Fiona Bragg1, Kun Tang2, Yu Guo3, Andri Iona4,5, Huaidong Du4,5, Michael V Holmes4,5, Zheng Bian3, Christiana Kartsonaki4,5, Yiping Chen4,5, Ling Yang4,5, Qiang Sun6, Caixia Dong7, Junshi Chen8, Rory Collins4, Richard Peto4, Liming Li3,9, Zhengming Chen1. 1. Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, U.K. fiona.bragg@ndph.ox.ac.uk zhengming.chen@ctsu.ox.ac.uk. 2. Department of Global Health, School of Public Health, Peking University, Beijing, People's Republic of China. 3. Chinese Academy of Medical Sciences, Beijing, People's Republic of China. 4. Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, U.K. 5. Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, U.K. 6. Pengzhou Centre for Disease Control and Prevention, Sichuan, People's Republic of China. 7. Gansu Centre for Disease Control and Prevention, Gansu, People's Republic of China. 8. National Center for Food Safety Risk Assessment, Beijing, People's Republic of China. 9. School of Public Health, Peking University, Beijing, People's Republic of China.
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.
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.
Authors: Gabriel Spieler; Andrew O Westfall; Dustin M Long; Andrea Cherrington; Greer A Burkholder; Nicholas Funderburg; James L Raper; Edgar T Overton; Amanda L Willig Journal: AIDS Date: 2022-08-10 Impact factor: 4.632
Authors: Kexin Li; Tianyu Feng; Lijuan Wang; Yang Chen; Pingping Zheng; Pan Pan; Min Wang; Isaac T S Binnay; Yingshuang Wang; Ruiyu Chai; Siyu Liu; Bo Li; Yan Yao Journal: Mol Genet Genomics Date: 2021-02-25 Impact factor: 3.291
Authors: Jonathan Q Purnell; Elizabeth N Dewey; Blandine Laferrère; Faith Selzer; David R Flum; James E Mitchell; Alfons Pomp; Walter J Pories; Thomas Inge; Anita Courcoulas; Bruce M Wolfe Journal: J Clin Endocrinol Metab Date: 2021-03-08 Impact factor: 5.958