The older, the less potential benefit for type 2 diabetes from weight control

Area of Science:

• Gerontology
• Endocrinology
• Public Health

Background:

• Obesity is a known risk factor for type 2 diabetes mellitus (T2DM) in younger and middle-aged adults.
• Limited high-quality evidence exists on the obesity-T2DM association in older populations.
• The relationship between obesity and T2DM may change across the lifespan.

Purpose of the Study:

• To investigate how the association between obesity and T2DM is modified by aging.
• To analyze the impact of age on the strength of the obesity-T2DM link.

Main Methods:

• Cross-sectional study involving 63,180 Chinese and US subjects from three datasets.
• Subjects categorized into young & middle-aged (≤59 years), young-old (60-75 years), and old-old (≥75 years).
• Logistic regression and sliding-window algorithms used to assess the association between obesity and T2DM, stratified by age and confounders.

Main Results:

• The odds ratio (OR) for obesity and T2DM significantly decreased with advancing age, from 5.91 in the young & middle-aged to 3.06 in the old-old group.
• This trend of reduced association persisted across different obesity types, regions, genders, and comorbidities.
• Gender disparity in the obesity-T2DM association was weakened in older age groups.

Conclusions:

• The association between obesity and T2DM is attenuated in older adults.
• Elderly individuals may derive fewer benefits from weight loss interventions for T2DM compared to younger patients.
• Clinicians must carefully weigh the benefits and risks of weight loss in geriatric T2DM management, considering geriatric syndromes.