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

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 40years, 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.