Overall and central obesity and risk of type 2 diabetes in US black women
Overall and central obesity and risk of type 2 diabetes in US black women
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DOI：
10.1038/oby.2007.220
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发表时间：
2007-07-01
期刊：
影响因子：
6.9
通讯作者：
Palmer, Julie R.
中科院分区：
文献类型：
--
作者：
Krishnan, Supriya;Rosenberg, Lynn;Palmer, Julie R.
目的：肥胖在美国已经上升到流行病的程度，导致2型糖尿病成为一种新兴的流行病。非裔美国女性受到这两种疾病的影响尤为严重。虽然黑人女性总体肥胖与糖尿病风险增加之间存在关联，但脂肪分布的影响，特别是腹部肥胖，尚未得到研究。我们研究了BMI、腹部肥胖和体重增加与2型糖尿病风险的关系。研究方法和程序：在对来自黑人妇女健康研究的49,766名妇女的8年随访中，发生了2472例糖尿病事件。采用Cox比例风险模型来估计发病率比（IRRs），并控制年龄、身体活动、糖尿病家族史、吸烟、受教育年限和数据收集时间。结果：61%的参与者体重指数>= 25 kg/m(2)（世界卫生组织超重定义）。与BMI < 23 kg/M-2相比，BMI≥45 kg/M-2的IRR为23（95%可信区间为17.0 ~ 31.0）。在对照BMI后，腰臀比最高五分位数相对于最低五分位数的IRR为2.3（95%可信区间，2.0至2.7）。此外，在每一个BMI水平上，腰臀比高的风险都比低的风险高。讨论：中心性肥胖，以及整体肥胖，是非裔美国女性患糖尿病的一个重要危险因素。努力减少非裔美国女性的肥胖患病率是至关重要的。
Objective: Obesity has risen to epidemic proportions in the United States, leading to an emerging epidemic of type 2 diabetes. African-American women are disproportionately affected by both conditions. While an association of overall obesity with increasing risk of diabetes has been documented in black women, the effect of fat distribution, specifically abdominal obesity, has not been studied. We examined the association of BMI, abdominal obesity, and weight gain with risk of type 2 diabetes.Research Methods and Procedures: During eight years of follow-up of 49,766 women from the Black Women's Health Study, 2472 incident cases of diabetes occurred. Cox proportional hazard models were used to estimate incidence rate ratios (IRRs), with control for age, physical activity, family history of diabetes, cigarette smoking, years of education, and time period of data collection.Results: Sixty-one percent of participants had a BMI >= 25 kg/m(2) (WHO definition of overweight). Compared with a BMI of < 23 kg/M-2, the IRR for a BMI of > 45 kg/M-2 was 23 (95% confidence interval, 17.0 to 31.0). The IRR for the highest quintile of waist-to-hip ratio relative to the lowest was 2.3 (95% confidence interval, 2.0 to 2.7) after control for BMI. Furthermore, at every level of BMI, an increased risk was observed for high waist-to-hip ratio relative to low.Discussion: Central obesity, as well as overall obesity, is a strong risk factor for diabetes in African-American women. Efforts to reduce the prevalence of obesity in African-American women are of paramount importance.