Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN.
Diabetes Care. 2019 Jan;42(1):126-133. doi: 10.2337/dc18-1413. Epub 2018 Oct 23.
The study objective was to examine the impact of race/ethnicity on associations between anthropometric measures and diabetes risk.
A total of 136,112 postmenopausal women aged 50-79 years participating in the Women's Health Initiative without baseline cancer or diabetes were followed for 14.6 years. BMI, waist circumference (WC), and waist-to-hip ratio (WHR) were measured in all participants, and a subset of 9,695 had assessment of whole-body fat mass, whole-body percent fat, trunk fat mass, and leg fat mass by DXA. Incident diabetes was assessed via self-report. Multivariate Cox proportional hazards regression models were used to assess associations between anthropometrics and diabetes incidence.
During follow-up, 18,706 cases of incident diabetes were identified. BMI, WC, and WHR were all positively associated with diabetes risk in each racial and ethnic group. WC had the strongest association with risk of diabetes across all racial and ethnic groups. Compared with non-Hispanic whites, associations with WC were weaker in black women ( < 0.0001) and stronger in Asian women ( < 0.0001). Among women with DXA determinations, black women had a weaker association with whole-body fat ( = 0.02) but a stronger association with trunk-to-leg fat ratio ( = 0.03) compared with white women.
In postmenopausal women across all racial/ethnic groups, WC was a better predictor of diabetes risk, especially for Asian women. Better anthropometric measures that reflect trunk-to-leg fat ratio may improve diabetes risk assessment for black women.
本研究旨在探讨种族/民族对人体测量指标与糖尿病风险之间关联的影响。
共有 136112 名年龄在 50-79 岁、无基线癌症或糖尿病的绝经后妇女参加了妇女健康倡议，随访时间为 14.6 年。所有参与者均测量了 BMI、腰围（WC）和腰臀比（WHR），其中 9695 名参与者进行了全身脂肪量、全身脂肪百分比、躯干脂肪量和腿部脂肪量的 DXA 评估。通过自我报告评估新发糖尿病。采用多变量 Cox 比例风险回归模型评估人体测量指标与糖尿病发病风险之间的关联。
在随访期间，共发生 18706 例新发糖尿病。在每个种族和民族群体中，BMI、WC 和 WHR 均与糖尿病风险呈正相关。在所有种族和民族群体中，WC 与糖尿病风险的相关性最强。与非西班牙裔白人相比，WC 与黑人女性（<0.0001）和亚洲女性（<0.0001）的糖尿病风险相关性较弱。在进行 DXA 测定的女性中，与白种女性相比，黑种女性与全身脂肪的相关性较弱（=0.02），与躯干-腿部脂肪比的相关性较强（=0.03）。
在所有种族/民族群体的绝经后妇女中，WC 是预测糖尿病风险的更好指标，尤其是对于亚洲女性。更好的人体测量指标，反映躯干-腿部脂肪比，可能会改善对黑人女性的糖尿病风险评估。
