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Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study

International Journal of Obesity volume 36, pages 826–833 (2012)Cite this article

Abstract

Background and aims:

In a population-based cohort study with older subjects and without specific interventions, we investigated the impact of body mass index (BMI) and BMI change (as well as waist circumference and change of waist circumference) on reversion from prediabetes to normal glucose tolerance (NGT) and on long-term persistence of NGT.

Materials and methods:

Oral glucose tolerance tests were conducted at baseline and at follow-up in a cohort study in Southern Germany (KORA S4/F4; 1223 subjects without diabetes aged 55–74 years at baseline in 1999–2001; 887 subjects (73%), of whom 436 had prediabetes at baseline, participated in the follow-up 7 years later).

Results:

BMI reduction, but not initial BMI, predicted reversion from prediabetes to NGT. The odds ratio (OR) for returning to NGT was 1.43 (95% CI: 1.18–1.73) for a BMI decrease of 1 kg m−2, after adjustment for age, sex, baseline glucose values and lifestyle factors. Initial BMI had no effect on reversion to NGT (OR=0.98, 95% CI: 0.91–1.06, per kg m−2). Persistence of NGT was associated with baseline BMI (OR=0.94, 95% CI: 0.88–0.998) and BMI reduction (OR=1.16, 95% CI: 1.02–1.33, per decrease by 1 kg m−2). For waist circumference and change of waist circumference similar results were obtained.

Conclusion:

In older adults, weight loss strongly increased the chances of returning from prediabetes to NGT irrespective of initial BMI. Long-term persistence of NGT depended both on initial BMI and on BMI change.

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Acknowledgements

The Diabetes Cohort Study was funded by a German Research Foundation project grant to the second author (DFG; RA 459/2-1). The German Diabetes Center is funded by the German Federal Ministry of Health, and the Ministry of Innovation, Science, Research and Technology of the State of North-Rhine-Westfalia. The KORA research platform and the KORA Augsburg studies are financed by the Helmholtz Zentrum München, German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. We thank the field staff in Augsburg who were involved in the conduct of the studies.

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Authors and Affiliations

  1. Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    B Kowall, W Rathmann, K Strassburger & G Giani

  2. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany

    M Heier, A Peters, B Thorand & C Meisinger

  3. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany

    R Holle

  4. Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    C Herder

Authors
  1. B Kowall
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  2. W Rathmann
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Corresponding author

Correspondence to B Kowall.

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Kowall, B., Rathmann, W., Heier, M. et al. Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study. Int J Obes 36, 826–833 (2012). https://doi.org/10.1038/ijo.2011.161

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