The association of body shape trajectories over the life course with type 2 diabetes risk in adulthood: a group-based modeling approach

Abstract Purpose Low birth weight is a well-recognized risk factor for type 2 diabetes (T2D), but less is known about risks associated with the evolution of body shape throughout life with incident T2D in adulthood. Methods In 80,110 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort study, trajectories of self-reported body shapes from age 8 years to 35–40 years were derived using a group-based modeling approach and studied in relation with incident T2D. Results Compared with women who maintained a stable midrange body shape trajectory from 8 to 40 years, women in all other observed trajectories were at a higher risk of developing T2D in adulthood: The highest risk was observed for women who were lean at age 8 years and had a sharp increase in body shape (hazards ratio = 2.91 [2.35–3.62]); their T2D risk was higher ( P for homogeneity = .059) than for women who maintained the largest body shape (hazards ratio = 2.18 [1.76–2.69]). Conclusions A group-based modeling approach has identified trajectories of body shape evolution with different risks of developing T2D in adulthood. A sharp increase in body shape after puberty in previously lean girls is a risk factor for the subsequent development of diabetes.