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

Research Article

Esther Molina-Montes¹  María-José Sánchez¹  Larraitz Arriola²  Pilar Amiano²  Nerea Larrañaga²  Miren Dorronsoro²  Eva Ardanaz³  Rosana Burgui³  Aurelio Barricarte³  Conchi Moreno-Iribas⁴  Michelle Mendez⁵  Diana Gavrila⁶  José María Huerta⁶  María-Dolores Chirlaque⁶  María-José Tormo⁷  Carmen Navarro⁷  Diego Salmerón⁷  Laudina Rodríguez⁸  José Ramón Quirós⁸  Estefanía Toledo⁹  Noémie Travier^1,10  Carlos A González^1,10 

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

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

DOI  :  10.1186/1472-6823-13-7

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

来源: Springer

【 摘 要 】

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.

【 授权许可】

Unknown   
© Huerta et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.