From the perspective of dynamic changes in BMI: the relationship between BMI trajectories and dysglycemia, all-cause mortality.

OBJECTIVES

The aim was to explore the body mass index (BMI) trajectory over dynamic time and its relationship with the dysglycemia (including Type 2 Diabetes Mellitus and prediabetes), all-cause mortality, and insulin resistance.

METHODS

The latent category trajectory model (LCTM) is used to identify the BMI trajectories. Logistic and Cox regression were fitted to assess the correlation between BMI trajectories/weight changes and Type 2 Diabetes Mellitus (T2DM)/prediabetes. Using linear regression to evaluate the correlation between the two and insulin resistance. Mediating role of inflammation was evaluated.

RESULTS

Four BMI trajectories were identified, including "stable" (74.32%), "light increase" (17.18%), "rapid increase" (2.82%), and "increase-to-decrease" (5.67%). Compared to stable trajectories, participants with slight increase or increase-to-decrease trajectories had higher risks of T2DM, while participats with a slight increase or rapid increase trajectory had a higher probability of developing prediabetes. Early weight changes such as decrease, increase, overweight, or obesity were associated with higher T2DM, while recent weight changes like decrease or obesity-stable only impacted T2DM prevalence, and there were no significant associations for prediabetes.

CONCLUSION

The findings underscore the critical impact of BMI trajectories and early/recent weight changes on T2DM and mortality risk.