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Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study.


ABSTRACT: BACKGROUND:Waist circumference (WC) is a simple and reliable measure of fat distribution that may add to the prediction of type 2 diabetes (T2D), but previous studies have been too small to reliably quantify the relative and absolute risk of future diabetes by WC at different levels of body mass index (BMI). METHODS AND FINDINGS:The prospective InterAct case-cohort study was conducted in 26 centres in eight European countries and consists of 12,403 incident T2D cases and a stratified subcohort of 16,154 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. We used Prentice-weighted Cox regression and random effects meta-analysis methods to estimate hazard ratios for T2D. Kaplan-Meier estimates of the cumulative incidence of T2D were calculated. BMI and WC were each independently associated with T2D, with WC being a stronger risk factor in women than in men. Risk increased across groups defined by BMI and WC; compared to low normal weight individuals (BMI 18.5-22.4 kg/m(2)) with a low WC (<94/80 cm in men/women), the hazard ratio of T2D was 22.0 (95% confidence interval 14.3; 33.8) in men and 31.8 (25.2; 40.2) in women with grade 2 obesity (BMI?35 kg/m(2)) and a high WC (>102/88 cm). Among the large group of overweight individuals, WC measurement was highly informative and facilitated the identification of a subgroup of overweight people with high WC whose 10-y T2D cumulative incidence (men, 70 per 1,000 person-years; women, 44 per 1,000 person-years) was comparable to that of the obese group (50-103 per 1,000 person-years in men and 28-74 per 1,000 person-years in women). CONCLUSIONS:WC is independently and strongly associated with T2D, particularly in women, and should be more widely measured for risk stratification. If targeted measurement is necessary for reasons of resource scarcity, measuring WC in overweight individuals may be an effective strategy, since it identifies a high-risk subgroup of individuals who could benefit from individualised preventive action.

SUBMITTER: InterAct Consortium 

PROVIDER: S-EPMC3367997 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study.

Langenberg Claudia C   Sharp Stephen J SJ   Schulze Matthias B MB   Rolandsson Olov O   Overvad Kim K   Forouhi Nita G NG   Spranger Joachim J   Drogan Dagmar D   Huerta José María JM   Arriola Larraitz L   de Lauzon-Guillan Blandine B   Tormo Maria-Jose MJ   Ardanaz Eva E   Balkau Beverley B   Beulens Joline W J JW   Boeing Heiner H   Bueno-de-Mesquita H Bas HB   Clavel-Chapelon Françoise F   Crowe Francesca L FL   Franks Paul W PW   Gonzalez Carlos A CA   Grioni Sara S   Halkjaer Jytte J   Hallmans Goran G   Kaaks Rudolf R   Kerrison Nicola D ND   Key Timothy J TJ   Khaw Kay Tee KT   Mattiello Amalia A   Nilsson Peter P   Norat Teresa T   Palla Luigi L   Palli Domenico D   Panico Salvatore S   Quirós J Ramón JR   Romaguera Dora D   Romieu Isabelle I   Sacerdote Carlotta C   Sánchez María-José MJ   Slimani Nadia N   Sluijs Ivonne I   Spijkerman Annemieke M W AM   Teucher Birgit B   Tjonneland Anne A   Tumino Rosario R   van der A Daphne L DL   van der Schouw Yvonne T YT   Feskens Edith J M EJ   Riboli Elio E   Wareham Nicholas J NJ  

PLoS medicine 20120605 6


<h4>Background</h4>Waist circumference (WC) is a simple and reliable measure of fat distribution that may add to the prediction of type 2 diabetes (T2D), but previous studies have been too small to reliably quantify the relative and absolute risk of future diabetes by WC at different levels of body mass index (BMI).<h4>Methods and findings</h4>The prospective InterAct case-cohort study was conducted in 26 centres in eight European countries and consists of 12,403 incident T2D cases and a stratif  ...[more]

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