From the perspective of dynamic changes in BMI: the relationship between BMI trajectories and dysglycemia, all-cause mortality.

Objectives: The aim was to explore the body mass index (BMI) trajectory over dynamic time and its relationship with the dysglycemia (including Type 2 Diabetes Mellitus and prediabetes), all-cause mortality, and insulin resistance.

Methods: The latent category trajectory model (LCTM) is used to identify the BMI trajectories. Logistic and Cox regression were fitted to assess the correlation between BMI trajectories/weight changes and Type 2 Diabetes Mellitus (T2DM)/prediabetes. Using linear regression to evaluate the correlation between the two and insulin resistance. Mediating role of inflammation was evaluated.

Results: Four BMI trajectories were identified, including "stable" (74.32%), "light increase" (17.18%), "rapid increase" (2.82%), and "increase-to-decrease" (5.67%). Compared to stable trajectories, participants with slight increase or increase-to-decrease trajectories had higher risks of T2DM, while participats with a slight increase or rapid increase trajectory had a higher probability of developing prediabetes. Early weight changes such as decrease, increase, overweight, or obesity were associated with higher T2DM, while recent weight changes like decrease or obesity-stable only impacted T2DM prevalence, and there were no significant associations for prediabetes.

Conclusion: The findings underscore the critical impact of BMI trajectories and early/recent weight changes on T2DM and mortality risk.