Abstract
BackgroundObesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessement.MethodsLongitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables.ResultsOverall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women.ConclusionsDiabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women.
Highlights
Obesity is a major risk factor for type 2 diabetes mellitus (T2DM)
Further evidence showed that ectopic visceral fat accumulation, but not subcutaneous adipose tissue [11], largely accounted for the metabolic complications of obesity [12], such as abnormalities in glucose and lipid metabolism [13] and hepatic insulin resistance [13,14], preceding the development of T2DM
Differences in anthropometric variables between cases and non-cases were larger in women
Summary
Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). Obesity is recognised as a major cause of type 2 diabetes mellitus (T2DM) [1,2,3,4]. In 2000, 15% of the Spain population were obese [8], and 9% suffered from T2DM [9]. Obesity is defined by the accumulation of excess body fat with potential harmful health effects [10]. Further evidence showed that ectopic visceral fat accumulation, but not subcutaneous adipose tissue [11], largely accounted for the metabolic complications of obesity [12], such as abnormalities in glucose and lipid metabolism [13] and hepatic insulin resistance [13,14], preceding the development of T2DM
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call