Early Weight Loss in Impaired Glucose Tolerance Is Associated With Reduced Long-term Mortality and Cardiovascular Risk: The Da Qing Diabetes Prevention Outcome Study

OBJECTIVE: To determine whether weight loss during the initial years following diagnosis of impaired glucose tolerance (IGT) is independently associated with reduced long-term mortality and cardiovascular risk. RESEARCH DESIGN AND METHODS: In the Da Qing Diabetes Prevention Study, 540 adults with IGT were categorized into three groups based on their weight change from baseline to the end of a 6-year lifestyle intervention trial: non-weight loss (n = 200), low weight loss (<5%, n = 163), and high weight loss (≥5%, n = 177). Participants were followed for 34 years to assess all-cause mortality, cardiovascular disease (CVD) mortality, and CVD events. Cox models were used to assess associations. RESULTS: Weight loss during the initial 6 years following IGT diagnosis was associated with reduced long-term risks of CVD events and mortality (P = 0.007-0.015). Compared with participants without weight loss, those with weight loss ≥5% had significantly lower risks of CVD death (hazard ratio [HR] 0.56, 95% CI 0.35-0.89), CVD events (HR 0.71, 95% CI 0.52-0.99), hospitalized heart failure (HR 0.48, 95% CI 0.26-0.88), and all-cause death (HR 0.67, 95% CI 0.48-0.95) after adjusting for age, sex, baseline weight, and other covariates. Furthermore, the high weight loss group showed delays in the median time to all-cause mortality and CVD mortality of 2.1 years and 6.5 years, respectively. CONCLUSIONS: Weight loss achieved in the early years after diagnosis of IGT in Chinese adults is associated with substantially lower long-term risks of CVD events and mortality, suggesting the critical importance of early weight management in individuals with prediabetes for improving long-term survival and cardiovascular health.