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Anthropometric Indices Predicting Incident Type 2 Diabetes in an Iranian Population: The Isfahan Cohort Study Publisher Pubmed



Talaei M1 ; Sadeghi M2 ; Marshall T3 ; Thomas GN3 ; Iranipour R1 ; Nazarat N1 ; Sarrafzadegan N1
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Authors Affiliations
  1. 1. Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom

Source: Diabetes and Metabolism Published:2013


Abstract

Background: The link between adiposity and type 2 diabetes (T2D) is well known. However, it remains controversial as to which index and cutoff point is the best predictor in different populations. Methods: A total of 2981 urban and rural Iranian adults over 35years of age, and free of cardiovascular disease and diabetes were followed for 7years. Anthropometric indices included body mass index (BMI), body adiposity index [BAI=(hip circumference/height1.5)-18], waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR), and waist and hip circumferences. T2D was defined as fasting plasma glucoseI126mg/dL or 2-h post-prandial plasma glucoseI200mg/dL, or the use of antidiabetic agents. Receiver operating characteristic curve analysis determined the best cutoff point for each adiposity index. Results: After 7years of follow-up, 389 new cases of diabetes were found. Most indices were linearly associated with increased risk of diabetes but the best continuous predictor was WHtR in men [odds ratio: 1.10 (95% confidence interval: 1.07-1.12) for one unit] and BMI in women [1.08 (1.04-1.11) for 0.1kg/m2]. BMI cutoffs of 26kg/m2 in men and 30kg/m2 in women were the best binary predictors in adjusted models, and showed increased T2D risks of 2.91 (2.06-4.12) and 1.94 (1.42-2.66) times, respectively. All central-obesity indices in men and WHpR in women were also significantly associated with T2D independent of BMI. BAI was significantly associated with T2D in men but not in women. Conclusion: BMI at the appropriate cutoffs in both genders and WHtR in men and BMI in women as continuous factors were the best predictors of incident T2D in this Iranian population.© 2013 Elsevier Masson SAS.
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