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Original Article
- Metabolic Risk/Epidemiology
- The Risk of Type 2 Diabetes Mellitus according to Changes in Obesity Status in Late Middle-Aged Adults: A Nationwide Cohort Study of Korea
- Joon Ho Moon, Yeonhoon Jang, Tae Jung Oh, Se Young Jung
- Diabetes Metab J. 2023;47(4):514-522. Published online April 25, 2023
- DOI: https://doi.org/10.4093/dmj.2022.0159
- 9,720 View
- 245 Download
- 7 Web of Science
- 7 Crossref
-
Abstract
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Supplementary Material
PubReader 
ePub - Background
Although obesity is a well-known risk factor of type 2 diabetes mellitus (T2DM), there is scant data on discriminating the contribution of previous obesity and recent weight gain on developing T2DM.
Methods
We analyzed the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 where Korean residents underwent biennial health checkups. Participants were classified into four groups according to their obesity status (body mass index [BMI] ≥25 kg/m2) before and after turning 50 years old: maintaining normal (MN), becoming obese (BO), becoming normal (BN), and maintaining obese (MO). Cox proportional hazards regression model was used to estimate the risk of T2DM factoring in the covariates age, sex, BMI, presence of impaired fasting glucose or hypertension, family history of diabetes, and smoking status.
Results
A total of 118,438 participants (mean age, 52.5±1.1 years; men, 45.2%) were prospectively evaluated for incident T2DM. A total of 7,339 (6.2%) participants were diagnosed with T2DM during a follow-up period of 4.8±2.6 years. Incidence rates of T2DM per 1,000 person-year were 9.20 in MN, 14.81 in BO, 14.42 in BN, 21.38 in MO. After factoring in covariates, participants in the groups BN (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.04 to 1.27) and MO (aHR, 1.14; 95% CI, 1.06 to 1.24) were at increased risk of developing T2DM compared to MN, whereas BO (hazard ratio, 1.06; 95% CI, 0.96 to 1.17) was not.
Conclusion
Having been obese before 50 years old increased the risk of developing T2DM in the future, but becoming obese after 50 did not. Therefore, it is important to maintain normal weight from early adulthood to prevent future metabolic perturbations. -
Citations
Citations to this article as recorded by
- Association between body weight time in target range and risk of type 2 diabetes in adults with obesity
Soojin Park, Seohyun Kim, Sang Ho Park, Minkyeong Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Gyuri Kim
Diabetology & Metabolic Syndrome.2026;[Epub] CrossRef - Income and risk of type 2 diabetes incidence varied associations according to obesity status: a nationwide study
Jee Hee Yoo, You-Bin Lee, Ji Eun Jun, Kyu-Na Lee, Kyungdo Han
BMC Public Health.2026;[Epub] CrossRef - Effect of smoking cessation on new-onset diabetes mellitus in dyslipidemic individuals: A population-based cohort study
Wooin Seo, Se Young Jung, KeeHyuck Lee, Woo Kyung Bae, Jong Soo Han, Hyejin Lee, Ji Soo Kim, Hye Yeon Koo, Seung Yeon Lee, Kiheon Lee
Tobacco Induced Diseases.2025; 23(June): 1. CrossRef - Lifestyle factors and colorectal cancer prediction: A nomogram-based model
Wooin Seo, Se Young Jung, Yeonhoon Jang, Kiheon Lee
BMC Cancer.2025;[Epub] CrossRef - National trends in the unmet healthcare needs among patients with hypertension or type 2 diabetes mellitus in Korea from 2009 to 2023
Yeona Jo, Seoyoung Park, Soeun Kim, Yejun Son, Jaeyu Park, Hanseul Cho, Louis Jacob, Damiano Pizzol, Guillermo F. López Sánchez, Lee Smith, Selin Woo, Dong Keon Yon
Scientific Reports.2025;[Epub] CrossRef - Accounting for time-varying exposures and covariates in the relationship between obesity and diabetes: analysis using parametric g-formula
Boyoung Park, Junghyun Yoon, Thi Xuan Mai Tran
Journal of Epidemiology and Community Health.2024; 78(11): 729. CrossRef - Association of Uterine Leiomyoma with Type 2 Diabetes Mellitus in Young Women: A Population-Based Cohort Study
Ji-Hee Sung, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
Diabetes & Metabolism Journal.2024; 48(6): 1105. CrossRef
- Association between body weight time in target range and risk of type 2 diabetes in adults with obesity
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