medwireNews: The highest risk for type 2 diabetes occurs in people who progress from a low body size in childhood to a high body size in adulthood, shows an analysis of data from the UK Biobank.
As expected, people with a high body size in adulthood, categorized according to BMI, had the highest risk for developing type 2 diabetes during 13 years of follow-up.
“However, we get to see that body size in childhood matters,” said Germán Carrasquilla (University of Copenhagen, Denmark), who presented the findings at the 58th EASD Annual Meeting in Stockholm, Sweden.
His team used data from 379,528 people of European ancestry from the UK Biobank, 5.7% of whom developed type 2 diabetes These people self-reported their childhood body size to be low, average, or high at age 10 years. The most numerous group, comprising 27.6% of the population, was people classed as average during both childhood and adulthood.
About 15% of people with a high body size in adulthood developed type 2 diabetes during follow-up, compared with about 5% of those with an average body size and approximately 2% of those with a high body size.
But there was a different pattern for childhood body size; those with high body size had the highest risk during follow-up, followed by those with a low body size, at hazard ratios of 1.54 and 1.22, respectively, relative to people with an average childhood body size, who had the lowest rate of diabetes in adulthood.
Considering childhood and adulthood body size together, the highest risk for incident type 2 diabetes was seen in the 3.7% of people who had a low childhood body size but went on to have a high body size in adulthood, at a hazard ratio of 4.49 relative to those with an average body size throughout life.
The hazard ratios for diabetes were 3.82 for people with a high body size throughout life and 3.50 for those who progressed from average to high. The likelihood of people with an average or low adult body size developing diabetes was considerably smaller, irrespective of their childhood body size.
Of note, people with a high childhood but low adult body size had a significantly lower risk for developing type 2 diabetes than those whose body size was average in both periods, at a hazard ratio of 0.37.
In response to an audience question, Carrasquilla suggested that physicians could consider childhood body size when assessing diabetes risk, although he advised basing this on objective measurements taken in childhood rather than self-report where possible.
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