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BMC Endocrine Disorders
Published in: BMC Endocrine Disorders 1/2013

Open Access 01-12-2013 | Research article

Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study

Authors: José María Huerta, María-José Tormo, María-Dolores Chirlaque, Diana Gavrila, Pilar Amiano, Larraitz Arriola, Eva Ardanaz, Laudina Rodríguez, María-José Sánchez, Michelle Mendez, Diego Salmerón, Aurelio Barricarte, Rosana Burgui, Miren Dorronsoro, Nerea Larrañaga, Esther Molina-Montes, Conchi Moreno-Iribas, José Ramón Quirós, Estefanía Toledo, Noémie Travier, Carlos A González, Carmen Navarro

Published in: BMC Endocrine Disorders | Issue 1/2013

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Abstract

Background

Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessement.

Methods

Longitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables.

Results

Overall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women.

Conclusions

Diabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women.
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Metadata
Title
Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study
Authors
José María Huerta
María-José Tormo
María-Dolores Chirlaque
Diana Gavrila
Pilar Amiano
Larraitz Arriola
Eva Ardanaz
Laudina Rodríguez
María-José Sánchez
Michelle Mendez
Diego Salmerón
Aurelio Barricarte
Rosana Burgui
Miren Dorronsoro
Nerea Larrañaga
Esther Molina-Montes
Conchi Moreno-Iribas
José Ramón Quirós
Estefanía Toledo
Noémie Travier
Carlos A González
Carmen Navarro
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2013
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/1472-6823-13-7

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