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Published in: Diabetologia 5/2024

Open Access 12-12-2023 | Type 2 Diabetes | Article

Child-to-adult body size change and risk of type 2 diabetes and cardiovascular disease

Authors: Germán D. Carrasquilla, Lars Ängquist, Thorkild I. A. Sørensen, Tuomas O. Kilpeläinen, Ruth J. F. Loos

Published in: Diabetologia | Issue 5/2024

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Abstract

Aims/hypothesis

Childhood overweight increases the risk of type 2 diabetes and cardiovascular disease in adulthood. However, the impact of childhood leanness on adult obesity and disease risk has been overlooked. We examined the independent and combined influences of child and adult body size on the risk of type 2 diabetes and cardiovascular disease.

Methods

Data from the UK Biobank on 364,695 individuals of European ancestry and free of type 2 diabetes and cardiovascular disease were divided into nine categories based on their self-reported body size at age 10 and measured BMI in adulthood. After a median follow-up of 12.8 years, 33,460 individuals had developed type 2 diabetes and/or cardiovascular disease. We used Cox regression models to assess the associations of body size categories with disease incidence.

Results

Individuals with low body size in childhood and high body size in adulthood had the highest risk of type 2 diabetes (HR 4.73; 95% CI 4.50, 4.99), compared to those with average body size in both childhood and adulthood. This was significantly higher than the risk in those with high body size in both childhood and adulthood (HR 4.05; 95% CI 3.84, 4.26). By contrast, cardiovascular disease risk was determined by adult body size, irrespective of childhood body size.

Conclusions/interpretation

Low body size in childhood exacerbates the risk of type 2 diabetes associated with adult obesity but not the risk of cardiovascular disease. Thus, promoting healthy weight management from childhood to adulthood, among lean children, is crucial.

Graphical Abstract

Appendix
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Literature
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go back to reference UK Biobank (2019) First occurrence of health outcomes defined by 3-character ICD10 code. UK Biobank, Stockport UK Biobank (2019) First occurrence of health outcomes defined by 3-character ICD10 code. UK Biobank, Stockport
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go back to reference World Health Organization (2022) WHO European regional obesity report 2022. WHO Regional Office for Europe, Copenhagen World Health Organization (2022) WHO European regional obesity report 2022. WHO Regional Office for Europe, Copenhagen
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go back to reference Hawkes G, Beaumont RN, Tyrrell J et al (2023) Genetic evidence that high BMI in childhood has a protective effect on intermediate diabetes traits, including measures of insulin sensitivity and secretion, after accounting for BMI in adulthood. Diabetologia 66(8):1472–1480. https://doi.org/10.1007/s00125-023-05923-6 Hawkes G, Beaumont RN, Tyrrell J et al (2023) Genetic evidence that high BMI in childhood has a protective effect on intermediate diabetes traits, including measures of insulin sensitivity and secretion, after accounting for BMI in adulthood. Diabetologia 66(8):1472–1480. https://​doi.​org/​10.​1007/​s00125-023-05923-6
Metadata
Title
Child-to-adult body size change and risk of type 2 diabetes and cardiovascular disease
Authors
Germán D. Carrasquilla
Lars Ängquist
Thorkild I. A. Sørensen
Tuomas O. Kilpeläinen
Ruth J. F. Loos
Publication date
12-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 5/2024
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-023-06058-4

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