Fluctuations in Waist Circumference Increase the Risk of Diabetes in 61,587 Older Adults: 4 Years’ Chort Study

Abstract Purpose:To evaluate the effect of fluctuations in waist circumference (WC), weight, body mass index (BMI) on diabetes incidence in older adults.Patients and methods:We examined a prospective cohort of 61,587 older adults (age, 60-96 years) who did not have diabetes at study initiation. Data on weight, BMI, and WC were collected and participants were followed-up until 31 December 2019 . The main endpoint was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants.Results:During a mean followed-up of 3.6 years, individuals being overweight (HR [95% CI] 1.87 [1.62-2.17]), obesity (1.41 [1.26-1.59]), abdominal obesity (1.42 [1.28-1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66-2.25]) had higher risk of diabetes onset. Compared with older adults who “remained normal WC”, who “remained abdominally obese” (HR=1.66), “became abdominally obese”(HR=1.58) and “achieved normal WC” (HR=1.36) were also significantly associated with diabetes onset,as well as increase in WC >3 cm or >5% compared with baseline level . Weight gain or loss >6 kg or weight gain >5%; increase or decrease in BMI >2 kg/m2 or an increase in BMI >10% were associated with a higher diabetes risk. Diabetes risk reduced by 19% in overweight older adults who exercised daily.Conclusion:For old adults, waist circumference, BMI and healthy weight maintenance reduce diabetes risk. The findings may provide evidence for developing guidelines of proper weight and waist circumference control for older adults.