Fatemeh Zameni1, Mahmood Bakhtiyari2, Mohammad Ali Mansournia3, Azra Ramezankhani1, Fereidoun Azizi4, Farzad Hadaegh5. 1. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: fzhadaegh@endocrine.ac.ir.
Abstract
AIMS: To examine the association of the risk of incident type 2 diabetes (T2D) with cumulative excess weight (CEW) and cumulative excess waist circumference (CEWC) scores. METHODS: Adults participants without T2D (n = 4635) aged ≥20 years were included in the study. The differences between the body mass index (BMI) and waist circumference (WC) values and their normal references were calculated until the incident T2D. The CEW and CEWC scores represent the accumulation of BMI and WC deviations from normal values over time, i.e. (kg/m2 × years and cm × years, respectively). Time-dependent Cox models, adjusting for confounders were used to examine the association between CEW/CEWC and the risk of T2D. Further multivariate analyses were performed to examine the association of CEW and CEWC with incident diabetes in baseline BMI and WC strata. RESULTS: There were 503 incident cases of T2D over a median follow-up 9.38 years. The multivariate sex adjusted hazard ratios (HR) per one standard deviation (SD) increase in CEW and CEWC were 1.23 (95% CI: 1.15-1.32) and 1.41 (1.25-1.59), respectively. After further adjustment for baseline BMI and WC, no significant association was observed for CEW (1.02: 0.84-1.23) and CEWC (1.09: 0.93-1.28) and incident T2D. A strong association was found between CEW and CEWC with incident diabetes among overweight (2.12: 1.20-3.74) and centrally obese individuals (1.29: 1.10-1.51), respectively. CONCLUSIONS: Generally, CEW and CEWC were not associated with risk of T2D, independent of baseline values for BMI and WC, respectively. Moreover, CEW and CEWC highlighted an increased risk among overweight and centrally obese participants for T2D.
AIMS: To examine the association of the risk of incident type 2 diabetes (T2D) with cumulative excess weight (CEW) and cumulative excess waist circumference (CEWC) scores. METHODS: Adults participants without T2D (n = 4635) aged ≥20 years were included in the study. The differences between the body mass index (BMI) and waist circumference (WC) values and their normal references were calculated until the incident T2D. The CEW and CEWC scores represent the accumulation of BMI and WC deviations from normal values over time, i.e. (kg/m2 × years and cm × years, respectively). Time-dependent Cox models, adjusting for confounders were used to examine the association between CEW/CEWC and the risk of T2D. Further multivariate analyses were performed to examine the association of CEW and CEWC with incident diabetes in baseline BMI and WC strata. RESULTS: There were 503 incident cases of T2D over a median follow-up 9.38 years. The multivariate sex adjusted hazard ratios (HR) per one standard deviation (SD) increase in CEW and CEWC were 1.23 (95% CI: 1.15-1.32) and 1.41 (1.25-1.59), respectively. After further adjustment for baseline BMI and WC, no significant association was observed for CEW (1.02: 0.84-1.23) and CEWC (1.09: 0.93-1.28) and incident T2D. A strong association was found between CEW and CEWC with incident diabetes among overweight (2.12: 1.20-3.74) and centrally obese individuals (1.29: 1.10-1.51), respectively. CONCLUSIONS: Generally, CEW and CEWC were not associated with risk of T2D, independent of baseline values for BMI and WC, respectively. Moreover, CEW and CEWC highlighted an increased risk among overweight and centrally obeseparticipants for T2D.