Diabetes and obesity in Down Syndrome across the lifespan: a retrospective cohort study using UK electronic health records

   Objective Down Syndrome (DS) is the commonest form of chromosomal trisomy. Genetic factors in DS may increase the risk for diabetes. This study aimed to determine whether DS is associated with increased incidence of diabetes and the relationship with obesity across the lifespan compared to controls.  Methods Matched population-based cohort study (UK Clinical Practice Research Datalink, 1990-2020).  Results 9,917 DS and 38,266 control patients were analysed. Diabetes rates were higher in DS individuals (incidence rate ratio 3.67; 95% CI 2.43 – 5.55; p Conclusions At younger ages, the incidence of diabetes in DS patients is up to four times that of controls. Peak mean BMI is higher and established earlier in DS, contributing to T2DM risk. Further investigation into the relationship between obesity and diabetes in DS is required to inform treatment and prevention measures.</p

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions