Diabetes, Metabolic Syndrome and Obesity (Dec 2021)
Prevalence of Abdominal Obesity in Chinese Middle-Aged and Older Adults with a Normal Body Mass Index and Its Association with Type 2 Diabetes Mellitus: A Nationally Representative Cohort Study from 2011 to 2018
Abstract
Xuan Chen,1,* Mingrui Duan,1,2,* Rui Hou,1,2,* Manqi Zheng,1,2 Haibin Li,3 Manjot Singh,4,5 Changwei Li,6 Kuo Liu,1,2 Feng Zhang,1,2 Xinghua Yang,1,2 Yanxia Luo,1,2 Yan He,1,2 Lijuan Wu,1,2 Deqiang Zheng1,2,7 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China; 3Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, University of Western Australia, Crawley, WA, Australia; 5School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia; 6Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; 7Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden*These authors contributed equally to this workCorrespondence: Deqiang ZhengDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, People’s Republic of ChinaTel/Fax +86 10 8391 1497Email [email protected] WuDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, People’s Republic of ChinaTel +86 10 8391 1497Email [email protected]: Few studies have focused on the prevalence of abdominal obesity in Chinese middle-aged and older adults with a normal body mass index (BMI). Furthermore, it is still unclear whether abdominal obesity is an independent risk factor for type 2 diabetes mellitus (T2DM). Participants with a normal BMI are usually neglected during assessments of abdominal obesity-associated T2DM risk since the current recommendations for medical interventions are mainly focused on overall body mass index rather than fat deposition patterns.Methods: In this study, 7942 normal-BMI participants aged over 45 years from the China Health and Retirement Longitudinal Study were included to assess the prevalence of abdominal obesity defined by waist circumference (WC) or waist-to-height ratio (WHtR). In addition, 4348 normal-BMI individuals with no diabetes at baseline were included to evaluate the association between abdominal obesity and the risk of T2DM with the Cox proportional hazards model.Results: The prevalence (95% confidence interval, CI) of increased WC and substantially increased WC among adults with a normal BMI was 22.0% (21.1%-22.9%) and 18.1% (17.3%-19.0%), respectively. The adjusted hazard ratios and 95% CIs for T2DM incidence were 1.39 (1.05– 1.85) and 1.89 (1.42– 2.53) for those with increased WC and substantially increased WC, respectively, compared to the individuals with a normal WC. Similar HRs were obtained for the association between WHtR and the risk of T2DM. In prediabetic patients, the HRs (95% CIs) for new-onset T2DM for those with increased WC and substantially increased WC were 1.85 (1.27– 2.69) and 2.46 (1.67– 3.61), respectively, when compared with individuals with normal WC. This positive association was observed in women but not in men or adults with normal glucose tolerance (NGT).Conclusion: Abdominal obesity is highly prevalent among middle-aged and older Chinese adults with a normal BMI, and maintaining a normal waist circumference may be beneficial in the prevention of T2DM.Keywords: abdominal obesity, normal body mass index, prevalence, type 2 diabetes mellitus, hazard ratio
