Sex difference in the associations among obesity-related indices with incidence of diabetes mellitus in a large Taiwanese population follow-up study

Abstract

BackgroundObesity is a major risk factor for diabetes mellitus (DM), which is in turn a major risk factor for cardiovascular diseases such as coronary artery disease and stroke. As few studies have investigated sex differences in the association between obesity and incidence of DM, the aim of this longitudinal study was to explore this issue in a large group of Taiwanese participants.MethodsA total of 24,346 participants were enrolled in this study, of whom 8,334 (mean age, 50.6 ± 11.0 years) were male and 16,012 (mean age, 50.5 ± 10.1 years) were female. The following obesity-related indices were studied: body mass index, waist-to-height ratio, waist-to-hip ratio (WHR), body roundness index, conicity index (CI), body adiposity index, abdominal volume index, lipid accumulation product (LAP), and visceral adiposity index (VAI).ResultsThe analysis showed significant associations between all of these indices with incidence of DM (all p < 0.001). In the male participants, the strongest predictors for incidence of DM were LAP (AUC = 0.692), WHtR (AUC = 0.684), and WHR (AUC = 0.683). In the female participants, the strongest predictors were LAP (AUC = 0.744), WHtR (AUC = 0.710) and VAI (AUC = 0.710), followed by BRI (AUC = 0.708).ConclusionStrong associations were found between the studied obesity-related indices and incidence of DM, and sex differences were found. Hence, to better control DM, reducing body weight may be beneficial in addition to lifestyle modifications, diet control, and pharmacological interventions.

The predictive significance of lipid accumulation products for future diabetes in a non-diabetic population from a gender perspective: an analysis using time-dependent receiver operating characteristics

“…Overall, there is a positive correlation between LAP and diabetes risk (24-35, 52-61), and LAP has been found to be effective in diagnosing/predicting diabetes (24)(25)(26)(27)(28)(29)(30)(31)(56)(57)(58)(59)(60)(61)(62). However, further differentiation between genders in the studies revealed some interesting trends, with two studies (26,27) showing stronger associations of LAP with diabetes in males than in females; furthermore, in a study involving the general Indonesian population (63), the cross-sectional analysis showed that LAP was associated with diabetes risk in females, while this association disappeared in the male population, and in a subsequent study of 2,427 baseline non-diabetic participants with 4-year follow-up period, LAP was not associated with the risk of future diabetes in either gender. In another cross-sectional study of 430 Brazilian hypertensive people (64), Marcadenti A et al showed that LAP was positively correlated with the incidence of diabetes in females, while there was no significant association in the male population.…”

“…In summary, there was some variation in LAP predictive thresholds for different regional populations, and in addition, the results of studies regarding LAP predictive thresholds in different genders were also inconsistent. Among them, in a large prospective study involving a Taiwanese population in China ( 26 ), Chung et al. evaluated the value of different parameters for predicting future diabetes, and the ROC analysis showed that the threshold for LAP to predict diabetes was higher in the male population than in the female.…”

“…Numerous epidemiological studies have independently linked LAP to future diabetes risk (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and demonstrated its predictive value for future diabetes (24)(25)(26)(27)(28)(29)(30)(31). A recent meta-analysis further highlighted that LAP exhibited a stronger association with diabetes risk in females and had a superior predictive capability for females compared to males (36).…”

Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Consistent with previous studies conducted in nine countries in Europe (De Pablos-Velasco et al, 2014) and Korea (Choe et al, 2018), inadequate management of glycemic levels was more common in women than men. One explanation might be that among diabetic patients, overweight or obesity is more prevalent in women than in men (Chung et al, 2023; Sattar, 2013). Consequently, the disparity in body fat percentage between women and men is a contributing factor that may lead to diminished sensitivity to insulin in the muscles and liver.…”

Normal-weight central obesity: implications for diabetes mellitus

“…Anthropometric parameters have been widely reported in recent years because they are easy to measure, non-invasive, and inexpensive ( 14–16 ). BMI (defined as general obesity) and waist circumference (defined as central obesity) are important indicators for measuring obesity, and their increase is associated with a higher risk of DM ( 17 ). However, a recent study has shown that obesity as defined by BMI is inversely associated with the occurrence of DM in men ( 18 ).…”