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Incident type 2 diabetes tied to net excess weight in overweight, central obesity
The risk for incident type 2 diabetes is associated with the degree and duration of excess waist circumference and excess weight, study data show.
In women with central obesity, the relevant measure is cumulative excess waist circumference; in men with normal weight, it is cumulative excess weight, according to researchers.
Farzad Hadaegh, MD, professor of internal medicine and endocrinology at the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences in Tehran, Iran, and colleagues evaluated data from the Tehran Lipid and Glucose Study on 4,635 adults (mean age, 42.7 years; mean BMI, 27 kg/m2; mean waist circumference, 90.4 cm) without type 2 diabetes to determine the association of the risk for incident type 2 diabetes with cumulative excess weight and cumulative excess waist circumference scores. Cumulative excess scores were computed as the waist measurement and BMI above the normal references for men and women multiplied by number of years.
During a median follow-up of 9.38 years, 503 incident cases of type 2 diabetes occurred among the cohort.
The risk for incident type 2 diabetes was increased with each 1-standard deviation (SD) increase in cumulative excess weight score in men (P < .001), women (P < .002) and the whole study population (P < .001), but after excluding baseline BMI, cumulative excess weight score was no longer associated with incident type 2 diabetes.
In participants with normal weight (BMI 25 kg/m2) at baseline, the association between cumulative excess weight score and incident type 2 diabetes was significant only among men (HR = 2.87; 95% CI, 1.37-5.1); among participants with overweight (BMI, 25-29.99 kg/m2) at baseline, the association with significant in men (P = .007) and in the population as a whole (P = .009). No significant associations were observed between cumulative excess weight score and incident type 2 diabetes in participants with obesity (BMI 30 kg/m2) at baseline.
The risk for incident type 2 diabetes was increased with each 1-SD increase in cumulative excess waist circumference score in men, women and the whole study population (P < .001 for all); however, after excluding baseline waist circumference, cumulative excess waist circumference score was no longer associated with incident type 2 diabetes.
Cumulative excess waist circumference score was not associated with incident type 2 diabetes among any participants with noncentral obesity at baseline, but among those with central obesity at baseline, the association was significant among women (HR = 1.33; 95% CI, 1.07-1.64) and the whole population (HR = 1.29; 95% CI, 1.1-1.51).
“These findings suggest that public health interventions for diabetes prevention should focus on weight-loss strategies at any time point to prevent or at least delay its onset,” the researchers wrote. – by Amber Cox
Disclosure s : The authors report no relevant financial disclosures.