Table 3.
Association between age of onset of overweight or obesity and adult HbA1c: ORs for elevated HbA1c ≥7 and regression coefficients for change in HbA1c (%)
| Duration/age of onset (N = 7,855)† | n (%)‡ | BMI at 45 years (kg/m2) mean (95% CI)‡ | Waist circumference (cm) mean (95% CI)‡ | HbA1c ≥7* OR (95% CI) |
HbA1c coefficient (95% CI)§ |
||
|---|---|---|---|---|---|---|---|
| Unadjusted | Adjusted$ | Unadjusted | Adjusted$ | ||||
| Obesity | |||||||
| Never | 5,819 (74.1) | 25.1 (25.0–25.2) | 86.9 (86.6–87.2) | — | — | — | — |
| Childhood only | 62 (0.8) | 26.3 (25.5–27.0) | 90.6 (87.9–93.4) | 7.01 (1.89–25.89) | 4.95 (1.30–18.93) | 0.034 (−0.147 to 0.214) | 0.012 (−0.158 to 0.181) |
| Onset in midadulthood | 1,171 (14.9) | 32.5 (32.3–32.7) | 103.5 (102.8–104.1) | 2.99 (1.77–5.03) | 1.13 (0.61–2.08) | 0.151 (0.112–0.189) | 0.026 (−0.026 to 0.078) |
| Onset in young adulthood | 652 (8.3) | 35.2 (35.0–35.5) | 109.2 (108.3–110.0) | 16.04 (10.63–24.17) | 3.96 (2.10–7.43) | 0.280 (0.211–0.349) | 0.115 (0.032–0.199) |
| Onset in childhood | 151 (1.9) | 37.8 (37.2–38.4) | 113.2 (111.4–115.1) | 23.86 (13.52–42.14)# | 4.38 (1.86–10.31)# | 0.363 (0.173–0.554)# | 0.170 (−0.009 to 0.348)# |
| Overweight (including obesity) | |||||||
| Never | 2,366 (30.1) | 22.6 (22.5–22.7) | 80.0 (79.5–80.4) | — | — | — | — |
| Childhood only | 163 (2.1) | 22.6 (22.1–23.2) | 78.1 (76.4–79.7) | — | — | −0.040 (−0.100 to 0.021) | −0.035 (−0.094 to 0.023) |
| Onset in midadulthood | 1,729 (22.0) | 27.2 (27.1–27.4) | 92.2 (91.7–92.6) | 1.88 (0.66–5.33) | 0.77 (0.27–2.19) | 0.044 (0.022–0.066) | −0.083 (−0.117 to −0.050) |
| Onset in young adulthood | 2,396 (30.5) | 29.9 (29.8–30.1) | 99.2 (98.7–99.6) | 8.63 (3.85–19.32) | 1.87 (0.79–4.45) | 0.112 (0.083–0.141) | −0.088 (−0.133 to −0.044) |
| Onset in childhood | 1,201 (15.3) | 32.1 (31.9–32.3) | 101.4 (100.8–102.1) | 21.63 (9.77–47.85)# | 3.25 (1.30–8.14)# | 0.183 (0.134–0.231)# | −0.059 (−0.116 to −0.001)# |
*Type 2 diabetes or HbA1c ≥7.
§Models control for type 2 diabetes treatment.
†Age at onset of obesity/overweight defined as: never (BMI less than World Health Organization cutoff at all ages); childhood only (BMI greater than or equal to cutoff at 7, 11, or 16 years but not at 23, 33, and 45 years); onset in childhood or adolescence (BMI greater than or equal to cutoff at 7, 11, or 16 years plus 23, 33, or 45 years); onset in young adulthood (BMI greater than or equal to cutoff at 23 or 33 years but not in childhood); or onset in midadulthood (BMI greater than or equal to cutoff at 45 years only). BMI in childhood classified using international age and sex-specific cutoffs (17, 25): thinness (moderate, i.e., grade 2), respectively, for ages 7, 11, and 16 years as 13.08, 13.72, and 16.08 kg/m2 for boys and 12.91, 13.79, and 16.44 kg/m2 for girls; overweight, respectively, as ≥17.92, ≥20.55, and ≥23.90 kg/m2 for boys and ≥17.75, ≥20.74, and ≥24.37 kg/m2 for girls; and obesity, respectively, as ≥20.63, ≥25.10, and ≥28.88 kg/m2 for boys and ≥20.51, ≥25.42, and ≥29.43 kg/m2 for girls.
‡Averaged across imputed datasets.
$Sex, total cholesterol, HDL cholesterol, family history of diabetes, menopausal status, smoking at 42 years, alcohol consumption at 42 years, social class in childhood, social class at 45 years, and qualifications by 42 years.
#Linear trend from never to onset in midadulthood P < 0.05 (tested including and excluding category of childhood only).