American Journal of Epidemiology Vol. 147, No. 2: 173-179
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Temporal Relations between Obesity and Insulin: Longitudinal Data from the Normative Aging Study
1 Department of Public Health and Community Medicine, University of Sydney Australia
2 Normative Aging Study, Department of Veterans Affairs Boston, MA
3 Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School Boston, MA
Although obesity and insulin levels are generally associated in cross-sectional data, the temporal and causal nature of their association is not yet clear. Increased obesity may have preceded increased insulin levels or vice versa. The authors examined the temporal relations between fasting insulin blood levels and weight in longitudinal data from the ongoing Normative Aging Study. Two insulin measurements from which a rate of change (
Insulin) could be calculated were available from 376 non-diabetic male subjects (mean age = 62.1 years). Rates of change in weight could be calculated for the previous inter-examination period (Weight1), the contemporaneous period (Weight2), and the inter-examination period following the second insulin measurement (Weight3), Weight2 was a significant predictor (p = 0.0005) of Insulin in multiple linear regression models that included control for potential confounders (body mass index, waist-to-hip ratio, antihypertensive and diuretic medication use, and age) and for correlation between the initial level and change in insulin (mean fasting insulin). Weight1 was added to the model and was found not to be statistically significant (p = 0.15). When the model was stratified by age tertile, the regression coefficient on Weight1 was –0.44 (p = 0.018) for the youngest stratum, –0.06 (p = 0.72) for the middle stratum, and 0.21 (p = 0.19) for the oldest men. Similarly, Insulin was a significant predictor of Weight3 (p = 0.026) in a separate regression model. These findings are consistent with both possible temporal sequences of association between changes in insulin and obesity. The intricate homeostatic mechanisms that regulate changes in insulin and obesity may not be readily amenable to description in terms of cause and effect. Am J Epidemiol 1998;147:173–9.
causality; diabetes mellitus, non-insulin-dependent; insulin; insulin resistance; obesity; risk factors
Reprint requests to Dr. Scott Weiss, Channing Laboratory, 180 Longwood Ave, Boston, MA 02115.
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