American journal of preventive medicine · 2026
Longitudinal BMI Trajectory in Reproductive-Age Women at Risk of Prediabetes: Implications for Preventive Screening.
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Tano Sho, Fuma Kazuya, Matsuo Seiko, Katsuki Satoru, Inamura Tatsuo, Fujito Sumire, Kajiyama Hiroaki, Ushida Takafumi
Аннотация
INTRODUCTION: Preventive strategies for dysglycemia typically rely on single BMI measurements or thresholds, despite evidence that gradual weight gain precedes metabolic deterioration. Whether longitudinal BMI trajectories may help to identify reproductive-age women at an elevated risk for prediabetes remains unclear.
METHODS: A retrospective cohort study was conducted using annual occupational health checkup data collected from 2015 to 2024 at 4 centers in Japan. The analysis included 2,271 normoglycemic women aged 18-40 years who remained free of prediabetes during the landmark period (2015-2017). Annual BMI change during the landmark period (kg/m²/year) was estimated using within-person regression. Incident prediabetes (HbA1c 5.7%-6.4%) after 2017 was evaluated using Cox proportional hazards models, including time-dependent analyses.
RESULTS: During a median follow-up of 7.0 years, 346 women (15.2%) developed prediabetes. Each 0.1 kg/m²/year increase in annual BMI gain was associated with a higher risk of incident prediabetes (hazard ratio=1.04, 95% CI=1.02, 1.05). Time-dependent analyses incorporating repeated BMI measurements demonstrated that persistent BMI gain remained associated with incident prediabetes. Kaplan-Meier analyses demonstrated earlier risk separation among women with greater BMI gain (≥0.6 kg/m2/year), whereas women with mild BMI gain (0.2 to <0.6 kg/m2/year) showed delayed but progressive separation after approximately 5 years, particularly among those with a normal baseline BMI.
CONCLUSIONS: Monitoring BMI trajectory in routine health checkups may improve the early identification of reproductive-age women at risk for dysglycemia and support trajectory-informed preventive strategies.
METHODS: A retrospective cohort study was conducted using annual occupational health checkup data collected from 2015 to 2024 at 4 centers in Japan. The analysis included 2,271 normoglycemic women aged 18-40 years who remained free of prediabetes during the landmark period (2015-2017). Annual BMI change during the landmark period (kg/m²/year) was estimated using within-person regression. Incident prediabetes (HbA1c 5.7%-6.4%) after 2017 was evaluated using Cox proportional hazards models, including time-dependent analyses.
RESULTS: During a median follow-up of 7.0 years, 346 women (15.2%) developed prediabetes. Each 0.1 kg/m²/year increase in annual BMI gain was associated with a higher risk of incident prediabetes (hazard ratio=1.04, 95% CI=1.02, 1.05). Time-dependent analyses incorporating repeated BMI measurements demonstrated that persistent BMI gain remained associated with incident prediabetes. Kaplan-Meier analyses demonstrated earlier risk separation among women with greater BMI gain (≥0.6 kg/m2/year), whereas women with mild BMI gain (0.2 to <0.6 kg/m2/year) showed delayed but progressive separation after approximately 5 years, particularly among those with a normal baseline BMI.
CONCLUSIONS: Monitoring BMI trajectory in routine health checkups may improve the early identification of reproductive-age women at risk for dysglycemia and support trajectory-informed preventive strategies.