Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study

BMC Endocrine Disorders

Carmen Navarro³  Carlos A González⁹  Noémie Travier⁹  Estefanía Toledo¹  José Ramón Quirós⁵  Conchi Moreno-Iribas⁶  Esther Molina-Montes²  Nerea Larrañaga⁸  Miren Dorronsoro⁸  Rosana Burgui¹  Aurelio Barricarte¹  Diego Salmerón³  Michelle Mendez⁷  María-José Sánchez²  Laudina Rodríguez⁵  Eva Ardanaz¹  Larraitz Arriola⁸  Pilar Amiano⁸  Diana Gavrila⁴  María-Dolores Chirlaque⁴  María-José Tormo³  José María Huerta⁴ 

[1] Public Health Institute of Navarra, Pamplona, Spain;Andalusian School of Public Health, Granada, Spain;Department of Sociosanitary Sciences, University of Murcia School of Medicine, Murcia, Spain;CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Public Health Directorate, Asturias, Spain;Autonomous University of Barcelona, Barcelona, Spain;Center for Environmental Epidemiology Research, Barcelona, Spain;Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain;Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain

关键词: Spain;    EPIC;    Body mass index;    Abdominal obesity;    Obesity;    Anthropometry;    Diabetes;   

Others  :  1085976
DOI  :  10.1186/1472-6823-13-7

 received in 2012-09-03, accepted in 2013-01-30,  发布年份 2013

【 摘 要 】

Background

Obesity 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.

Methods

Longitudinal 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.

Results

Overall 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.

Conclusions

Diabetes 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.

【 授权许可】

   
2013 Huerta et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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