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. 2015;25(7):489-95.
doi: 10.2188/jea.JE20140160. Epub 2015 May 23.

Changes in Waist Circumference and the Incidence of Type 2 Diabetes in Community-Dwelling Men and Women: The Suita Study

Yukako Tatsumi  1 , Makoto Watanabe, Michikazu Nakai, Yoshihiro Kokubo, Aya Higashiyama, Kunihiro Nishimura, Takashi Kobayashi, Misa Takegami, Yoko M Nakao, Takuya Watanabe, Akira Okayama, Tomonori Okamura, Yoshihiro Miyamoto
Affiliations

Changes in Waist Circumference and the Incidence of Type 2 Diabetes in Community-Dwelling Men and Women: The Suita Study

Yukako Tatsumi et al. J Epidemiol. 2015.

Abstract
in English, Japanese

Backgrounds: The association between weight gain and the incidence of type 2 diabetes is well known. The aim of our study was to investigate the relationship between change in waist circumference (WC) and type 2 diabetes incidence.

Methods: The participants in the Suita Study, a population-based cohort study in an urban area of Japan, underwent a baseline survey between 1989 and 1994 (Exam 1) and were examined at follow-up every 2 years. We performed a 9.3-year cohort study of 946 men and 1327 women with no history of diabetes who underwent Exam 1 and Exam 2 (between 1997 and 1999). Participants were stratified by sex and median WC at Exam 1, and, in each stratum, participants were further classified into three categories by tertile of WC change per year between Exam 1 and Exam 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes incidence were calculated by Cox proportional hazard models. The endpoints were first diagnosis of type 2 diabetes or March 2011.

Results: During follow-up, 287 participants developed type 2 diabetes. In both sexes with median WC or higher, participants in the highest tertile of WC change had a significantly higher risk of developing type 2 diabetes. Multivariable adjusted HRs were 1.84 (95% CI, 1.10-3.08) in men and 2.30 (95% CI, 1.31-4.04) in women. No significant association was observed among participants with WC below median.

Conclusions: Preventing WC gain is important in preventing type 2 diabetes in the Japanese population, especially among individuals with a relatively high WC.

背景：: これまで体重増加と2型糖尿病発症の関連については多くの報告があるが、腹囲の増加と2型糖尿病発症の関連についてはほとんど検討されていない。そこで、本研究では日本人集団において腹囲の変化と2型糖尿病発症との関連を明らかにすることを目的とした。

方法：: 吹田研究は大阪府吹田市住民から無作為抽出した者を対象としたコホート研究であり、1989年から1994年にベースライン調査（調査Ⅰ）を実施し、その後2年毎に追跡のための健康診断を実施している。本研究では、1997年から1999年の間に追跡のための健康診断（調査Ⅱ）を受診し、糖尿病の既往のない男性946名、女性1327名を2011年3月まで追跡した(平均追跡期間9.3年)。性別に調査Ⅰの腹囲の中央値で層化し、各層において調査Ⅰから調査Ⅱの間の腹囲の変化量（1年あたり）を3分位点で3群[変化量の低い方から順にT1, T2, T3]に分類した。2型糖尿病発症をアウトカムとし、Cox比例ハザードモデルにより、そのハザード比（95%信頼区間）を各層で算出した。

結果：: 追跡期間中、287名が2型糖尿病を発症した。腹囲が中央値より高い層において、男女とも、T2群と比較して、T3群で有意な2型糖尿病発症リスクの上昇が認められた。多変量調整後のハザード比は、男性：1.84(1.10-3.08)、女性：2.30 (1.31–4.04)であった。腹囲が中央値より低い層では、男女とも腹囲の変化と2型糖尿病発症リスクの間に有意な関連を認めなかった。

結論：: 日本人集団で腹囲増加を予防することは、特に比較的腹囲の大きい集団において、2型糖尿病の発症予防のために重要であることが示唆された。

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Figures

Figure 1.
Figure 1.. Process of selecting the study participants and overview of analysis of waist circumference (WC) change and the incidence of type 2 diabetes (shown in italics).
Figure 2.
Figure 2.. Scatter plots of waist circumference (WC) change and body mass index (BMI) change between examination 1 and examination 2 by sex and WC.
See this image and copyright information in PMC

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