Objective: To explore the effect of BMI and waist circumference on diabetes of adults. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited. Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes. Results: Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years), a total of 944 men and 1 643 women were diagnosed as having diabetes. Compared to those with normal weight, after adjusting for known or potential factors, HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95%CI: 2.47-2.99) and 6.27 (95%CI: 5.33-7.36), respectively. The corresponding figures in women were 2.19 (95%CI: 2.04-2.36) and 3.78 (95%CI: 3.36-4.26). Compared to those with normal waist circumference, after adjusting for known or potential factors, HR of Ⅰgrade andⅡgrade in men for diabetes were 2.56 (95%CI: 2.22-2.95) and 4.66 (95%CI: 4.14-5.24), respectively. The corresponding figures in women were 1.99 (95%CI: 1.80-2.21) and 3.16 (95%CI: 2.90-3.44), respectively. Conclusions: Overweight, obesity and central obesity were all associated with the increased incident of diabetes. Strategies on diabetes prevention should include not only losing weight, but reducing waist circumference as well.
目的： 探讨BMI和腰围对成年人糖尿病发病的影响。 方法： 使用"中国慢性病前瞻性研究"（CKB）浙江省桐乡市数据，剔除基线时自报患有恶性肿瘤、心脏病、脑卒中和糖尿病患者后，纳入分析30~79岁53 916人。采用Cox比例风险模型计算糖尿病发病风险比（HR）。 结果： 调查对象累计随访391 512人年（平均随访7.26年）。随访期间，男性944人和女性1 643人被新诊断为糖尿病。多因素调整后，与BMI正常组的人群相比，男性超重和肥胖组糖尿病发病的HR值（95%CI）分别为2.72（95%CI：2.47~2.99）和6.27（95%CI：5.33~7.36）。女性超重和肥胖组HR值（95%CI）分别为2.19（95%CI：2.04~2.36）和3.78（95%CI：3.36~4.26）；与腰围正常组的人群相比，男性Ⅰ级（85.0~89.9）和Ⅱ级中心性肥胖（≥90.0）组糖尿病发病的HR值（95%CI）分别为2.56（2.22~2.95）和4.66（4.14~5.24）。女性Ⅰ级（80.0~84.9）和Ⅱ级中心性肥胖（≥85.0）组HR值（95%CI）分别为1.99（1.80~2.21）和3.16（2.90~3.44）。 结论： 超重/肥胖以及中心性肥胖人群糖尿病发病风险均会升高。在开展控制体重预防糖尿病的同时，更应控制腰围。.
Keywords: Body mass index; Diabetes; Prospective study; Waist circumference.