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Diabetes was diagnosed via fasting glucose, HbA<jats:sub>1c<\/jats:sub>, and self-report. Latent-class trajectory analyses were performed to identify BMI trajectories. Longitudinal changes in BMI, visceral adiposity, and glucose metabolism were estimated using mixed models. 1,892 individuals developed diabetes. Three distinct BMI trajectories were identified in adults developing and not developing diabetes, respectively. Among adults developing diabetes, 47.3% were classified as \u201cmedium BMI\u201d (n\u2009=\u2009895), and had increased mean BMI within the obesity category before diagnosis. The \u201clow BMI\u201d group (38.4%, n\u2009=\u2009726) had an initial mean BMI of 21.9\u2009kg\/m<jats:sup>2<\/jats:sup>, and demonstrated small weight gain. The \u201chigh BMI\u201d group (n\u2009=\u2009271) were severely obese and showed greater increase in BMI until diagnosis. All groups which developed diabetes showed absolute and\/or relative increase in visceral fat and impaired \u03b2-cell compensation for insulin resistance. All groups not developing diabetes showed measured variables were relatively stable during observation. These data suggest that visceral fat gain may induce \u03b2-cell failure in compensation for insulin resistance, resulting in diabetes regardless of obesity level.<\/jats:p>","DOI":"10.1038\/srep43521","type":"journal-article","created":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T11:52:40Z","timestamp":1488887560000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Body mass index trajectory patterns and changes in visceral fat and glucose metabolism before the onset of type 2 diabetes"],"prefix":"10.1038","volume":"7","author":[{"given":"Keisuke","family":"Kuwahara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Honda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tohru","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuichiro","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Mizoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,3,7]]},"reference":[{"key":"BFsrep43521_CR1","unstructured":"NCD Risk Factor Collaboration (NCD-RisC). 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No other potential conflicts of interest relevant to this article were reported.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43521"}}