Five-year changes in biologic risk factors and risk of type 2 diabetes: Are attained but not initial risk factor levels of importance?

Gast, Gerrie-Cor M., Spijkerman, Annemieke M. W., van der A, Daphne L., Jacobs-van der Bruggen, Monique A. M. and Verschuren, W. M. Monique (2012) Five-year changes in biologic risk factors and risk of type 2 diabetes: Are attained but not initial risk factor levels of importance?. American Journal of Epidemiology, 176 8: 720-725. doi:10.1093/aje/kws189


Author Gast, Gerrie-Cor M.
Spijkerman, Annemieke M. W.
van der A, Daphne L.
Jacobs-van der Bruggen, Monique A. M.
Verschuren, W. M. Monique
Title Five-year changes in biologic risk factors and risk of type 2 diabetes: Are attained but not initial risk factor levels of importance?
Journal name American Journal of Epidemiology   Check publisher's open access policy
ISSN 0002-9262
1476-6256
Publication date 2012-10
Year available 2012
Sub-type Article (original research)
DOI 10.1093/aje/kws189
Open Access Status Not Open Access
Volume 176
Issue 8
Start page 720
End page 725
Total pages 6
Place of publication Cary, NC, United States
Publisher Oxford University Press
Collection year 2014
Language eng
Abstract Independent effects of changes in biologic risk factors on type 2 diabetes incidence remain unclear. The authors examined whether associations between changes in biologic risk factors and diabetes risk are driven by initial or attained risk factor levels. Biologic risk factors were measured at baseline and at each 5-year interval follow-up (rounds 2, 3, and 4) among 4,204 initially healthy men and women, aged 20-59 years, participating in the Dutch Doetinchem Cohort Study (1987-2007). Time-dependent Cox regression analyses were used to analyze associations between changes in waist circumference, blood pressure, and high density lipoprotein cholesterol (HDL cholesterol) and incident diabetes, adjusted for initial or attained levels; 130 diabetes cases occurred during 9 years of follow-up. Five-year increases in waist circumference and blood pressure and decreases in HDL cholesterol were positively associated with risk of diabetes after adjustment for initial levels but no longer after adjustment for attained levels: waist circumference (hazard ratio (HR) 0.86, 95 confidence interval (CI): 0.69, 1.07), systolic blood pressure (HR 0.96, 95 CI: 0.84, 1.10), diastolic blood pressure (HR 0.96, 95 CI: 0.87, 1.06), and HDL cholesterol (HR 0.91, 95 CI: 0.81, 1.01). In conclusion, the associations between changes in biologic risk factors and risk of diabetes are mainly driven by the attained levels. Hence, not the prior changes, but the attained levels seem to be of importance with regard to diabetes risk.
Keyword Blood pressure
Cholesterol
HDL
Risk factors
Type 2 diabetes
Waist circumference
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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Created: Wed, 04 Sep 2013, 17:11:13 EST by Gerrie-Cor Herber-Gast on behalf of School of Public Health