1641-P: Patterns of Four-Year Weight Change and Reversion of Prediabetes in Middle-Aged and Older Adults with Overweight or Obesity

Introduction and Objective: Reversion to normoglycemia is increasingly recognized as a key goal in pre-diabetes management. Weight loss is a vital strategy to facilitate prediabetes reversion. This study assessed the association of weight change patterns with prediabetes reversion. Methods: Data were from the China Health and Retirement Longitudinal Study Waves 1-3 (2011, 2013, and 2015). Participants with impaired fasting glucose (FPG 5.6-6.9 mmol/L) and BMI ≥23 kg/m2 at baseline were included. Weight status was classified using WHO ethnic-specific criteria (underweight, normal, overweight, obesity). Weight change between successive waves was categorized as gain (shift to a higher status), loss (shift to a lower status), or stable (no change). Based on weight change across three waves, participants were categorized into “Stable”, “Consistent Loss”, “Consistent Gain”, “Gain then Loss”, and “Loss then Gain”. Reversion to normoglycemia was defined as FPG <5.6 mmol/L. Logistic regressions were conducted, adjusting for age, sex, education, smoking, alcohol intake, hypertension, dyslipidemia, and baseline FPG and BMI. Results: This study included 939 individuals. At baseline, mean (SD) age was 57.42 (8.24) years, 39.0% was males, and mean (SD) BMI was 26.17 (2.54) kg/m2. At 4 years, 58.0% reverted to normoglycemia. Mean (SD) 4-year percent weight change was 0.40% (4.06) in “Stable” (n=514), 0.71% (5.05) in “Loss then Gain” (n=67), -1.09% (5.49) in “Gain then Loss” (n=65), -7.31% [5.23] in “Consistent Loss” (n=170), and 8.02% (5.49) in “Consistent Gain” (n=123). Compared to “Stable”, “Consistent Loss” (OR=1.70 [1.16, 2.50], p=0.007) and “Loss then Gain” (OR=2.05 [1.18, 3.68], p=0.013) had significantly higher odds of reversion, with no significant differences found for other two patterns. Conclusion: Compared to persistent overweight or obesity, weight loss increases reversion likelihood in middle-aged and older adults with prediabetes. Regain may not erode the benefits, but future studies are needed to unveil underlying mechanisms.