Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 11, 2022
Date Accepted: Nov 26, 2022
The independent and joint association of Body Mass Index, waist circumference with the onset of Type 2 Diabetes Mellitus in Chinese adults: a data linkage prospective study
ABSTRACT
Background:
General obesity and abdominal obesity, usually measured by body mass index (BMI) and waist circumference (WC) are associated with the risk of type 2 diabetes mellitus (T2DM). However, the magnitude of association of these two obesity indicators and the joint association with the onset of T2DM is controversial.
Objective:
This study aimed to investigate the associations between these two obesity indicators and T2DM to better provide scientific evidences for T2DM interventions among Chinese population.
Methods:
A cohort of 3001 eligible participants is formed based on the Ningbo Adult Chronic Disease Surveillance Project since 2015. BMI is categorized as underweight or normal, overweight, and obese; WC is categorized as normal, pre-central obesity and central obesity. The follow-up was completed by linking data of the baseline dataset with the diabetes and the vital registry dataset mainly using identity number. These two registry datasets were obtained from the Ningbo Municipal Integrated Noncommunicable Disease Collaborative Management System (NCDCMS). Follow-up was ended when participants were 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: 6.483/1,000 person-years) with a median 4.72 years of follow-up. After controlling for age, gender, hypertension, dyslipidemia, smoking status, family history of diabetes, the multivariate adjusted hazard ratios (HRs) across categories of BMI were 1.000, 1.653 (1.030~2.654) and 2.375 (1.261~4.473). The multivariate adjusted HRs across categories of WC were 1.000, 1.215 (0.689~2.142) and 1.663 (1.016~2.723). Compared with the reference group (normal WC with an underweight and normal BMI), the multivariate adjusted HR for participants with both central obesity by WC and obese by BMI was 2.489 (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 onsets of T2DM.
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