Abdominal volume index trajectories and risk of diabetes mellitus: Results from the China Health and Nutrition Survey

• Published in: Journal of diabetes investigation Vol. 13; no. 5; pp. 868 - 877
• Main Authors: Hu, Xiangming, Appleton, Allison A, Ou, Yanqiu, Zhang, Ying, Cai, Anping, Zhou, Yingling, Dong, Haojian
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.05.2022; John Wiley and Sons Inc; Wiley
• Subjects: Abdomen; Abdominal fat; Adipose tissue; Age; Alcohol; Body Mass Index; China - epidemiology; Cholesterol; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Education; Fasting; Growth models; Hemoglobin; Humans; Hypertension; Insulin resistance; Nutrition; Nutrition Surveys; Obesity; Obesity - complications; Obesity, Abdominal - complications; Obesity, Abdominal - epidemiology; Original; Population; Public health; Public health practice; Regression analysis; Risk Factors; China; United States > US; Japan; Abdominal fat; Diabetes mellitus; Public health practice
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13733

Aims/Introduction Abdominal obesity is a risk factor for developing diabetes mellitus, but trajectories of abdominal obesity over time and incident diabetes mellitus have not been considered. We derived trajectories of abdominal volume index (AVI) over 16 years of follow up, and examined the associations between AVI trajectories and risk of diabetes mellitus. Materials and Methods Data were used from the China Health and Nutrition Survey, and 5,267 participants were enrolled to fit the trajectory of AVI by using latent class growth models. Multivariate logistic regression models explored the relationship between different AVI trajectories and risk of diabetes mellitus. In addition, we examined the slope of the AVI trajectories in relation to age to identify appropriate life course intervention opportunities for the prevention of diabetes mellitus. Results Three trajectories were derived reflecting graded categories in the speed and slope of increase in AVI over time: slow, intermediate and fast increase group, respectively. After multivariate adjustment, the odds ratios for diabetes mellitus among those in the intermediate and fast increase groups were 1.81 (95% confidence interval 1.37–2.38, P < 0.001) and 2.80 (95% confidence interval 1.85–4.24, P < 0.001) respectively, relative to the slow increase group. The distribution of AVI slope in the slow increase group showed an inverted "U" shape, whereas the fast increase group presented a "U" shape. Conclusions AVI trajectory is associated with an increased risk of diabetes mellitus. These results provide new insights on the relationship between abdominal adiposity and diabetes mellitus, which in turn can help improve clinical and public health intervention for diabetes mellitus prevention. Based on a 16‐year large‐scale cohort study, we identified three types of abdominal obesity trajectories with different incidences of diabetes mellitus in adults. Our research provides a new perspective on the management of abdominal obesity for the prevention of diabetes.