC increased over 3cm or 5%all connected with the significantly higher risk of diabetes.6.Compared with elderly without initiative exercise habits,the risk of diabetes reduced by 19%in overweight elderly people with the habit of daily exercise.ConclusionsThe rates of overweight,obesity and abdominal obesity of the elderly from Binhai New Area generally increased year by year.The levels of SBP,DBP,TG,ALT,HGB and PLT were significantly increased in overweight,obese,or abdominal obese people at baseline.The increased levels of BMI,FBG,ALT and the use of statins were independent risk factors of diabetes.Obesity,overweight or abdominal obesity at baseline and increased or decreased body weight,BMI,and WC during follow-up period were associated with an increased risk of diabetes.Daily exercise can reduce the risk of diabetes and benefit more for overweight elderly people. |
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