Diabetes Metab J.  2023 Nov;47(6):846-858. 10.4093/dmj.2022.0242.

Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program

• Yoo TK
• Han KD
• Kim YH
• Nam GE
• Park SH
• Rhee EJ
• Lee WY

• KMID: 2548161
• DOI: http://doi.org/10.4093/dmj.2022.0242

Abstract

Background
The effect of obesity on the development of type 2 diabetes mellitus (DM) in different age groups remains unclear. We assessed the impact of obesity on the development of DM for two age groups (40-year-old, middle age; 66-year-old, older adults) in the Korean population.
Methods
We analyzed Korean National Health Insurance Service data of 4,145,321 Korean adults with 40- and 66-year-old age without DM, between 2009 and 2014. Participants were followed up until 2017 or until the diagnosis of DM. We assessed the risk of DM based on the body mass index and waist circumference of the participants. Multiple confounding factors were adjusted.
Results
The median follow-up duration was 5.6 years. The association of general and abdominal obesity with the risk of DM development was stronger in the 40-year-old group (general obesity: hazard ratio [HR], 3.566, 95% confidence interval [CI], 3.512 to 3.622; abdominal obesity: HR, 3.231; 95% CI, 3.184 to 3.278) than in the 66-year-old group (general obesity: HR, 1.739; 95% CI, 1.719 to 1.759; abdominal obesity: HR, 1.799; 95% CI, 1.778 to 1.820). In the 66-year-old group, abdominal obesity had a stronger association with the development of DM as compared to general obesity. In the 40-year-old group, general obesity had a stronger association with the risk of DM development than abdominal obesity.
Conclusion
The influence of general and abdominal obesity on the development of DM differed according to age. In older adults, abdominal obesity had a stronger association with DM development than general obesity.

Keyword

Aging; Diabetes mellitus, type 2; Obesity; Obesity, abdominal

Figure

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  Fig. 1. Risk of diabetes mellitus (DM) development based on body mass index (BMI). Risk of DM according to BMI in (A) 40 years old and (B) 66 years old, X-axis=BMI (kg/m2); Y-axis=hazard ratio (HR). Risk of DM according to waist circumference (WC) in (C) 40 years old and (D) 66 years old, X-axis=WC, men/women, cm; Y-axis=HR.

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  Fig. 2. Risk of diabetes mellitus development based on presence of general and abdominal obesity, (A) 40 years old, (B) 66 years old. X-axis=presence of general obesity or abdominal obesity; Y-axis=hazard ratio. General obesity (+)=body mass index (BMI) ≥25 kg/m2; general obesity (–)=BMI <25 kg/m2; abdominal obesity (+)=waist circumference (WC) ≥90 cm for men and ≥85 cm for women; abdominal obesity (–)=WC <90 cm for men and <85 cm for women.

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