Park Min Jeong, Kang Minwoong, Jang Soo Yeon, Jang Ahreum, Song Eyun, Choi Kyung Mook, Baik Sei Hyun, Yoo Hye Jin
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea.
Department of Biomedical Research Center, Korea University Medical Center, Seoul, Republic of Korea.
BMJ Open. 2025 Mar 18;15(3):e093598. doi: 10.1136/bmjopen-2024-093598.
Hormonal and age-related differences in body composition require tailored approaches for predicting new-onset type 2 diabetes (NODM). Previous studies lacked in-depth stratified analyses. We investigate sex- and age-specific body composition indices associated with NODM.
A retrospective, nationwide, population-based cohort study.
We analysed 4 058 891 adults who underwent a health examination in the year 2009 and 10-year follow-up data from the National Health Insurance Service.
NODM risk stratified by sex and age groups in 20-year intervals according to quartiles or per 1 SD increase in body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI) and weight-adjusted waist index (WWI).
Among the total subjects, 625 715 individuals (15.4%) developed NODM during median 10-year follow-up. The fourth quartile of WHtR showed the highest HR for NODM compared with the first quartile among various indices across the entire population (HR 2.54, 95% CI 2.52 to 2.57). In men, WHtR consistently exhibited the strongest association with NODM across all age groups in analysis based on 1 SD increase; ages 20-39 years (HR 1.54, 95% CI 1.53 to 1.55), ages 40-59 years (HR 1.39, 95% CI 1.38 to 1.39), ages 60-79 years (HR 1.23, 95% CI 1.22 to 1.24). In women, the most relevant body composition index for NODM varied by age group; BMI for ages 20-39 years (HR 1.48, 95%CI 1.47 to 1.49), WHtR for ages 40-59 years (HR 1.46, 95% CI 1.45 to 1.47) and WC for ages 60-79 years (HR 1.23, 95%CI 1.22 to 1.24).
WHtR was the strongest predictor of NODM in men across all ages, while the relevant indices varied by age group in women. These findings highlight the need for sex- and age-specific body composition assessments in predicting NODM risk.
身体成分的激素和年龄相关差异需要采用量身定制的方法来预测新发2型糖尿病（NODM）。以往研究缺乏深入的分层分析。我们研究与NODM相关的性别和年龄特异性身体成分指标。
一项基于全国人口的回顾性队列研究。
我们分析了2009年接受健康检查的4058891名成年人以及来自国民健康保险服务的10年随访数据。
根据四分位数或体重指数（BMI）、腰围（WC）、腰高比（WHtR）、内脏脂肪指数（VAI）、体型指数（ABSI）和体重调整腰围指数（WWI）每增加1个标准差，按20年间隔对NODM风险进行性别和年龄组分层。
在全部受试者中，625715人（15.4%）在中位10年随访期间发生了NODM。在整个人口中，与第一四分位数相比，WHtR的第四四分位数在各种指标中显示出最高的NODM风险比（HR 2.54，95%CI 2.52至2.57）。在男性中，基于每增加1个标准差的分析中，WHtR在所有年龄组中始终与NODM表现出最强的关联；20-39岁（HR 1.54，95%CI 1.53至1.55），40-59岁（HR 1.39，95%CI 1.38至1.39），60-79岁（HR 1.23，95%CI 1.22至1.24）。在女性中，与NODM最相关的身体成分指标因年龄组而异；20-39岁为BMI（HR 1.48，95%CI 1.47至1.49），40-59岁为WHtR（HR 1.46，95%CI 1.45至1.47），60-79岁为WC（HR 1.23，95%CI 1.22至1.24）。
WHtR是所有年龄段男性NODM的最强预测指标，而女性的相关指标因年龄组而异。这些发现凸显了在预测NODM风险时进行性别和年龄特异性身体成分评估的必要性。
