The epidemiology of obesity and the development of disorders of glucose metabolism according to a prospective study in Siberia

Abstract

Introduction: Persons who are overweight and obese have a higher risk of development of diabetes mellitus. In Russia, the epidemiological trends of glucose metabolism disorders in obese persons are understudied.Aim. To study the prevalence of overweight and obesity in a population sample aged 45–69 (Novosibirsk), and to assess the relationship between body mass index and 3-year dynamics of glucose metabolism disorders in a prospective cohort study.Material and Methods: A representative population sample of men and women 45–69 years old was examined in Novosibirsk in 2003–2005 (baseline survey, HAPIEE Project). In a prospective study 2,787 individuals without baseline diabetes who participated in the first and repeated surveys (2006–2008) were analyzed. The average duration of prospective follow–up comprised 3±0.01 years. Anthropometric measurements, biochemical assessment including lipids and carbohydrate metabolism were performed. Diabetes mellitus was defined by epidemiological criteria in patients with established diabetes history and in individuals with fasting blood glucose level ≥7,0mmol/l (WHO, 1999). The classification of obesity by BMI value was used according to WHO (1997).Results: In a population sample aged 45–69 in 2002–2006 the proportions of persons with BMI value ≥25 and 30kg/m2 was 37.5%, and with BMI≥30kg/m2 – 35%. Among persons with baseline overweight, the rate of new diabetes cases was 2.5 times higher than among those with normal body weight. In persons with baseline obesity the rate of new diabetes cases was 6 times higher than in those with normal body weight. Men with BMI ≥25 and 30 kg/m2 had a frequency of new diabetes 3.4 times higher, and in persons with BMI≥30 kg/m2 – 8.5 times higher than in men with normal BMI. Women with excess body weight had a rate of newly emerged diabetes mellitus 1.7 times higher, and women with obesity – 6 times higher than in a group with normal body weight.Conclusion: The prevalence of obesity in a Siberian population aged 45–69 years comprises 35%. In studied population sample, person with excess body weight have a 3-year incidence of new-onset diabetes 2.5 times higher compared to those with normal body weight. In obese persons the frequency of new diabetes was 6 times higher compared to those with BMI ≤25 kg/m2. Among persons with obesity, the frequency of new diabetes is 2 times higher in men than in women