Waist Circumference and its Changes Are More Strongly Associated with the Risk of Type 2 Diabetes than Body Mass Index and Changes in Body Weight in Chinese Adults

Fan, Yuxin; Wang, Ruodan; Ding, Li; Meng, Zhaowei; Zhang, Qing; Shen, Yun; Hu, Gang; Liu, Ming

doi:10.1093/jn/nxaa014

Cited by 43 publications

(55 citation statements)

References 40 publications

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“…28 Along with these findings, waist circumference, which provides better characteristic information for the visceral fat accumulation than BMI, 29 has been shown to more strongly associated with the risk of incident T2D than the latter in Chinese population. 30,31 In our study, increased waist circumference is also a predictor for the MHO-to-MUO transition. Our results support this biological mechanism underlying MHO and, for the first time, show that the FLI is an independent clinical predictor for the short-term MHO-to-MUO transition, implicating that the relatively higher ectopic fat deposition in MHO predispose subjects to an unhealthy metabolic status, which increase the susceptibility to cardiometabolic complications.…”

Section: Discussionsupporting

confidence: 54%

Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults

Min

Zhang

et al. 2021

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Purpose: Changes in transition from metabolically healthy overweight/obesity (MHO) to metabolically unhealthy overweight/obesity (MUO) are associated with the risk for cardiometabolic complications. This study aims to investigate the effects of short-term dynamic changes in body mass index (BMI) and metabolic status on the risk of type 2 diabetes (T2D) and to identify biological predictors for the MHO-to-MUO transition. Patients and Methods: A total of 4604 subjects from the REACTION study were included for a 3-year follow-up. Subjects were categorized based on their BMI and metabolic syndrome status. Overweight/obesity was defined as BMI ≥ 24 kg/m 2 . Metabolically healthy was defined as having two or fewer of the metabolic syndrome components proposed by the Chinese Diabetes Society. Thus, subjects were divided into four groups: metabolically healthy normal weight (MHNW), MHO, metabolically unhealthy normal weight (MUNW), and MUO. Results: Compared with MHNW, MHO was not predisposed to an increased risk for T2D (OR 1.08, 95% CI 0.64-1.83, P = 0.762). However, a 3-year transition probability of 20.6% was identified for subjects who shifted from MHO to MUO; this conversion increased the risk of T2D by 3-fold (OR 3.04, 95% CI 1.21-7.68, P = 0.018). The fatty liver index independently predicted the MHO-to-MUO transition with an OR 3.14 (95% CI 1.56-7.46, P = 0.002) when comparing the fourth quartile to the first quartile. Conclusion:This study reveals that metabolic changes affect the short-term susceptibility to T2D in the overweight/obese Chinese population, and the fatty liver index is an efficient clinical parameter for identifying those with a metabolic deterioration risk.

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Section: Discussionsupporting

confidence: 54%

Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults

Min

Zhang

et al. 2021

DMSO

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“…11 Waist circumference was recorded either as normal (< 85 cm in women and < 90 cm in men) or indicative of abdominal obesity (≥ 85 cm in women and ≥ 90 cm in men). 12 …”

Section: Methodsmentioning

confidence: 99%

“…11 Waist circumference was recorded either as normal (< 85 cm in women and < 90 cm in men) or indicative of abdominal obesity (≥ 85 cm in women and ≥ 90 cm in men). 12 The educational categories used in this study were low (primary and lower), middle (middle and high school), and high (college and above). disease.…”

Section: Definitionsmentioning

confidence: 99%

Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study

Xia¹,

Liu²,

Feng³

et al. 2021

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“…Notably, abdominal obesity is expected to continue increasing at a rate greater than overall obesity (measured by BMI) alone [3,4]. Excess abdominal adiposity, independent of overall adiposity, is associated with higher risk of metabolic disease [5,6], type 2 diabetes (T2D) [7][8][9], and cardiovascular disease (CVD) [7,[10][11][12]. The relation between abdominal obesity and these diseases may be mediated through increased inflammation, dyslipidemia, and insulin resistance [5,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Indices of Carbohydrate Quality and Food Sources of Dietary Fiber on Longitudinal Changes in Waist Circumference in the Framingham Offspring Cohort

et al. 2021

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The long-term impact of carbohydrate quality on abdominal weight gain is not fully understood. We aimed to examine the prospective relation of a carbohydrate quality index (CQI; defined by four criteria: dietary fiber, glycemic index, whole grain-to-total grain ratio, and solid-to-total carbohydrate ratio), total, cereal grain, vegetable, and fruit fiber, carbohydrate-to-total fiber ratio, and carbohydrate-to-cereal fiber ratio with changes in waist circumference (WC). Subjects were middle-aged to older, mostly white, participants in the Framingham Offspring cohort (n = 3101 subjects), with mean baseline age 54.9 ± 0.2 years (mean ± SE) and body mass index (BMI) 27.2 ± 0.1 kg/m2. Food frequency questionnaire (FFQ), health, and lifestyle data were collected approximately every four years over a median total follow-up of 18 years. Repeated measure mixed models were used to estimate adjusted mean change in WC per four-year interval across quartiles of carbohydrate variables. In the most adjusted model, a higher CQI was marginally associated with a smaller increase in WC (2.0 ± 0.1 vs. 2.4 ± 0.1 cm in highest vs. lowest quartile, p-trend = 0.04). Higher ratios of carbohydrate-to-fiber and carbohydrate-to-cereal fiber were associated with greater increases in WC per four-year interval (2.6 ± 0.1 vs. 2.0 ± 0.1 cm, p-trend < 0.001, and 2.5 ± 0.1 vs. 2.1 ± 0.1 cm in highest versus lowest categories, p-trend = 0.007, respectively); whereas higher intake of total fiber (1.8 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001), cereal fiber (2.0 ± 0.1 vs. 2.5 ± 0.1 cm, p-trend = 0.001), and fruit fiber (2.0 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001) were associated with smaller increases in WC compared to lower intakes. There was a significant interaction between total fiber and total carbohydrate (as % of total energy intake). After stratification, the association between fiber intake and change in WC was not maintained in the context of a high carbohydrate diet. Better carbohydrate quality, primarily higher fiber intake and lower carbohydrate-to-fiber ratios, may help attenuate increases in abdominal adiposity over time.

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Waist Circumference and its Changes Are More Strongly Associated with the Risk of Type 2 Diabetes than Body Mass Index and Changes in Body Weight in Chinese Adults

Cited by 43 publications

References 40 publications

Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults

Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults

Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study

Comparison of Indices of Carbohydrate Quality and Food Sources of Dietary Fiber on Longitudinal Changes in Waist Circumference in the Framingham Offspring Cohort

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