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Aims/hypothesis <p>The temporal evolution of body composition surrounding type 2 diabetes diagnosis is unclear. To clarify this process, we characterised and compared the trajectories of BMI, boplledy roundness index (BRI) and handgrip strength (HGS) in the years preceding and following the diagnosis.</p> Methods <p>We analysed data from participants aged ≥50 years from the Health and Retirement Study (HRS, waves 7–14), the English Longitudinal Study of Ageing (ELSA, waves 2–6), and the Survey of Health, Ageing and Retirement in Europe (SHARE, waves 2–9). Incident diabetes cases were matched 1:4 with control participants based on age, sex and education level, with the timeline centred on the year of diagnosis. Linear mixed-effects models (LMMs) allowing for non-linear trends were employed to estimate the trajectories of BMI, BRI and HGS, and to assess the temporal evolution of differences between cases and controls.</p> Results <p>The analysis included 74,790 participants for BMI, 19,895 for BRI, and 69,560 for HGS. Over a follow-up period of up to 14 years surrounding diagnosis, BMI trajectories exhibited a distinct inverted U shape, peaking approximately 2–4 years prior to diagnosis. BRI showed an overall upward trend, but its growth in cases was accelerated during weight gain and attenuated during weight loss relative to controls. HGS declined universally; although the rates of decline were similar between groups in HRS and ELSA, cases in the SHARE cohort experienced a significantly accelerated decline compared with controls.</p> Conclusions/interpretation <p>When evaluated through multidimensional surrogate indicators, the trajectory of type 2 diabetes involves patterns that are indicative of a rise then a fall in total body mass, persistent visceral accumulation (albeit attenuated during weight loss), and probably accelerated muscle depletion. The dynamic evolution of these proxy metrics provides novel insights for capturing the full picture of body composition remodelling.</p> Graphical Abstract <p></p>

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Remodelling of body composition surrounding the diagnosis of type 2 diabetes in three longitudinal cohorts

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Jiaxing Du,
  • Kun Zeng,
  • Fen Zhang,
  • Yanyan Wang,
  • Mei Liu,
  • Jiayu Huang,
  • Sujun Chen,
  • Yanhan Zhao,
  • Yan Lin

摘要

Aims/hypothesis

The temporal evolution of body composition surrounding type 2 diabetes diagnosis is unclear. To clarify this process, we characterised and compared the trajectories of BMI, boplledy roundness index (BRI) and handgrip strength (HGS) in the years preceding and following the diagnosis.

Methods

We analysed data from participants aged ≥50 years from the Health and Retirement Study (HRS, waves 7–14), the English Longitudinal Study of Ageing (ELSA, waves 2–6), and the Survey of Health, Ageing and Retirement in Europe (SHARE, waves 2–9). Incident diabetes cases were matched 1:4 with control participants based on age, sex and education level, with the timeline centred on the year of diagnosis. Linear mixed-effects models (LMMs) allowing for non-linear trends were employed to estimate the trajectories of BMI, BRI and HGS, and to assess the temporal evolution of differences between cases and controls.

Results

The analysis included 74,790 participants for BMI, 19,895 for BRI, and 69,560 for HGS. Over a follow-up period of up to 14 years surrounding diagnosis, BMI trajectories exhibited a distinct inverted U shape, peaking approximately 2–4 years prior to diagnosis. BRI showed an overall upward trend, but its growth in cases was accelerated during weight gain and attenuated during weight loss relative to controls. HGS declined universally; although the rates of decline were similar between groups in HRS and ELSA, cases in the SHARE cohort experienced a significantly accelerated decline compared with controls.

Conclusions/interpretation

When evaluated through multidimensional surrogate indicators, the trajectory of type 2 diabetes involves patterns that are indicative of a rise then a fall in total body mass, persistent visceral accumulation (albeit attenuated during weight loss), and probably accelerated muscle depletion. The dynamic evolution of these proxy metrics provides novel insights for capturing the full picture of body composition remodelling.

Graphical Abstract