Assessing prediction of diabetes in older adults using different adiposity measures: a 7 year prospective study in 6,923 older men and women

Wannamethee, S. G., Papacosta, O., Whincup, P. H., Carson, C., Thomas, M. C., Lawlor, D. A., Ebrahim, S. and Sattar, N. (2010) Assessing prediction of diabetes in older adults using different adiposity measures: a 7 year prospective study in 6,923 older men and women. Diabetologia, 53(5), pp. 890-898. (doi: 10.1007/s00125-010-1670-7)

Abstract

The aim of this study was to examine whether waist circumference (WC) or WHR improve diabetes prediction beyond body mass index in older men and women, and to define optimal cut-off points. In this prospective study, non-diabetic men (n = 3,519) and women (n = 3,404) aged 60-79 years were followed up for 7 years. There were 169 and 128 incident cases of type 2 diabetes in men and women, respectively. BMI, WC and WHR all showed strong associations with incident type 2 diabetes independent of potential confounders. In men, the adjusted relative risks (top vs lowest quartile) were 4.71 (95% CI 2.45-9.03) for BMI, 3.53 (95% CI 1.92-6.48) for WC and 2.76 (95% CI 1.58-4.82) for WHR. For women, the corresponding relative risks were 4.10 (95% CI 2.16-7.79), 12.18 (95% CI 4.83-30.74) and 5.61 (95% CI 2.84-11.09) for BMI, WC and WHR, respectively. Receiver-operating characteristic curve analysis revealed similar associations for BMI and WC in predicting diabetes in men (AUC = 0.726 and 0.713, respectively); WHR was the weakest predictor (AUC = 0.656). In women, WC was a significantly stronger predictor (AUC = 0.780) than either BMI (AUC = 0.733) or WHR (AUC = 0.728; p < 0.01 for both). Inclusion of both WC and BMI did not improve prediction beyond BMI alone in men or WC alone in women. Optimal sensitivity and specificity for the prediction of type 2 diabetes was observed at a WC of 100 cm in men and 92 cm in women. In older men, BMI and WC yielded similar prediction of risk of type 2 diabetes, whereas WC was clearly a superior predictor in older women

• Item Type: Articles
• Keywords: Abdominal adiposity adiposity ADULTS aged ASSOCIATION ASSOCIATIONS BMI body mass index BODY-MASS INDEX BODY-MASS-INDEX CARE Cohort diabetes ENGLAND FAT DISTRIBUTION HEALTH HEART INDEX MASS MEN Metabolism Obesity OLDER MEN OLDER-ADULTS POPULATION PREDICTION PRIMARY-CARE Prospective Prospective study RISK RISK-FACTORS Type 2 diabetes TYPE-2 WAIST CIRCUMFERENCE Waist-to-hip ratio WOMEN
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Sattar, Professor Naveed
• Authors: Wannamethee, S. G., Papacosta, O., Whincup, P. H., Carson, C., Thomas, M. C., Lawlor, D. A., Ebrahim, S., and Sattar, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences
• Journal Name: Diabetologia
• ISSN: 0012-186X