Obesity, as measured by BMI, was significantly associated with an increased risk of developing type 2 diabetes mellitus (HR 2.375) compared to normal weight, showing a stronger association than waist circumference.
Cohort (n=3,001)
Yes
Do elevated BMI and waist circumference increase the risk of incident Type 2 Diabetes Mellitus in Chinese adults?
Both elevated BMI and waist circumference are independently associated with an increased risk of incident T2DM in Chinese adults, with BMI showing a stronger association.
Hazard Ratio: 2.375 (95% CI 1.261–4.473)
p-value: p=<0.001
BACKGROUND: General obesity and abdominal obesity, typically measured by BMI and waist circumference (WC), respectively, are associated with an increased risk of type 2 diabetes mellitus (T2DM). However, the magnitude of the association of these two obesity indicators and their joint association with the onset of T2DM remain controversial. OBJECTIVE: The aim of this study was to investigate the associations between these two obesity indicators and T2DM among the Chinese population to contribute scientific evidence for appropriate T2DM interventions. METHODS: A cohort of 3001 eligible participants was selected from the Ningbo Adult Chronic Disease Surveillance Project running since 2015. Based on BMI, individuals were categorized into groups of underweight or normal, overweight, and obesity. Based on WC, individuals were categorized in groups of normal, precentral obesity, and central obesity. Follow-up was performed by linking data of the baseline data set with the diabetes registry data set and the vital registry data set (both from the Ningbo Municipal Integrated Noncommunicable Disease Collaborative Management System), mainly using the participants' identity numbers. Follow-up was completed when a participant was diagnosed with T2DM. The associations were estimated with multivariate Cox proportional hazard regression. RESULTS: In the cohort, 90 of 3001 participants developed T2DM (incidence density: 6.483/1000 person-years) with a median 4.72 years of follow-up. After controlling for age, sex, hypertension, dyslipidemia, smoking status, and family history of diabetes, the multivariate adjusted hazard ratios (HRs) across underweight/normal, overweight, and obesity BMI categories were 1.000, 1.653 (95% CI 1.030-2.654), and 2.375 (95% CI 1.261-4.473), respectively. The multivariate adjusted HRs across the normal, precentral obesity, and central obesity WC categories were 1.000, 1.215 (95% CI 0.689-2.142), and 1.663 (95% CI 1.016-2.723), respectively. Compared with the reference group (normal WC with an underweight/normal BMI), the multivariate adjusted HR for participants with both central obesity according to WC and obesity according to BMI was 2.489 (95% CI 1.284-4.825). CONCLUSIONS: Both elevated BMI and WC at baseline increased the risk of T2DM. Compared with WC, BMI as an obesity indicator was more strongly associated with the onset of T2DM.
Li et al. (Wed,) conducted a cohort in Type 2 Diabetes Mellitus (n=3,001). Elevated BMI (Obesity) vs. Underweight or normal BMI was evaluated on Onset of Type 2 Diabetes Mellitus (HR 2.375, 95% CI 1.261-4.473, p=<0.001). Obesity, as measured by BMI, was significantly associated with an increased risk of developing type 2 diabetes mellitus (HR 2.375) compared to normal weight, showing a stronger association than waist circumference.