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

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE

Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991-

Adiposity* ; Body Mass Index* ; Waist Circumference*; Diabetes Mellitus, Type 2/*epidemiology; Adolescent ; Adult ; Aged ; Aged, 80 and over ; England ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal/anatomy & histology ; Scotland

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.

Geriatr Gerontol Int. 2014 Feb;14 Suppl 1:115-21. (PMID: 24450569)
Obesity (Silver Spring). 2008 Feb;16(2):463-9. (PMID: 18239660)
J Clin Endocrinol Metab. 2011 Sep;96(9):2898-903. (PMID: 21778224)
J Health Econ. 2008 Mar;27(2):519-29. (PMID: 18166236)
Am J Clin Nutr. 2014 Oct;100(4):1041-51. (PMID: 25240071)
J Clin Hypertens (Greenwich). 2019 Feb;21(2):230-238. (PMID: 30525280)
J Rehabil Res Dev. 2008;45(2):261-72. (PMID: 18566944)
QJM. 2016 Jul;109(7):443-446. (PMID: 26527773)
Clin Sci (Lond). 2015 Apr;128(7):405-10. (PMID: 25515001)
Epidemiol Rev. 2007;29:115-28. (PMID: 17494056)
Nutrition. 2001 Jan;17(1):26-30. (PMID: 11165884)
Curr Opin Support Palliat Care. 2017 Sep;11(3):205-213. (PMID: 28661901)
Eur J Clin Nutr. 1996 Nov;50(11):747-52. (PMID: 8933122)
Diabetes Care. 2009 Nov;32 Suppl 2:S157-63. (PMID: 19875544)
Diabetes Care. 1994 May;17(5):382-6. (PMID: 8062604)
J Intern Med. 1997 Nov;242(5):401-6. (PMID: 9408070)
Dis Model Mech. 2013 Jan;6(1):25-39. (PMID: 23268536)
Am J Clin Nutr. 2002 Apr;75(4):683-8. (PMID: 11916754)
Int J Obes (Lond). 2016 Apr;40(4):622-32. (PMID: 26499438)
Am J Clin Nutr. 1996 Jan;63(1):4-14. (PMID: 8604668)
Diabetes Care. 1994 Sep;17(9):961-9. (PMID: 7988316)
Obes Res. 2002 Sep;10(9):923-31. (PMID: 12226141)
Obes Res. 2001 Oct;9(10):644-6. (PMID: 11595782)
Dtsch Arztebl Int. 2010 Jul;107(26):470-6. (PMID: 20644701)
Eur J Clin Nutr. 2004 Jun;58(6):888-93. (PMID: 15164109)
Eur J Clin Nutr. 2011 Mar;65(3):357-67. (PMID: 21179050)
Diabetes. 2016 Oct;65(10):2862-75. (PMID: 27358494)
Diabet Med. 1998 Feb;15(2):129-35. (PMID: 9507913)

Keywords: Adiposity; Anthropometry; Health surveys; Obesity

Date Created: 20190331 Date Completed: 20191015 Latest Revision: 20210109

20240628

PMC6597601

10.1007/s00592-019-01328-3

30927105