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Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women

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Abstract

Obesity, defined by body mass index (BMI), is a well-established risk factor of type 2 diabetes, but BMI has been criticized for its inability to discriminate fat mass and lean body mass. We examined the association between predicted fat mass and type 2 diabetes risk in two large US prospective cohorts, and compared the magnitude of the association with BMI and other obesity indicators. Validated anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey were used to estimate predicted fat mass and percent fat for 97,111 participants from the Health Professionals Follow-up Study (1987–2012) and the Nurses’ Health Study (1986–2012) who were followed up for type 2 diabetes. Multivariable-adjusted hazard ratios for type 2 diabetes across quintiles of predicted fat mass were 1.00, 1.96, 2.96, 3.90, and 8.38 for men and 1.00, 2.20, 3.50, 5.73, and 12.1 for women; of BMI were 1.00, 1.69, 2.45, 3.54, and 6.94 for men and 1.00, 1.76, 2.86, 4.88, and 9.88 for women. Predicted FM showed the strongest association with type 2 diabetes in men followed by waist circumference (WC), waist-to-height ratio (WHtR), predicted percent fat, BMI, Waist-to-hip ratio (WHR), and a body shape index (ABSI). For women, the strongest association was shown for WHtR, followed by WC, predicted percent fat, predicted fat mass, BMI, ABSI, and WHR. Compared to BMI, predicted fat mass demonstrated consistently stronger association with type 2 diabetes risk. However, there was inconclusive evidence to suggest that predicted fat mass is substantially superior to other obesity indicators.

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Funding

This work was supported by the National Institutes of Health (UM1 CA186107, UM1 CA167552, and R03 CA223619).

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Authors and Affiliations

  1. Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA

    Dong Hoon Lee, NaNa Keum, Frank B. Hu, Eric B. Rimm, Walter C. Willett & Edward L. Giovannucci

  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Frank B. Hu, Eric B. Rimm, Walter C. Willett & Edward L. Giovannucci

  3. Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea

    NaNa Keum

  4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Frank B. Hu, Eric B. Rimm, Walter C. Willett & Edward L. Giovannucci

  5. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    E. John Orav

  6. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    E. John Orav

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  1. Dong Hoon Lee
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  2. NaNa Keum
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  7. Edward L. Giovannucci
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Corresponding author

Correspondence to Edward L. Giovannucci.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lee, D.H., Keum, N., Hu, F.B. et al. Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women. Eur J Epidemiol 33, 1113–1123 (2018). https://doi.org/10.1007/s10654-018-0433-5

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  • DOI: https://doi.org/10.1007/s10654-018-0433-5

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