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Original Articles
- Metabolic Risk/Epidemiology
- Do Time-Dependent Repeated Measures of Anthropometric and Body Composition Indices Improve the Prediction of Incident Diabetes in the Cohort Study? Findings from a Community-Based Korean Genome and Epidemiology Study
- Hye Ah Lee, Hyesook Park, Bomi Park
- Diabetes Metab J. 2025;49(2):275-285. Published online November 15, 2024
- DOI: https://doi.org/10.4093/dmj.2024.0357
- 932 View
- 67 Download
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
Cumulative evidence consistently shows that anthropometric and body composition measurements are strongly linked to the risk of incident diabetes, typically based on baseline measurements. This study aims to assess whether repeated measurements enhance the prediction of diabetes risk beyond baseline assessments alone.
Methods
We utilized data from a 16-year population-based follow-up cohort within the Korean Genome and Epidemiology Study, comprising 6,030 individuals aged 40 to 69 years at baseline. We included eight indices: a body shape index (ABSI), body adiposity index (BAI), waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), weight-adjusted skeletal muscle index (SMI), percent body fat, and fat-to-muscle ratio. The effect of these measurements for incident diabetes was estimated using Harrell’s C-indexes and hazard ratios with 95% confidence intervals, employing time-dependent Cox proportional hazard models.
Results
Over the 16-year follow-up, 939 new diabetes cases were identified (cumulative incidence, 15.6%). The median number of indicator measurements per participant was eight. The basic model, including 10 features (sex, age, education levels, physical activity, alcohol intake, current smoking, total energy intake, dietary diversity score, and log-transformed C-reactive protein levels, and quartiles of unweighted genetic risk score at baseline), yielded a Harrell’s C-index of 0.610. The highest C-index in repeated measurements was for WC (0.668) across the general population, weight-adjusted SMI in men, and WHR in women. However, except for ABSI and BAI, the diabetes predictive power of the other indicators was comparable. Additionally, repeated measurements of WC, BMI, and WHR in women were found to contribute to improved discrimination compared to baseline measurements, but not in men.
Conclusion
Utilizing repeated measurements of general and central adiposity to predict diabetes may be helpful in predicting hidden risks, especially in women.
- Metabolic Risk/Epidemiology
- Associations between Weight-Adjusted Waist Index and Abdominal Fat and Muscle Mass: Multi-Ethnic Study of Atherosclerosis
- Ji Yoon Kim, Jimi Choi, Chantal A. Vella, Michael H. Criqui, Matthew A. Allison, Nam Hoon Kim
- Diabetes Metab J. 2022;46(5):747-755. Published online March 30, 2022
- DOI: https://doi.org/10.4093/dmj.2021.0294
- 8,025 View
- 299 Download
- 85 Web of Science
- 94 Crossref
-
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
The weight-adjusted waist index (WWI) reflected body compositional changes with aging. This study was to investigate the association of WWI with abdominal fat and muscle mass in a diverse race/ethnic population.
Methods
Computed tomography (CT) data from 1,946 participants for abdominal fat and muscle areas from the Multi-Ethnic Study of Atherosclerosis (785 Whites, 252 Asians, 406 African American, and 503 Hispanics) were used. Among them, 595 participants underwent repeated CT. The WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). The associations of WWI with abdominal fat and muscle measures were examined, and longitudinal changes in abdominal composition measures were compared.
Results
In all race/ethnic groups, WWI was positively correlated with total abdominal fat area (TFA), subcutaneous fat area, and visceral fat area, but negatively correlated with total abdominal muscle area (TMA) and abdominal muscle radiodensity (P<0.001 for all). WWI showed a linear increase with aging regardless of race and there were no significant differences in the WWI distribution between Whites, Asians, and African Americans. In longitudinal analyses, over 38.6 months of follow-up, all abdominal fat measures increased but muscle measures decreased, along with increase in WWI. The more the WWI increased, the more the TFA increased and the more the TMA decreased.
Conclusion
WWI showed positive associations with abdominal fat mass and negative associations with abdominal muscle mass, which likely reflects the abdominal compositional changes with aging in a multi-ethnic population. -
Citations
Citations to this article as recorded by
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- Korean Diabetes J. 2000;24(3):365-374. Published online January 1, 2001
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Abstract
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- BACKGROUND
It is well demonstrated that obesity is associated with many chronic disorders like type 2 diabetes, dyslipidemia, and hypertension. In Korea, there are numerous reports revealed the possible relationship between anthropometric indices of obesity and the aformentioned disorders in nondiabetic healthy population, but the reports in type 2 diabetics are limited. Therefore, in this study we evaluated the relationship among the anthropometric indices and fasting insulin, C-peptide, and serum lipid levels in recently diagnosed type 2 diabetics. METHOD: A total of 160 type 2 diabetics were recruited from the out-patient department of endocrinoloy of Kyungpook National University Hospital from March to June 1999. The following subjects were excluded from the study: duration of type 2 diabetes > 5year, receiving of insulin or lipid lowering agents. For all participants, body mass index, percent of body fat, waist and hip circumference were measured. Fasting plasma insulin, C-peptide, blood glucose, HbA1c, total cholesterol, triglyceride and high-density lipoprotein cholesterol were also assayed. Partial correlation analysis was used to test the relationships between anthropometric indices and laboratory data. RESULTS: 1) In male subjects, fasting plasma insulin level was not significantly correlated with any of the anthropometric variables. However, in female subjects, fasting plasma insulin level was significantly correlated with body mass index, percent of body fat, and waist circumference. 2) Fasting plasma C-peptide level significantly correlated to all of the anthropometric variables in female patients, but in males only significant association was seen between fasting plasma C-peptide level and waist circumference. 3) Total cholesterol level was significantly correlated with percent of body fat and waist/hip ratio in male andfemale subjects respectively. CONCLUSION: Anthropometric indices of abdominal obesity appear to be correlated with insulin production and lipid changes in recently diagnosed type 2 diabetics. Waist circumference is a more useful predictor of hyperinsulinemia than waist/hip ratio in both sexes.
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