School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada.
BMJ Open. 2019 Jul 19;9(7):e023829. doi: 10.1136/bmjopen-2018-023829.
To characterise the sex-specific difference in the association between anthropometric changes and risk of diabetes in the general population in Canada.
From 2000 to 2008, Alberta's Tomorrow Project (ATP) invited Alberta's residents aged 35-69 years to a prospective cohort study. A total of 19 655 diabetes-free ATP participants having anthropometrics measured at the baseline and follow-ups were included.
A longitudinal study design was used to examine the association between anthropometric changes and risk of diabetes and the sex difference in this association. Changes in weight, body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) were calculated as the difference between baseline and follow-up measures. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm with administrative healthcare data (2000-2015) linked to the ATP cohort. The sex-specific association between anthropometric changes and incidence of diabetes were examined by multivariable Cox regression models.
Changes in weight, BMI, WC and WHR over time were positively associated with incidence of diabetes in both men and women. The sex difference in risk of diabetes associated with 1 standard deviation (SD) increase in anthropometrics was 0.07 (95% CI -0.02 to 0.14) for weight, 0.08 (95% CI -0.03 to 0.17) for BMI, 0.07 (95% CI -0.02 to 0.15) for WC and 0.09 (95% CI 0.03 to 0.13) for WHR. Similar results were found in sex difference in the associations with changes per 5% and changes per categories (5% loss, ±5%, 5% gain).
The positive association between anthropometric changes and risk of diabetes was generally stronger in men than in women. However, this sex-specific difference of approximately 10% of the total risk associated with anthropometric changes had limited significance. For population-based public health programmes aiming to control obesity and incidence of diabetes, it may not be necessary to set up sex-specific goals for anthropometric reduction.
描述加拿大普通人群中，人体测量学变化与糖尿病风险之间的性别特异性差异。
从 2000 年到 2008 年，艾伯塔省明日计划（ATP）邀请艾伯塔省 35-69 岁的居民参加前瞻性队列研究。共纳入 19655 名无糖尿病的 ATP 参与者，基线和随访时均测量了人体测量学指标。
采用纵向研究设计，检验人体测量学变化与糖尿病风险之间的关联，以及这种关联的性别差异。体重、体重指数（BMI）、腰围（WC）和腰臀比（WHR）的变化通过基线和随访测量值之间的差值计算。利用加拿大国家糖尿病监测系统算法，通过与 ATP 队列相关联的行政医疗保健数据（2000-2015 年）确定糖尿病病例。采用多变量 Cox 回归模型检验人体测量学变化与糖尿病发病率之间的性别特异性关联。
体重、BMI、WC 和 WHR 的变化与男性和女性的糖尿病发病率呈正相关。在与人体测量学变化相关的 1 个标准差（SD）增加的风险中，性别差异为体重 0.07（95%CI-0.02 至 0.14）、BMI 0.08（95%CI-0.03 至 0.17）、WC 0.07（95%CI-0.02 至 0.15）和 WHR 0.09（95%CI 0.03 至 0.13）。在与变化每 5%和每类别（5%下降、±5%、5%上升）相关的关联中，也发现了类似的性别差异。
人体测量学变化与糖尿病风险之间的正相关关系在男性中通常比女性更强。然而，这种与人体测量学变化相关的大约 10%的总风险的性别差异意义有限。对于旨在控制肥胖和糖尿病发病率的基于人群的公共卫生计划，可能没有必要为人体测量学降低设定特定于性别的目标。
