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Kowall, B.* ; Rathmann, W.* ; Kuss, O.* ; Herder, C.* ; Roden, M.* ; Stang, A.* ; Huth, C. ; Thorand, B. ; Meisinger, C. ; Peters, A.

Reversion from prediabetes to normoglycaemia after weight change in older persons: The KORA F4/FF4 study.

Nutr. Metab. Cardiovasc. Dis. 31, 429-438 (2021)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Background and aims: In a non-interventional study of older persons, we assessed the impact of changes in BMI and waist circumference (WC) on reversion from glucose- and HbA1c-defined prediabetes to normoglycaemia (in short: reversion) and on persistence of normoglycaemia. Moreover, we studied whether reversion reduced cardiovascular risk. Methods and results: From the population-based KORA S4/F4/FF4 cohort study conducted in Southern Germany, we utilized data from the second and third visit to the study center (median follow-up 6.5 years). We used two overlapping data sets, one with 563 persons with HbA1c<6.5% (mean age 69 years, 51.5% men), one with 510 persons with glucose-based prediabetes or normal glucose tolerance. We calculated proportions of reversion, and estimated adjusted relative risks for the association between initial BMI/WC and change of BMI/WC, respectively, and reversion (and persistence of normoglycaemia, respectively). We estimated 10-year cardiovascular risks using the Framingham 2008 score. Overall, 27.3% of persons with HbA1c-defined prediabetes and 9.2% of persons with glucose-based prediabetes returned to normoglycaemia during follow-up. Lower initial BMI/WC and reduction of BMI/WC were associated with larger probabilities of returning to normoglycaemia (e.g., for HbA1c 5.7–6.4%, RR = 1.24 (95% CI: 1.09–1.41) per 1 kg/m2 decline of BMI). Moreover, reduction of BMI/WC increased probabilities of maintaining normoglycaemia (e.g., for glucose-based prediabetes, RR = 1.09 (1.02–1.16) per 1 kg/m2 decline of BMI). 10-year cardiovascular risk was 5.6 (1.7–9.6) percentage points lower after reversion from glucose-based prediabetes to normoglycaemia. Conclusion: In older adults, even moderate weight reduction contributes to reversion from prediabetes to normoglycaemia and to maintaining normoglycaemia.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Body Mass Index ; Cardiovascular Risk ; Hba1c ; Normal Glucose Tolerance ; Prediabetes ; Waist Circumference ; Weight Reduction
ISSN (print) / ISBN 0939-4753
Journal Nutrition, Metabolism and Cardiovascular Diseases
Quellenangaben Volume: 31, Issue: 2, Pages: 429-438 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place The Boulevard, Langford Lane, Kidlington, Oxford Ox5 1gb, Oxon, England
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Independent Research Group Clinical Epidemiology (KEPI)
Grants State of Bavaria
German Federal Ministry of Science and Research (Berlin, Germany)
German Research Center for Environmental Health
Helmholtz Zentrum Munchen
German Federal Ministry of Education and Research (BMBF)
German Research Foundation (DFG)
German Federal Ministry of Health (BMG)
Ministry of Culture and Science of the State of North Rhine-Westphalia (MIWF NRW)