Association of Overweight and Obesity with Type 2 Diabetes Mellitus: A Meta-Analysis of Cohort Studies_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Jun ¹ , GUO Yi ^1,2 , LIU Qing ¹ , ZHOU Minxin ¹ ,  ZHANG Qingjun ³

1. Department of Epidemiology, School of Public Health, Wuhan University, Wuhan 430071, China;2. State Key Lab of Virology, Wuhan University, Wuhan 430071, China;3. Chronic Disease Research Institute, Hubei Center for Disease Control and Prevention, Wuhan 430079, China;

Corresponding author：

ZHANG Qingjun, Email: qingjunzhang@163.com

Keywords：

Overweight; Obesity; Type 2 Ddiabetes mellitus; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.20130033

Video：

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Objective 　To explore the correlation between overweight, obesity and incidence of type 2 diabetes mellitus (T2DM).
Methods 　Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CNKI, VIP, CBM and WanFang Data were searched from inception to May, 2012 to collect the cohort studies on the correlation between overweight, obesity and incidence of T2DM. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, the quality was evaluated, the data were extracted, and then meta-analysis was performed using RevMan 5.1 and Stata 11.0 software.
Results 　A total of 8 studies involving 101 864 participants were included. The results of meta-analysis showed that, compared with the normal weight population, the onset risk of T2DM was obviously higher in the overweight (RR=2.59, 95%CI 2.11 to 3.19, P lt;0.000 01), and obese (RR=6.28, 95%CI 4.99 to 7.91, P lt;0.000 01) populations. In the subgroup analysis, the onset risk of T2DM was higher in the western obese population (RR=6.91, 95%CI 5.59 to 8.56) than the eastern obese population (RR=4.19, 95%CI 2.93 to 5.99). Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the quality of the included studies on T2DM developed by overweight and obesity was low and medium respectively.
Conclusion 　Overweight and obesity can increase the onset risk of T2DM which is higher in the female and western obese populations than the male and eastern obese populations respectively.

Citation： LIU Jun,GUO Yi,LIU Qing,ZHOU Minxin,ZHANG Qingjun. Association of Overweight and Obesity with Type 2 Diabetes Mellitus: A Meta-Analysis of Cohort Studies. Chinese Journal of Evidence-Based Medicine, 2013, 13(2): 190-195. doi: 10.7507/1672-2531.20130033 Copy

1.	中国肥胖问题工作组数据汇总分析协作组. 我国成人体重指数和腰围对相关疾病危险因素异常的预测价值: 适宜体重指数和腰围切点的研究. 中华流行病学杂志, 2002, 23(1): 10-15.
2.	Hitman GA, Sudagani J. Searching for genes in diabetes and the metabolic syndrome. Int J Clin Pract Suppl, 2004, 10(143): 3-8.
3.	Field AE, Mason JE, Laird N, et al. Weight cycling and the risk of developing type 2 diabetes among adult women in the United States. Obes Res, 2004, 12(2): 267-274.
4.	Astrup A, Finer N. Redefining type 2 diabetes: ’diabesity’ or ’obesity dependent diabetes mellitus’? Obes Rev, 2000, 1(2): 57-59.
5.	Nemesure B, Wu SY, Hennis A, et al. The relationship of body mass index and waist-hip ratio on the 9-year incidence of diabetes and hypertension in a predominantly African-origin population. Ann Epidemiol, 2008, 18(8): 657-663.
6.	Krishnan S, Rosenberg L, Djousse L, et al. Overall and central obesity and risk of type 2 diabetes in U.S. black women. Obesity (Silver Spring), 2007, 15(7): 1860-1866.
7.	Hu FB, Mason JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med, 2001, 345(11): 790-797.
8.	Wells GA, Shea B, O’Connel D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from:URL:http//www.ohri.ca/ programs /clinical_ epidemiology/oxford.asp.
9.	Balshem H, Helfanda M, Schunemann HJ, 等. GRADE指南: Ⅲ.证据质量分级. 中国循证医学杂志, 2011, 11(4): 451-455.
10.	Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA, 2004, 292(10): 1188-1194.
11.	Harati H, Hadaeqh F, Saadat N, et al. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran. BMC Public Health, 2009, 9: 186.
12.	Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health, 2005, 59(2): 134-139.
13.	Sung EJ, Sunwoo S, Kim SW, et al. Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea. J Korean Med Sci, 2001, 16(4): 391-396.
14.	Wang Z, Hoy WE, Si D. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study. BMC Public Health, 2010, 10: 487.
15.	Patja K, Jousilahti P, Hu G, et al. Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med, 2005, 258(4): 356-362.
16.	Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab, 2006, 91(8): 2906-2912.
17.	Meisinger C, Doring A, Thorand B, et al. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr, 2006, 84(3): 483-489.
18.	Ni MC, Parag V, Nakamura M, et al. Body mass index and risk of diabetes mellitus in the Asia-Pacific region. Asia Pac J Clin Nutr, 2006, 15(2): 127-133.
19.	Abdullah A, Stoelwinder J, Shortreed S, et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr, 2011, 14(1): 119-126.
20.	Nagaya T, Yoshida H, Takahashi H, et al. Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med, 2005, 22(8): 1107-1111.
21.	Seidell JC. Obesity, insulin resistance and diabetes–a worldwide epidemic. Br J Nutr, 2000, 83 Suppl 1: S5-8.
22.	Ko GT, Tang JS. Waist circumference and BMI cut-off based on 10-year cardiovascular risk: evidence for "central pre-obesity". Obesity (Silver Spring), 2007, 15(11): 2832-2839.
23.	Rosengren A. Overweight, obesity and BMI. The INTERHEART study shows that the BMI should probably be abolished--the waist-hip ratio is better. Lakartidningen, 2006, 103(9): 628.
24.	Balkau B, Sapinho D, Petrella A, et al. Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study. Eur J Clin Nutr, 2006, 60(3): 295-304.

1. 中国肥胖问题工作组数据汇总分析协作组. 我国成人体重指数和腰围对相关疾病危险因素异常的预测价值: 适宜体重指数和腰围切点的研究. 中华流行病学杂志, 2002, 23(1): 10-15.
2. Hitman GA, Sudagani J. Searching for genes in diabetes and the metabolic syndrome. Int J Clin Pract Suppl, 2004, 10(143): 3-8.
3. Field AE, Mason JE, Laird N, et al. Weight cycling and the risk of developing type 2 diabetes among adult women in the United States. Obes Res, 2004, 12(2): 267-274.
4. Astrup A, Finer N. Redefining type 2 diabetes: ’diabesity’ or ’obesity dependent diabetes mellitus’? Obes Rev, 2000, 1(2): 57-59.
5. Nemesure B, Wu SY, Hennis A, et al. The relationship of body mass index and waist-hip ratio on the 9-year incidence of diabetes and hypertension in a predominantly African-origin population. Ann Epidemiol, 2008, 18(8): 657-663.
6. Krishnan S, Rosenberg L, Djousse L, et al. Overall and central obesity and risk of type 2 diabetes in U.S. black women. Obesity (Silver Spring), 2007, 15(7): 1860-1866.
7. Hu FB, Mason JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med, 2001, 345(11): 790-797.
8. Wells GA, Shea B, O’Connel D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from:URL:http//www.ohri.ca/ programs /clinical_ epidemiology/oxford.asp.
9. Balshem H, Helfanda M, Schunemann HJ, 等. GRADE指南: Ⅲ.证据质量分级. 中国循证医学杂志, 2011, 11(4): 451-455.
10. Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA, 2004, 292(10): 1188-1194.
11. Harati H, Hadaeqh F, Saadat N, et al. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran. BMC Public Health, 2009, 9: 186.
12. Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health, 2005, 59(2): 134-139.
13. Sung EJ, Sunwoo S, Kim SW, et al. Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea. J Korean Med Sci, 2001, 16(4): 391-396.
14. Wang Z, Hoy WE, Si D. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study. BMC Public Health, 2010, 10: 487.
15. Patja K, Jousilahti P, Hu G, et al. Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med, 2005, 258(4): 356-362.
16. Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab, 2006, 91(8): 2906-2912.
17. Meisinger C, Doring A, Thorand B, et al. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr, 2006, 84(3): 483-489.
18. Ni MC, Parag V, Nakamura M, et al. Body mass index and risk of diabetes mellitus in the Asia-Pacific region. Asia Pac J Clin Nutr, 2006, 15(2): 127-133.
19. Abdullah A, Stoelwinder J, Shortreed S, et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr, 2011, 14(1): 119-126.
20. Nagaya T, Yoshida H, Takahashi H, et al. Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med, 2005, 22(8): 1107-1111.
21. Seidell JC. Obesity, insulin resistance and diabetes–a worldwide epidemic. Br J Nutr, 2000, 83 Suppl 1: S5-8.
22. Ko GT, Tang JS. Waist circumference and BMI cut-off based on 10-year cardiovascular risk: evidence for "central pre-obesity". Obesity (Silver Spring), 2007, 15(11): 2832-2839.
23. Rosengren A. Overweight, obesity and BMI. The INTERHEART study shows that the BMI should probably be abolished--the waist-hip ratio is better. Lakartidningen, 2006, 103(9): 628.
24. Balkau B, Sapinho D, Petrella A, et al. Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study. Eur J Clin Nutr, 2006, 60(3): 295-304.

Chinese Journal of Evidence-Based Medicine

Association of Overweight and Obesity with Type 2 Diabetes Mellitus: A Meta-Analysis of Cohort Studies

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