Does Resolving Obesity Mitigate the Risk of Glucose Metabolic Abnormalities? A Longitudinal Study from Grade 4 to Grade 7
1
Community Nursing, Faculty of Medicine, Kagawa University, Miki, Japan
2
Hygiene, Faculty of Medicine, Kagawa University, Miki, Japan
3
Pharmaco-Bio-Informatics, Faculty of Medicine, Kagawa University, Miki, Japan
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Childhood obesity is a well-established predictor of metabolic syndrome. However, the extent to which reversing obesity during the transition from childhood (prepuberty) to early adolescence mitigates the risk of impaired glucose metabolism remains unclear. This study examined how weight status trajectories influence HbA1c risk in junior high students.
METHODS:
We conducted a longitudinal study using data from the ‘Pediatric lifestyle-related disease prevention checkup in Kagawa,’ which includes paired health examination records of schoolchildren (Grade 4, age 9–10; Grade 7, age 12–13) in Japan. The participants were 496 students (276 boys and 220 girls), categorized into four groups based on changes in weight status: Normal–Normal (NN), Normal–Obese (NO), Obese–Normal (ON), and Obese–Obese (OO). The outcome was defined as elevated HbA1c (≥ 5.6%) in Grade 7. Multivariate logistic regression analysis was performed to calculate adjusted odds ratios (AORs) for elevated HbA1c after adjusting for sex, survey year, and baseline HbA1c status in Grade 4.
RESULTS:
A total of 407 students had complete data (follow-up rate: 82.1%). Elevated HbA1c at baseline (Grade 4) was the strongest independent predictor of outcomes in Grade 7 (AOR: 13.0, 95% CI: 6.0–28.1). Regarding weight trajectories, the NO group (incident obesity) showed a trend toward increased risk compared with the NN group. Notably, the ON group (those who resolved obesity) demonstrated no significant increase in risk compared with the NN group (AOR: 0.62, 95% CI: 0.13–3.05), suggesting a risk reduction comparable to those who were never obese.
CONCLUSIONS:
Normalizing weight status before early adolescence may effectively "reset" the risk of developing glucose metabolism abnormalities. Although baseline metabolic status is a strong predictor, weight management interventions during elementary school provide a critical window of opportunity for reversibility and prevention of future diabetes risk.
Childhood obesity is a well-established predictor of metabolic syndrome. However, the extent to which reversing obesity during the transition from childhood (prepuberty) to early adolescence mitigates the risk of impaired glucose metabolism remains unclear. This study examined how weight status trajectories influence HbA1c risk in junior high students.
METHODS:
We conducted a longitudinal study using data from the ‘Pediatric lifestyle-related disease prevention checkup in Kagawa,’ which includes paired health examination records of schoolchildren (Grade 4, age 9–10; Grade 7, age 12–13) in Japan. The participants were 496 students (276 boys and 220 girls), categorized into four groups based on changes in weight status: Normal–Normal (NN), Normal–Obese (NO), Obese–Normal (ON), and Obese–Obese (OO). The outcome was defined as elevated HbA1c (≥ 5.6%) in Grade 7. Multivariate logistic regression analysis was performed to calculate adjusted odds ratios (AORs) for elevated HbA1c after adjusting for sex, survey year, and baseline HbA1c status in Grade 4.
RESULTS:
A total of 407 students had complete data (follow-up rate: 82.1%). Elevated HbA1c at baseline (Grade 4) was the strongest independent predictor of outcomes in Grade 7 (AOR: 13.0, 95% CI: 6.0–28.1). Regarding weight trajectories, the NO group (incident obesity) showed a trend toward increased risk compared with the NN group. Notably, the ON group (those who resolved obesity) demonstrated no significant increase in risk compared with the NN group (AOR: 0.62, 95% CI: 0.13–3.05), suggesting a risk reduction comparable to those who were never obese.
CONCLUSIONS:
Normalizing weight status before early adolescence may effectively "reset" the risk of developing glucose metabolism abnormalities. Although baseline metabolic status is a strong predictor, weight management interventions during elementary school provide a critical window of opportunity for reversibility and prevention of future diabetes risk.
| eISSN: | 2654-1459 |
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