Early Weight Loss in Impaired Glucose Tolerance Is Associated With Reduced Long-term Mortality and Cardiovascular Risk: The Da Qing Diabetes Prevention Outcome Study.

Abstract

To determine whether weight loss during the initial years following diagnosis of impaired glucose tolerance (IGT) is independently associated with reduced long-term mortality and cardiovascular risk. In the Da Qing Diabetes Prevention Study, 540 adults with IGT were categorized into three groups based on their weight change from baseline to the end of a 6-year lifestyle intervention trial: non-weight loss (n = 200), low weight loss (<5%, n = 163), and high weight loss (≥5%, n = 177). Participants were followed for 34 years to assess all-cause mortality, cardiovascular disease (CVD) mortality, and CVD events. Cox models were used to assess associations. Weight loss during the initial 6 years following IGT diagnosis was associated with reduced long-term risks of CVD events and mortality (P = 0.007-0.015). Compared with participants without weight loss, those with weight loss ≥5% had significantly lower risks of CVD death (hazard ratio [HR] 0.56, 95% CI 0.35-0.89), CVD events (HR 0.71, 95% CI 0.52-0.99), hospitalized heart failure (HR 0.48, 95% CI 0.26-0.88), and all-cause death (HR 0.67, 95% CI 0.48-0.95) after adjusting for age, sex, baseline weight, and other covariates. Furthermore, the high weight loss group showed delays in the median time to all-cause mortality and CVD mortality of 2.1 years and 6.5 years, respectively. Weight loss achieved in the early years after diagnosis of IGT in Chinese adults is associated with substantially lower long-term risks of CVD events and mortality, suggesting the critical importance of early weight management in individuals with prediabetes for improving long-term survival and cardiovascular health.