Associations of General and Central Adiposity With Incident Diabetes in Chinese Men and Women
Year: 2018
Type: article
Study design: Observational Study
Abstract: OBJECTIVE We assess associations of general and central adiposity in middle age and of young adulthood adiposity with incident diabetes in adult Chinese and estimate the associated population burden of diabetes. RESEARCH DESIGN AND METHODS The prospective China Kadoorie Biobank enrolled 512,891 adults 30–79 years of age from 10 localities across China during 2004–2008. During 9.2 years of follow-up, 13,416 cases of diabetes were recorded among 482,589 participants without diabetes at baseline. Cox regression yielded adjusted hazard ratios (HRs) for incident diabetes associated with measures of general (e.g., BMI and BMI at 25 years) and central (e.g., waist circumference [WC]) adiposity. RESULTS The mean (SD) BMI was 23.6 kg/m2 (3.4 kg/m2), and 3.8% had a BMI ≥30 kg/m2. Throughout the range examined (19–32 kg/m2), BMI showed a positive log-linear relationship with diabetes, with adjusted HRs per SD higher usual BMI greater in men (1.98; 95% CI 1.93–2.04) than in women (1.77; 1.73–1.81) (P for heterogeneity <0.001). For WC, HRs per SD were 2.13 (95% CI 2.07–2.19) in men and 1.91 (1.87–1.95) in women (P for heterogeneity <0.001). Mutual adjustment attenuated these associations, especially those of BMI. BMI at age 25 years was weakly positively associated with diabetes (men HR 1.09 [95% CI 1.05–1.12]; women 1.04 [1.02–1.07] per SD), which was reversed after adjustment for baseline BMI. In China, the increase in adiposity accounted for ∼50% of the increase in diabetes burden since 1980. CONCLUSIONS Among relatively lean Chinese adults, higher adiposity—general and central—was strongly positively associated with the risk of incident diabetes. The predicted continuing increase in adiposity in China foreshadows escalating rates of diabetes.
Source: Diabetes Care
DOI: 10.2337/dc17-1852
Authors: Fiona Bragg, Kun Tang, Yu Guo, Andri Iona, Huaidong Du, Michael V. Holmes, Zheng Bian, Christiana Kartsonaki, Yiping Chen, Ling Yang, Qiang Sun, Caixia Dong, Junshi Chen, Rory Collins, Richard Peto, Liming Li, Zhengming Chen, for the China Kadoorie Biobank (CKB) Collaborative Group
Institutions: University of Oxford, Peking University, Chinese Academy of Medical Sciences & Peking Union Medical College, MRC Population Health Research Unit, Sichuan Center for Disease Control and Prevention, Gansu Provincial Center for Disease Control and Prevention, China National Center for Food Safety Risk Assessment
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Wellcome Trust, Cancer Research UK, British Heart Foundation, National Natural Science Foundation of China, Ministry of Science and Technology of the People's Republic of China, BHF Centre of Research Excellence, Oxford, Kadoorie Charitable Foundation, Centers for Disease Control and Prevention, Medical Research Council, National Key Research and Development Program of China
Awards: G120662964, G1300722292, China Kadoorie Biobank of 0.5 million adults, China Kadoorie Biobank (CKB) prospective study of 0.5 million adults, China Kadoorie Biobank (CKB) of 0.5 million adults., G2492221092, G2579291025, G2870375487, G297046553, The Kadoorie Biobank study., G4420358607, G5200873167, China Kadoorie Biobank (CKB) of 0.5 million adults., The Kadoorie Biobank study., G5898025071, China kadoorie biobank - University of Oxford, Drug target validation and risk prediction for coronary heart disease using targeted blood-based metabolomics and proteomics, G910090267
OpenAlex ID: W2781777062