Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults

Han, T.S., Al-Gindan, Y.Y., Govan, L. , Hankey, C.R. and Lean, M.E.J. (2019) Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults. Acta Diabetologica, 56(8), pp. 947-954. (doi: 10.1007/s00592-019-01328-3) (PMID:30927105) (PMCID:PMC6597601)

Abstract

Aims: Type 2 diabetes (T2D) is known to be associated with high BMI and waist circumference (WC). These measures do not discriminate well between skeletal muscle (SM) and body fat (BF), which may have opposite influences. Methods: We conducted a secondary analysis of population-based data from 58,128 aged 18–85 yrs from Scottish Health Surveys (2003, 2008–2011) and Health Surveys for England (2003–2006, 2008–2013), excluding pregnant women and insulin-treated diabetes. Logistic regression was used to assess associations of known T2D, and of screened HbA1c > 48 mmol/mol (> 6.5%), with sex-specific quintiles of BMI, WC, and BF% and SM% estimated by validated anthropometric equations, adjusted for age, sex, smoking, ethnicity, country, and survey year. Results: As expected, ORs for having known T2D rose with quintiles of BMI (1, 1.5, 2.3, 3.1, and 6.5) and WC (1, 1.8, 2.5, 3.5, and 8.7). Compared to the lowest BF% quintile, OR for having T2D in highest BF% quintile was 11.1 (95% CI = 8.4–14.6). Compared to the highest SM% quintile, OR for having T2D in lowest SM% quintile was 2.0 (1.7–2.4). Of 72 adults with T2D/HbA1c > 6.5% in the lowest quintile of BF%, 27 (37.5%) were in quintile 1 of SM%. Similar patterns of OR were observed for having HbA1c > 6.5% in those without known T2D. Conclusions: Estimated BF% associates strongly with T2D. Low SM% also has a significant association, suggesting a neglected aspect of aetiology within T2D. These two simple measures with biological relevance, available from data collected in most health surveys, may be more useful than the purely statistical terms BMI.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Govan, Dr Lindsay and Lean, Professor Michael and Hankey, Dr Catherine and Algindan, Yasmin
• Authors: Han, T.S., Al-Gindan, Y.Y., Govan, L., Hankey, C.R., and Lean, M.E.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Acta Diabetologica
• Publisher: Springer
• ISSN: 0940-5429
• ISSN (Online): 1432-5233
• Published Online: 29 March 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in Acta Diabetologica 56(8): 947-954
• Publisher Policy: Reproduced under a Creative Commons License