Key result
Excess body weight is linked to ~51% developing prediabetes or diabetes over 8 years.
Why the study?
The effects of obesity with normal HbA1c and low body weight with high-normal HbA1c on diabetes onset are poorly understood.
Does excess body weight affect HbA1c progression and the onset of diabetes irrespective of baseline HbA1c levels in non-diabetic Japanese individuals?
Cohort (n=5,325)
Does excess body weight affect HbA1c progression and the onset of diabetes irrespective of baseline HbA1c levels in non-diabetic Japanese individuals?
Excess body weight is a primary driver of HbA1c progression and diabetes onset, even in individuals with normal baseline HbA1c, highlighting weight management as a key preventive target.
Obesity may accelerate glycemic progression despite normal baseline HbA1c; hypothesis-generating and requires prospective validation before guiding practice.
PURPOSE/AIM: Obese individuals with normal HbA1c levels and low-body-weight individuals with high-normal HbA1c levels are frequently encountered in clinical settings, but the effects of these phenotypes on the onset of diabetes are poorly understood. Therefore, we addressed this issue in a longitudinal study. MATERIALS AND METHODS: We analyzed clinical parameters, including body mass index (BMI) and HbA1c levels, in 5325 non-diabetic Japanese people aged 20-75 years who underwent four medical checkups between 1999 (baseline) and 2007. The subjects were then classified into six baseline BMI categories, each of which was divided into two HbA1c groups, resulting in a total of 12 groups. RESULTS: In 405 obese subjects with a normal baseline HbA1c (BMI ≥ 27.0 kg/m(2), HbA1c 5.2-5.6%), the mean HbA1c level increased during the study period, and 50.9% developed prediabetes/diabetes. In contrast, in 77 low-body-weight subjects with a high-normal baseline HbA1c (BMI ≤ 18.9 kg/m(2), HbA1c 5.7-6.4%), the mean HbA1c level remained constant. Similar changes occurred in the other groups during the study, resulting in a linear increase in HbA1c levels with increasing BMI. CONCLUSION: Our results suggest that approximately half of the obese individuals with HbA1c in the normal range develop prediabetes or diabetes within 8 years, whereas low-body-weight individuals with high-normal HbA1c are less likely to exhibit worsening in glycemia. Thus, excess body weight may be the primary therapeutic target to prevent the early onset of diabetes, regardless of the individual's HbA1c.
No takes yet. Share an insight, caveat, or question.
Nakajima et al. (2014) conducted a cohort in Non-diabetic (n=5,325). Excess body weight (BMI ≥ 27.0 kg/m2) vs. Low body weight (BMI ≤ 18.9 kg/m2) was evaluated on Development of prediabetes or diabetes. Excess body weight in individuals with normal baseline HbA1c led to 50.9% developing prediabetes or diabetes over 8 years, whereas low-body-weight individuals with high-normal HbA1c remained stable.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: