Impact of weight gain on the evolution and regression of prediabetes: a quantitative analysis.

BACKGROUND/OBJECTIVES: The quantitative impact of weight gain on prediabetic glucose dysregulation remains unknown; only one study quantitated the impact of weight loss. We quantified the impact of weight gain on the evolution and regression of prediabetes (PDM).

SUBJECTS/METHODS: In 4234 subjects without diabetes, using logistic regression analysis with a 4.8-year follow-up period, we analyzed the relationship between (1) δBMI (BMIfollow-up-basal ) and the progression from normal glucose regulation (NGR) to PDM or diabetes, and (2) δBMI and the regression from PDM to NGR.

RESULTS: Mean (±s.d.) δBMI was 0.17 (±1.3) kg/m2 in subjects with NGR and δBMI was positively and independently related to progression (adjusted odds ratio (ORadj ) (95% CI), 1.24 (1.15-1.34), P<0.01). Mean (±s.d.) δBMI was -0.03 (±1.25) kg/m2 in those with PDM and δBMI was negatively related to the regression (ORadj , 0.72 (0.65-0.80), P<0.01). The relation of δBMI to the progression was significant in men (ORadj , 1.42 (1.28-1.59), P<0.01) but not in women (ORadj , 1.05 (0.94-1.19), P=0.36). Also, the negative impact of δBMI on the regression was significant only in men (men, ORadj , 0.65 (0.57-0.75), P<0.01; women, ORadj , 0.94 (0.77-1.14), P=0.51).

CONCLUSIONS: In Japanese adults, an increase in the BMI by even 1 kg/m2 was related to 24% increase in the risk of development of PDM or diabetes in NGR subjects and was related to 28% reduction in the regression from PDM to NGR. In women, we did not note any significant impact of weight gain on the evolution or regression of PDM.