Abstract
Objective
The aim of the study was to explore the variations in body mass index (BMI) trajectories during the 20 years before diagnosis of type 2 diabetes mellitus (T2DM) over four decades between 1968 and 2007.
Methods
Longitudinal measurements of BMI from 437 men, all with a diagnosis of T2DM, were used in the analysis. A mixed method approach was used to fit individual patterns of BMI measurements during the 20 years before diagnosis of T2DM.
Results
The mean BMI at diagnosis was 26.7 kg/m2 (95% confidence interval, 26.4-27.1). Compared with men whose condition was diagnosed between 1968 and 1977, for men with a diagnosis between 1978 and 2007 the mean BMI about 10 years before diagnosis significantly increased by 0.92 to 1.54 BMI units. Decades also varied in how long there was a persistent increase in BMI during the 20 years before diagnosis. The rate of change in mean BMI among men whose T2DM was diagnosed in the most recent two decades increased by 8.8% to 22.6% during the 10-year interval before diagnosis, but there was no significant difference among men given a diagnosis between 1978 and 1987. The quadratic trend of BMI prior to diagnosis was also significantly affected by age at diagnosis.
Conclusion
The BMI trajectories during the 20 years leading up to T2DM varied by decade of diagnosis. The increase in BMI persisted for much longer among relatively younger men with a diagnosis in more recent decades. Strategies to prevent T2DM, informed by the pattern of BMI trajectories, should be customized to consider a potential age-period effect.
Key words: Diabetes mellitus, body mass index trajectories, men, longitudinal study, Canada
Résumé
objectif
Le but de l’étude était d’analyser les écarts dans les trajectoires de l’indice de masse corporelle (IMC) au cours des 20 années antérieures à un diagnostic de diabète sucré de type 2 (DST2) sur une période de quatre décennies (1968 à 2007).
Méthode
Les mesures longitudinales de l’IMC de 437 hommes ayant tous un diagnostic de DST2 ont été analysées. Nous avons employé une approche à méthodes mixtes pour intégrer les trajectoires individuelles des mesures de l’IMC au cours des 20 années antérieures au diagnostic de DST2.
Résultats
L’IMC moyen au diagnostic était de 26,7 kg/m2 (intervalle de confiance de 95 %, 26,4-27,1). Comparativement aux hommes chez qui la maladie a été diagnostiquée entre 1968 et 1977, pour les hommes ayant reçu leur diagnostic entre 1978 et 2007, l’IMC moyen environ 10 ans avant le diagnostic présentait une hausse significative de 0,92 à 1,54 unité d’IMC. La durée de la période pendant laquelle il y avait eu une hausse persistante de l’IMC au cours des 20 années antérieures au diagnostic variait également selon la décennie. Le taux de changement de l’IMC moyen chez les hommes dont le DST2 avait été diagnostiqué au cours des deux décennies les plus récentes a augmenté de 8,8 % à 22,6 % au cours de l’intervalle de 10 ans précédant le diagnostic, mais il n’y avait aucun écart significatif chez les hommes ayant reçu un diagnostic entre 1978 et 1987. La tendance quadratique de l’IMC avant le diagnostic était aussi significativement affectée par l’âge au diagnostic.
Conclusion
Les trajectoires de l’IMC au cours des 20 années antérieures au DST2 variaient selon la décennie du diagnostic. L’augmentation de l’IMC persistait beaucoup plus longtemps chez les hommes relativement plus jeunes diagnostiqués au cours des décennies plus récentes. Les stratégies de prévention du DST2, éclairées par les trajectoires de l’IMC, devraient être individualisées pour tenir compte d’un éventuel effet selon l’âge et la période.
Mots Clés: diabète sucré, trajectoires de l’indice de masse corporelle, hommes, étude longitudinale, Canada
Footnotes
Acknowledgement: The authors acknowledge Dr. D. Prabhakaran and T. Manyanga for helpful feedback on an earlier version of the paper.
Conflict of Interest: None to declare.
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