Vol 8, No 10 (2007): Practical Diabetology
Other materials agreed with the Editors
Published online: 2008-02-01
Body size and shape changes and the risk of diabetes in the Diabetes Prevention Program
Diabetologia Praktyczna 2007;8(10):386-395.
Abstract
The researchers conducted this study to test the
hypothesis that risk of type 2 diabetes is less following
reductions in body size and central adiposity.
The Diabetes Prevention Program (DPP) recruited and
randomized individuals with impaired glucose tolerance
to treatment with placebo, metformin, or lifestyle
modification. Height, weight, waist circumference,
and subcutaneous and visceral fat at L2-L3
and L4-L5 by computed tomography were measured
at baseline and at 1 year. Cox proportional hazards
models assessed by sex the effect of change
in these variables over the 1st year of intervention
upon development of diabetes over subsequent follow-
up in a subset of 758 participants. Lifestyle reduced
visceral fat at L2-L3 (men -24.3%, women
-18.2%) and at L4-L5 (men -22.4%, women -17.8%),
subcutaneous fat at L2-L3 (men -15.7%, women
-11.4%) and at L4-L5 (men -16.7%, women -11.9%),
weight (men –8.2%, women –7.8%), BMI (men -8.2%,
women -7.8%), and waist circumference (men
-7.5%, women -6.1%). Metformin reduced weight
(-2.9%) and BMI (-2.9%) in men and subcutaneous
fat (-3.6% at L2-L3 and -4.7% at L4-L5), weight
(-3.3%), BMI (-3.3%), and waist circumference
(-2.8%) in women. Decreased diabetes risk by lifestyle
intervention was associated with reductions of
body weight, BMI, and central body fat distribution
after adjustment for age and self-reported ethnicity.
Reduced diabetes risk with lifestyle intervention
may have been through effects upon both overall
body fat and central body fat but with metformin
appeared to be independent of body fat.