Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study
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). T...
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| creator | Langenberg, Claudia Sharp, Stephen J Schulze, Matthias B Rolandsson, Olov Overvad, Kim Forouhi, Nita G Spranger, Joachim Drogan, Dagmar Huerta, José María Arriola, Larraitz de Lauzon-Guillan, Blandine Tormo, Maria-Jose Ardanaz, Eva Balkau, Beverley Beulens, Joline W J Boeing, Heiner Bueno-de-Mesquita, H Bas Clavel-Chapelon, Françoise Crowe, Francesca L Franks, Paul W Gonzalez, Carlos A Grioni, Sara Halkjaer, Jytte Hallmans, Goran Kaaks, Rudolf Kerrison, Nicola D Key, Timothy J Khaw, Kay Tee Mattiello, Amalia Nilsson, Peter Norat, Teresa Palla, Luigi Palli, Domenico Panico, Salvatore Quirós, J Ramón Romaguera, Dora Romieu, Isabelle Sacerdote, Carlotta Sánchez, María-José Slimani, Nadia Sluijs, Ivonne Spijkerman, Annemieke M W Teucher, Birgit Tjonneland, Anne Tumino, Rosario van der A, Daphne L van der Schouw, Yvonne T Feskens, Edith J M Riboli, Elio Wareham, Nicholas J |
| description | 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).
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 (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).
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. |
| doi_str_mv | 10.1371/journal.pmed.1001230 |
| format | Article |
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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).
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.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1001230</identifier><identifier>PMID: 22679397</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>abdominal adiposity ; Annan klinisk medicin ; Anthropometry ; association ; Body Mass Index ; cancer ; Clinical Medicine ; Cohort Studies ; Development and progression ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Endocrinology and Diabetes ; Endokrinologi och diabetes ; Europe - epidemiology ; Female ; Health aspects ; Humans ; Incidence ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medical research ; Medicin och hälsovetenskap ; Medicine ; mellitus ; Middle Aged ; Nutrition ; Obesity ; Obesity - complications ; Obesity - physiopathology ; Other Clinical Medicine ; participants ; Physiological aspects ; prevention ; primary-care ; Proportional Hazards Models ; Risk Factors ; Time Factors ; Type 2 diabetes ; waist circumference ; Waist Circumference - physiology</subject><ispartof>PLoS medicine, 2012-06, Vol.9 (6), p.e1001230-e1001230</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Langenberg et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: The InterAct Consortium (2012) Long-Term Risk of Incident Type 2 Diabetes and Measures of Overall and Regional Obesity: The EPIC-InterAct Case-Cohort Study. PLoS Med 9(6): e1001230. doi:10.1371/journal.pmed.1001230</rights><rights>Langenberg et al. 2012</rights><rights>Wageningen University & Research</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1020t-a623a3b175e2c5289a95ccb5354b495a1266eabbea6c32ef6803874558ecfbe83</citedby><cites>FETCH-LOGICAL-c1020t-a623a3b175e2c5289a95ccb5354b495a1266eabbea6c32ef6803874558ecfbe83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3367997/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3367997/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22679397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-57667$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/3001805$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><contributor>Patel, Anushka</contributor><creatorcontrib>Langenberg, Claudia</creatorcontrib><creatorcontrib>Sharp, Stephen J</creatorcontrib><creatorcontrib>Schulze, Matthias B</creatorcontrib><creatorcontrib>Rolandsson, Olov</creatorcontrib><creatorcontrib>Overvad, Kim</creatorcontrib><creatorcontrib>Forouhi, Nita G</creatorcontrib><creatorcontrib>Spranger, Joachim</creatorcontrib><creatorcontrib>Drogan, Dagmar</creatorcontrib><creatorcontrib>Huerta, José María</creatorcontrib><creatorcontrib>Arriola, Larraitz</creatorcontrib><creatorcontrib>de Lauzon-Guillan, Blandine</creatorcontrib><creatorcontrib>Tormo, Maria-Jose</creatorcontrib><creatorcontrib>Ardanaz, Eva</creatorcontrib><creatorcontrib>Balkau, Beverley</creatorcontrib><creatorcontrib>Beulens, Joline W J</creatorcontrib><creatorcontrib>Boeing, Heiner</creatorcontrib><creatorcontrib>Bueno-de-Mesquita, H Bas</creatorcontrib><creatorcontrib>Clavel-Chapelon, Françoise</creatorcontrib><creatorcontrib>Crowe, Francesca L</creatorcontrib><creatorcontrib>Franks, Paul W</creatorcontrib><creatorcontrib>Gonzalez, Carlos A</creatorcontrib><creatorcontrib>Grioni, Sara</creatorcontrib><creatorcontrib>Halkjaer, Jytte</creatorcontrib><creatorcontrib>Hallmans, Goran</creatorcontrib><creatorcontrib>Kaaks, Rudolf</creatorcontrib><creatorcontrib>Kerrison, Nicola D</creatorcontrib><creatorcontrib>Key, Timothy J</creatorcontrib><creatorcontrib>Khaw, Kay Tee</creatorcontrib><creatorcontrib>Mattiello, Amalia</creatorcontrib><creatorcontrib>Nilsson, Peter</creatorcontrib><creatorcontrib>Norat, Teresa</creatorcontrib><creatorcontrib>Palla, Luigi</creatorcontrib><creatorcontrib>Palli, Domenico</creatorcontrib><creatorcontrib>Panico, Salvatore</creatorcontrib><creatorcontrib>Quirós, J Ramón</creatorcontrib><creatorcontrib>Romaguera, Dora</creatorcontrib><creatorcontrib>Romieu, Isabelle</creatorcontrib><creatorcontrib>Sacerdote, Carlotta</creatorcontrib><creatorcontrib>Sánchez, María-José</creatorcontrib><creatorcontrib>Slimani, Nadia</creatorcontrib><creatorcontrib>Sluijs, Ivonne</creatorcontrib><creatorcontrib>Spijkerman, Annemieke M W</creatorcontrib><creatorcontrib>Teucher, Birgit</creatorcontrib><creatorcontrib>Tjonneland, Anne</creatorcontrib><creatorcontrib>Tumino, Rosario</creatorcontrib><creatorcontrib>van der A, Daphne L</creatorcontrib><creatorcontrib>van der Schouw, Yvonne T</creatorcontrib><creatorcontrib>Feskens, Edith J M</creatorcontrib><creatorcontrib>Riboli, Elio</creatorcontrib><creatorcontrib>Wareham, Nicholas J</creatorcontrib><creatorcontrib>InterAct Consortium</creatorcontrib><creatorcontrib>The InterAct Consortium</creatorcontrib><title>Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>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).
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).
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.</description><subject>abdominal adiposity</subject><subject>Annan klinisk medicin</subject><subject>Anthropometry</subject><subject>association</subject><subject>Body Mass Index</subject><subject>cancer</subject><subject>Clinical Medicine</subject><subject>Cohort Studies</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Endocrinology and Diabetes</subject><subject>Endokrinologi och diabetes</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Klinisk medicin</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medical research</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>mellitus</subject><subject>Middle Aged</subject><subject>Nutrition</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - physiopathology</subject><subject>Other Clinical Medicine</subject><subject>participants</subject><subject>Physiological aspects</subject><subject>prevention</subject><subject>primary-care</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Type 2 diabetes</subject><subject>waist circumference</subject><subject>Waist Circumference - 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incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study</title><author>Langenberg, Claudia ; Sharp, Stephen J ; Schulze, Matthias B ; Rolandsson, Olov ; Overvad, Kim ; Forouhi, Nita G ; Spranger, Joachim ; Drogan, Dagmar ; Huerta, José María ; Arriola, Larraitz ; de Lauzon-Guillan, Blandine ; Tormo, Maria-Jose ; Ardanaz, Eva ; Balkau, Beverley ; Beulens, Joline W J ; Boeing, Heiner ; Bueno-de-Mesquita, H Bas ; Clavel-Chapelon, Françoise ; Crowe, Francesca L ; Franks, Paul W ; Gonzalez, Carlos A ; Grioni, Sara ; Halkjaer, Jytte ; Hallmans, Goran ; Kaaks, Rudolf ; Kerrison, Nicola D ; Key, Timothy J ; Khaw, Kay Tee ; Mattiello, Amalia ; Nilsson, Peter ; Norat, Teresa ; Palla, Luigi ; Palli, Domenico ; Panico, Salvatore ; Quirós, J Ramón ; Romaguera, Dora ; Romieu, Isabelle ; Sacerdote, Carlotta ; Sánchez, María-José ; Slimani, Nadia ; Sluijs, Ivonne ; Spijkerman, Annemieke M W ; Teucher, Birgit ; Tjonneland, Anne ; Tumino, Rosario ; van der A, Daphne L ; van der Schouw, Yvonne T ; Feskens, Edith J M ; Riboli, Elio ; Wareham, Nicholas J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1020t-a623a3b175e2c5289a95ccb5354b495a1266eabbea6c32ef6803874558ecfbe83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>abdominal adiposity</topic><topic>Annan klinisk medicin</topic><topic>Anthropometry</topic><topic>association</topic><topic>Body Mass Index</topic><topic>cancer</topic><topic>Clinical Medicine</topic><topic>Cohort Studies</topic><topic>Development and progression</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Endocrinology and Diabetes</topic><topic>Endokrinologi och diabetes</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Klinisk medicin</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medical research</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>mellitus</topic><topic>Middle Aged</topic><topic>Nutrition</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - physiopathology</topic><topic>Other Clinical Medicine</topic><topic>participants</topic><topic>Physiological aspects</topic><topic>prevention</topic><topic>primary-care</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Type 2 diabetes</topic><topic>waist circumference</topic><topic>Waist Circumference - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langenberg, Claudia</creatorcontrib><creatorcontrib>Sharp, Stephen J</creatorcontrib><creatorcontrib>Schulze, Matthias B</creatorcontrib><creatorcontrib>Rolandsson, Olov</creatorcontrib><creatorcontrib>Overvad, Kim</creatorcontrib><creatorcontrib>Forouhi, Nita G</creatorcontrib><creatorcontrib>Spranger, Joachim</creatorcontrib><creatorcontrib>Drogan, Dagmar</creatorcontrib><creatorcontrib>Huerta, José María</creatorcontrib><creatorcontrib>Arriola, Larraitz</creatorcontrib><creatorcontrib>de Lauzon-Guillan, Blandine</creatorcontrib><creatorcontrib>Tormo, Maria-Jose</creatorcontrib><creatorcontrib>Ardanaz, Eva</creatorcontrib><creatorcontrib>Balkau, Beverley</creatorcontrib><creatorcontrib>Beulens, Joline W J</creatorcontrib><creatorcontrib>Boeing, Heiner</creatorcontrib><creatorcontrib>Bueno-de-Mesquita, H Bas</creatorcontrib><creatorcontrib>Clavel-Chapelon, Françoise</creatorcontrib><creatorcontrib>Crowe, Francesca L</creatorcontrib><creatorcontrib>Franks, Paul W</creatorcontrib><creatorcontrib>Gonzalez, Carlos A</creatorcontrib><creatorcontrib>Grioni, Sara</creatorcontrib><creatorcontrib>Halkjaer, Jytte</creatorcontrib><creatorcontrib>Hallmans, Goran</creatorcontrib><creatorcontrib>Kaaks, Rudolf</creatorcontrib><creatorcontrib>Kerrison, Nicola D</creatorcontrib><creatorcontrib>Key, Timothy J</creatorcontrib><creatorcontrib>Khaw, Kay Tee</creatorcontrib><creatorcontrib>Mattiello, Amalia</creatorcontrib><creatorcontrib>Nilsson, Peter</creatorcontrib><creatorcontrib>Norat, Teresa</creatorcontrib><creatorcontrib>Palla, Luigi</creatorcontrib><creatorcontrib>Palli, Domenico</creatorcontrib><creatorcontrib>Panico, Salvatore</creatorcontrib><creatorcontrib>Quirós, J Ramón</creatorcontrib><creatorcontrib>Romaguera, Dora</creatorcontrib><creatorcontrib>Romieu, Isabelle</creatorcontrib><creatorcontrib>Sacerdote, Carlotta</creatorcontrib><creatorcontrib>Sánchez, María-José</creatorcontrib><creatorcontrib>Slimani, Nadia</creatorcontrib><creatorcontrib>Sluijs, Ivonne</creatorcontrib><creatorcontrib>Spijkerman, Annemieke M W</creatorcontrib><creatorcontrib>Teucher, Birgit</creatorcontrib><creatorcontrib>Tjonneland, Anne</creatorcontrib><creatorcontrib>Tumino, Rosario</creatorcontrib><creatorcontrib>van der A, Daphne L</creatorcontrib><creatorcontrib>van der Schouw, Yvonne T</creatorcontrib><creatorcontrib>Feskens, Edith J M</creatorcontrib><creatorcontrib>Riboli, Elio</creatorcontrib><creatorcontrib>Wareham, Nicholas J</creatorcontrib><creatorcontrib>InterAct Consortium</creatorcontrib><creatorcontrib>The InterAct Consortium</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & 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Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Umeå universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Umeå universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Lunds universitet full text</collection><collection>SWEPUB Lunds universitet</collection><collection>NARCIS:Publications</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langenberg, Claudia</au><au>Sharp, Stephen J</au><au>Schulze, Matthias B</au><au>Rolandsson, Olov</au><au>Overvad, Kim</au><au>Forouhi, Nita G</au><au>Spranger, Joachim</au><au>Drogan, Dagmar</au><au>Huerta, José María</au><au>Arriola, Larraitz</au><au>de Lauzon-Guillan, Blandine</au><au>Tormo, Maria-Jose</au><au>Ardanaz, Eva</au><au>Balkau, Beverley</au><au>Beulens, Joline W J</au><au>Boeing, Heiner</au><au>Bueno-de-Mesquita, H Bas</au><au>Clavel-Chapelon, Françoise</au><au>Crowe, Francesca L</au><au>Franks, Paul W</au><au>Gonzalez, Carlos A</au><au>Grioni, Sara</au><au>Halkjaer, Jytte</au><au>Hallmans, Goran</au><au>Kaaks, Rudolf</au><au>Kerrison, Nicola D</au><au>Key, Timothy J</au><au>Khaw, Kay Tee</au><au>Mattiello, Amalia</au><au>Nilsson, Peter</au><au>Norat, Teresa</au><au>Palla, Luigi</au><au>Palli, Domenico</au><au>Panico, Salvatore</au><au>Quirós, J Ramón</au><au>Romaguera, Dora</au><au>Romieu, Isabelle</au><au>Sacerdote, Carlotta</au><au>Sánchez, María-José</au><au>Slimani, Nadia</au><au>Sluijs, Ivonne</au><au>Spijkerman, Annemieke M W</au><au>Teucher, Birgit</au><au>Tjonneland, Anne</au><au>Tumino, Rosario</au><au>van der A, Daphne L</au><au>van der Schouw, Yvonne T</au><au>Feskens, Edith J M</au><au>Riboli, Elio</au><au>Wareham, Nicholas J</au><au>Patel, Anushka</au><aucorp>InterAct Consortium</aucorp><aucorp>The InterAct Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>9</volume><issue>6</issue><spage>e1001230</spage><epage>e1001230</epage><pages>e1001230-e1001230</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>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).
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).
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22679397</pmid><doi>10.1371/journal.pmed.1001230</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2012-06, Vol.9 (6), p.e1001230-e1001230 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_1288096520 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; SWEPUB Freely available online; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | abdominal adiposity Annan klinisk medicin Anthropometry association Body Mass Index cancer Clinical Medicine Cohort Studies Development and progression Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Endocrinology and Diabetes Endokrinologi och diabetes Europe - epidemiology Female Health aspects Humans Incidence Klinisk medicin Male Medical and Health Sciences Medical research Medicin och hälsovetenskap Medicine mellitus Middle Aged Nutrition Obesity Obesity - complications Obesity - physiopathology Other Clinical Medicine participants Physiological aspects prevention primary-care Proportional Hazards Models Risk Factors Time Factors Type 2 diabetes waist circumference Waist Circumference - physiology |
| title | Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study |
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