Body-weight fluctuation and risk of diabetes in older adults: The China Health and Retirement Longitudinal Study (CHARLS)

Aims Body-weight fluctuation is associated with an increased risk of all-cause mortality. Yet no studies investigate its association with risk of diabetes in adults aged ≥ 60 years. This study aimed to address this issue. Methods A total of 1,565 participants free of diabetes at baseline in the CHARLS were followed for 4-year. Body-weight was collected at baseline and every 2-year. Body-weight fluctuation was primarily calculated as the root-mean-square-error deviation from the regression line of body-weights against years. The risk of diabetes was estimated using logistic regression analysis. Results During the 4-year follow-up, 153 participants developed diabetes. The risk of diabetes was increased by 23% (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.06 to 1.43) per every 1-standard deviation higher of body-weight fluctuation after controlling for cardiovascular risk factors. The association appeared pronounced among participants with poor physical performance (both P < 0.03). Participants with overweight/obesity and a high body-weight fluctuation had the largest increase in the risk for diabetes (OR 3.03). Body-weight fluctuation correlated with hemoglobin A1c and white blood cells at follow-up or their change scores from baseline, especially in females (all P < 0.02). Conclusions Body-weight fluctuation led to an increased risk of diabetes in adults aged ≥ 60 years.