IJE Advance Access published online on December 22, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi281
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1 Institut National de la Santé et de la Recherche Médicale U258, Villejuif, France; Université Paris Sud, IFR69, Villejuif, France; Center for Health Research Northwest/Hawaii, Kaiser Permanente, Portland, OR, USA
* To whom correspondence should be addressed. Background How weight change affects the metabolic syndrome (MS) and its parameters is unknown, particularly, in a leaner European population such as the French prospective D.E.S.I.R. cohort. Methods In 3770 D.E.S.I.R. participants (sex ratio = 1) averaging 47.5 years (range 30-64), with measured weight and MS parameters at baseline (D0) and at 6 year follow-up (D6), we assessed this relationship across five weight-change classes, using stable weight as the referent group (-2 to +2 kg). We used analysis-of-covariance to assess changes in each MS parameter and logistic regression to assess incident MS, according to the National Cholesterol Education Program (NCEP). We also assessed weight-change effect on MS status between D0 and D6. Results At D0, average weight was 68.4 kg (SD 12.3); BMI was 24.8 kg/m2 (SD 3.5). From D0-D6, the cohort gained a mean 2.1 kg (median 2.0; SD 4.4). After adjustment for age and D0 weight, there was a strong linear relationship with weight change and worsening of the following MS parameters at D6: fasting insulin, waist girth, fasting glucose, fasting triglycerides, HDL cholesterol, and systolic and diastolic blood pressure (P < 0.0001). After age adjustment, for every kilogram gained over 6 years, risk of developing the NCEP Syndrome increased 22% (OR 1.22; 95% CI 1.18-1.25). NCEP-MS was incident in 3% of those with stable weight compared with 21% among those gaining >9 kg; 10% of those who lost >2 kg reverted to non-NCEP-MS. Conclusions All continuous MS measures are linearly related to weight change, and MS can resolve with modest weight loss, underscoring the importance of maintaining lifelong normal weight.
Accepted November 8, 2005
Original paper
Weight change and changes in the metabolic syndrome as the French population moves towards overweight: The D.E.S.I.R. Cohort
T. A. Hillier 1,
A. Fagot-Campagna 2,
E. Eschwège 3,
S. Vol 4,
M. Cailleau 4,
B. Balkau 3 *,
and
the D.E.S.I.R. Study group 4
2 Institut de Veille Sanitaire, Département des Maladies Chroniques et Traumatismes (Programme Diabète), Saint Maurice Cedex, France
3 Institut National de la Santé et de la Recherche Médicale U258, Villejuif, France; Université Paris Sud, IFR69, Villejuif, France
4 Institut inter Régional pour la Santé (IRSA), Étude D.E.S.I.R., Tours, France
B. Balkau, E-mail: balkau{at}vjf.inserm.fr
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