Abstract
In order to estimate the associations of different adiposity indicators and long-term adiposity changes with risk of incident type 2 diabetes (T2DM), we conducted a 10-year prospective cohort study of 7441 adults in Guizhou, China, from 2010 to 2020. Adiposity was measured at baseline and follow-up. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs). A total of 764 new diabetes cases were identified over an average follow-up of 7.06 years. Adiposity indicators, body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), and long-term adiposity changes (both weight change and WC change) were significantly associated with an increased risk of T2DM (adjusted HRs: 1.16–1.48). Significant non-linear relationships were found between weight/WC change and incident T2DM. Compared with subjects with stable WC from baseline to follow-up visit, the subjects with WC gain ≥9 cm had a 1.61-fold greater risk of T2DM; those with WC loss had a 30% lower risk. Furthermore, the associations were stronger among participants aged 40 years or older, women, and Han Chinese. Preventing weight or WC gain and promoting maintenance of normal body weight or WC are important approaches for diabetes prevention, especially for the elderly, women, and Han Chinese.
Highlights
Diabetes is one of the leading causes of death and disability worldwide and affects more than 422 million people [1], while around 90% of patients have type 2 diabetes (T2DM).China has the highest number of people with diabetes (114.4 million) in the world, and842,993 deaths are attributed to diabetes in 2017 [2]
Compared with participants who remained free of T2DM, new T2DM cases were older and had higher baseline body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR), and they were more likely to be farmers, to be current smokers, or to have a higher prevalence of hypertension, dyslipidemia, or Impaired glucose regulation (IGR),5 and had a
The average BMI, WC, and WHtR were higher at the follow-up compared with those at baseline (Table S1)
Summary
Diabetes is one of the leading causes of death and disability worldwide and affects more than 422 million people [1], while around 90% of patients have type 2 diabetes (T2DM). 842,993 deaths are attributed to diabetes in 2017 [2]. Diabetes patients are at elevated risk of complications including diabetic nephropathy, cardiovascular disease, stroke, vision loss, and amputation of feet or legs [3]. The Global Burden of Disease (GBD) Study reported that high fast plasma glucose became China’s sixth-leading cause of disabilityadjusted life-years (DALYs) with the attributable DALYs burden affecting 1802.3/100,000 of the population in 2016 [4]. The GBD study indicated that high BMI scores is one of the most important risk factors for diabetes [4], which was consistent with previous epidemiological studies
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