Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg Cohort Study
Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg Cohort Study
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DOI：
10.1093/ajcn/84.3.483
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发表时间：
2006-09-01
影响因子：
7.1
通讯作者：
Lowel, Hannelore
中科院分区：
文献类型：
--
作者：
Meisinger, Christa;Doring, Angela;Lowel, Hannelore
背景：身体质量指数（BMI）、腰围（WC）或腰臀比（WHR）是否能更好地预测2型糖尿病仍存在争议。目的：目的是检查WC、WHR和BMI与2型糖尿病发展的性别特异性相关性。设计：前瞻性人群队列研究基于参加第二次（1989-1990）或第三次（1994-1995）MONICA奥格斯堡调查的年龄在35-74岁的3055名男性和2957名女性。受试者在基线时无糖尿病。风险比（hr）由Cox比例风险模型估计。结果：在平均9.2年的随访期间，243例男性发生2型糖尿病，158例女性发生2型糖尿病。男性BMI四分位数经多变量调整后的hr分别为1.0、1.37、2.08和4.15，女性为1.0、3.77、4.95和10.58；男性WC分别为1.0、1.15、1.57、3.40，女性分别为1.0、3.21、3.98、10.70；男性WHR分别为1.0、1.14、1.80、2.84，女性WHR分别为1.0、0.82、2.06、3.51。在联合分析中，观察到高BMI、高WC和高WHR的男性和女性的风险最高。结论：整体肥胖和腹部肥胖与2型糖尿病的发生密切相关。由于整体肥胖和腹部肥胖对风险预测存在叠加效应，因此除了BMI外，还应测量腰围，以评估男女患2型糖尿病的风险。
Background: It remains controversial whether body mass index (BMI), waist circumference (WC), or waist-hip ratio (WHR) is a better risk predictor of type 2 diabetes.Objective: The objective was to examine the sex-specific relevance of WC, WHR, and BMI to the development of type 2 diabetes.Design: The prospective population-based cohort study was based on 3055 men and 2957 women aged 35-74 y who participated in the second (1989-1990) or third (1994-1995) MONICA (Monitoring Trends and Determinants on Cardiovascular Diseases) Augsburg survey. The subjects were free of diabetes at baseline. Hazard ratios (HRs) were estimated from Cox proportional hazards models.Results: During a mean follow-up of 9.2 y, 243 cases of incident type 2 diabetes occurred in men and 158 occurred in women. Multivariable-adjusted HRs across quartiles of BMI were 1.0, 1.37, 2.08, and 4.15 in men and 1.0, 3.77,4.95, and 10.58 in women; those of WC were 1.0, 1.15, 1.57, and 3.40 in men and 1.0, 3.21, 3.98, and 10.70 in women; those of WHR were 1.0, 1.14,1.80, and 2.84 in men and 1.0, 0.82, 2.06, and 3.51 in women. In joint analyses, the highest risk was observed in men and women with a high BMI in combination with a high WC and a high WHR.Conclusions: Both overall and abdominal adiposity were strongly related to the development of type 2 diabetes. Because there was an additive effect of overall and abdominal obesity on risk prediction, WC should be measured in addition to BMI to assess the risk of type 2 diabetes in both sexes.