Relationship between Body Roundness Index and Risk of Type 2 Diabetes in Japanese Men and Women: A Reanalysis of a Cohort Study

Purpose. The purpose of this study was to investigate the association between body roundness index (BRI) and type 2 diabetes (T2DM) in each sex, explore the dose-response relationship between them, and evaluate the predictive value of BRI for T2DM. Materials and Methods. A retrospective cohort study was performed on 15,464 Japanese patients at the Murakami Memorial Hospital. Data on anthropometric indices and biochemical parameters were obtained. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident T2DM associated with BRI. Dose-response relationships were evaluated using a smoothing function analysis and the threshold effect. Receiver operating characteristic curves were used to evaluate and compare the predictive values of BRI, body mass index (BMI), and waist circumference (WC) for T2DM. Results. During a median 5.4-year follow-up period, 373 subjects were diagnosed with T2DM. After adjusting for age, alcohol intake, smoking status, fatty liver, systolic blood pressure, fasting plasma glucose, glycated hemoglobin, high-density lipoprotein cholesterol, triglycerides, and total cholesterol, the relationship between BRI and T2DM was linear in women (HR (95% CI) for BRI Z score = 1.48 (1.26,1.74)) and curvilinear in men (HR (95% CI) on the left and right of the inflection point = 0.70 (0.44, 1.10) and 1.46 (1.27, 1.67), respectively). Compared with BMI (area under the curve (AUC) = 0.684; p < 0.001 ) and WC (AUC = 0.700; p = 0.007 ), BRI was the strongest predictor of T2DM in men (AUC = 0.715). Similarly, the AUC of BRI was larger than that of BMI (AUC = 0.757; p = 0.966 ) and WC (AUC = 0.733; p = 0.015 ) in women. Conclusions. BRI was positively linearly associated with an elevated risk of incident T2DM in women. In men, the relationship between BRI and T2DM was J-shaped. BRI is an effective indicator of predicting T2DM. Its discriminatory power was higher than that of BMI and WC in both sexes.

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Dietary Copper-Zinc Ratio and Type 2 Diabetes Risk in Women: The E3N Cohort Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_059 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1431-1431

Author(s):

Nasser Laouali ◽

Conor-James MacDonald ◽

Douae El Fatouhi ◽

Francesca Romana Mancini ◽

Guy Fagherazzi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Trace Elements ◽

Cohort Study ◽

Lower Risk ◽

Cox Regression ◽

Smoking Status ◽

Normal Weight ◽

Biological Processes ◽

Obese Women

Abstract Objectives Trace elements are essential minerals that are required for a variety of biological processes. Zinc (Zn) is a trace element involved in many biological processes including regulation of insulin and glycaemia. It has been suggested that the serum copper (Cu) to Zn ratio could be of importance towards risk of diabetes. However, little is known about the effect of suboptimal intakes of these two competitive trace elements. We aimed to investigate the association between type 2 diabetes (T2D) incidence and the dietary Cu-Zn, ratio. Methods A total of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort study were followed for 20 years. The individual daily energy-adjusted intakes of Cu and Zn were estimated at baseline using a validated food frequency questionnaire. T2D cases were identified and validated using diabetes-specific questionnaires and drug reimbursement insurance databases. Multivariable Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) between dietary Cu-Zn ratio intakes and T2D risk. Interactions were tested between Cu-Zn ratio and smoking status and BMI on incident T2D. Results A total of 3292 incident T2D cases were identified during follow-up. A lower Cu-Zn ratio was associated with a lower risk of T2D. Compared to the 1st quintile group, women from the 2nd (HR 0.87 [95% CI 0.78, 0.97]) and 3rd (HR 0.89 [95% CI 0.79, 0.99]) quintile groups had a lower risk of T2D. Spline analysis showed that a Cu-Zn ratio intake < 0.30 was associated with a lower risk of T2D and that there was no departure from a linear association (P = 0.1180). There was an interaction between the Cu-Zn ratio and BMI on T2D risk (pInteraction = 0.0010) but not smoking status (pInteraction = 0.6956). Cu-Zn ratio was positively associated with T2D only in obese women, but not in normal-weight or overweight women. Conclusions Our findings suggest that a lower dietary Cu-Zn ratio intake is associated with a lower T2D risk, especially among obese women. Further studies are warranted to validate our results and determine whether the associations are similar in men. Funding Sources This work was supported by a grant for the E4N study project by the Agence Nationale de Recherche and by a grant for the Nutriperso Project (IDEX Paris Saclay).

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Abstract MP041: Menopausal Age, Reproductive Lifespan And Type 2 Diabetes Risk: A Case-cohort Study (InterAct)

Circulation ◽

10.1161/circ.125.suppl_10.amp041 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Judith Brand ◽

Yvonne T van der Schouw ◽

N C Onland-Moret ◽

Stephen Sharp ◽

Ken Ong ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Cox Regression ◽

Disease Risk ◽

Smoking Status ◽

Random Effect ◽

Age At Menarche ◽

Future Health ◽

Age At Menopause

Background: Early menopause and estrogen deficiency are important determinants of future health outcomes. While experimental data suggest a role for estrogens in glucose homeostasis, the relationship between menopausal age and type 2 diabetes (T2D) risk is relatively unexplored. Objective: To investigate associations of menopausal age and reproductive lifespan (defined as menopausal age minus age at menarche) with T2D risk. Methods: A case cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), including 3691 incident T2D cases and a random subcohort of 4408 postmenopausal women (including 235 incident diabetes cases). Prentice weighted Cox regression and random effect meta-analyses were used to investigate the associations between menopausal age, reproductive lifespan and T2D risk. Results: Earlier age at menopause was associated with an increased T2D risk. After adjustment for reproductive and classical T2D risk factors, the HRs across categories of menopausal age (< 40, 40–44, 45–49, 50–54 and ≥ 55 years) were 1.31 (1.01–1.69), 1.10 (0.91–1.34), 1.00 (0.88–1.13), 1.00 (reference) and 0.86 (0.70–1.05) respectively ( P trend = 0.01). The association between reproductive lifespan and T2D risk was weaker: HRs across quartiles of reproductive lifespan were 1.18 (0.98–1.41), 1.02 (0.86–1.22), 0.96 (0.81–1.14) and 1.00 (reference) respectively ( P trend = 0.02). No effect modification with body mass index, waist circumference or smoking status was observed ( P interaction all > 0.05). Conclusion: Earlier age at menopause and a shorter reproductive lifespan are associated with an increased T2D risk, supporting a protective role for estrogens in metabolic disease risk.

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Mannose-binding Lectin and Risk of Cardiovascular Events and Mortality in Type 2 Diabetes: A Danish Cohort Study

10.2337/figshare.12240836 ◽

2020 ◽

Author(s):

Anne Gedebjerg ◽

Mette Bjerre ◽

Alisa Devedzic Kjaergaard ◽

Rudi Steffensen ◽

Jens Steen Nielsen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cohort Study ◽

Cardiovascular Events ◽

Cox Regression ◽

Mannose Binding Lectin ◽

Mannose Binding ◽

All Cause Mortality ◽

Binding Lectin

Objective: Mannose-binding lectin (MBL) is linked to risk of cardiovascular disease in diabetes, but the nature of the association is unclear. We investigated the association between MBL and risk of cardiovascular events (CVE) and all-cause mortality in type 2 diabetes. Research Design and Methods: In a cohort study of 7588 patients with type 2 diabetes, we measured serum MBL in 7305 and performed MBL expression genotyping in 3043. We grouped serum MBL and MBL expression genotypes into three categories: low, intermediate, and high. Outcomes were CVE (myocardial infarction, stroke, coronary revascularization, unstable angina, and cardiovascular death) and all-cause mortality. The association with outcomes was examined by spline and Cox regression analyses. Results: Serum MBL and CVE showed a U-shaped association. Compared to the intermediate serum MBL category, the adjusted hazard ratio (HR) for CVE was 1.82 (95% CI, 1.34 to 2.46) for the low-MBL category and 1.48 (95% CI, 1.14 to 1.92) for the high-MBL category. We found a similar U-shaped association for all-cause mortality, but with lower risk estimates. Compared to the intermediate MBL expression genotype, the adjusted HR for CVE was 1.40 (95% CI, 0.87 to 2.25) for the low-expression genotype and 1.44 (95% CI, 1.01 to 2.06) for the high-expression genotype. MBL expression genotype was not associated with all-cause mortality. Conclusions: Both serum MBL and MBL expression genotype showed a U-shaped association with CVE risk in individuals with type 2 diabetes. Our findings suggest that serum MBL is a risk factor for cardiovascular disease in this population.

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Mannose-binding Lectin and Risk of Cardiovascular Events and Mortality in Type 2 Diabetes: A Danish Cohort Study

10.2337/figshare.12240836.v1 ◽

2020 ◽

Author(s):

Anne Gedebjerg ◽

Mette Bjerre ◽

Alisa Devedzic Kjaergaard ◽

Rudi Steffensen ◽

Jens Steen Nielsen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cohort Study ◽

Cardiovascular Events ◽

Cox Regression ◽

Mannose Binding Lectin ◽

Mannose Binding ◽

All Cause Mortality ◽

Binding Lectin

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Abstract MP05: Leisure-Time Running and Incident Type 2 Diabetes

Circulation ◽

10.1161/circ.131.suppl_1.mp05 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Duck-chul Lee ◽

Carl J. Lavie ◽

Timothy S. Church ◽

Xuemei Sui ◽

Steven N. Blair

Keyword(s):

Type 2 Diabetes ◽

Lower Risk ◽

Leisure Time ◽

Cox Regression ◽

Smoking Status ◽

Physical Activities ◽

Incident Type ◽

Incident Type 2 Diabetes

Introduction: There is still little evidence on the dose-response relation between leisure-time running and incident type 2 diabetes (T2D). Hypothesis: We examined the hypothesis that running reduces the risk of developing T2D. Methods: Participants were 19,347 adults aged 18 to 100 years (mean age, 44) who received an extensive preventive medical examination during 1974-2006 in the Aerobics Center Longitudinal Study. Participants were free of cardiovascular disease, cancer, and T2D at baseline. Running and other physical activities were assessed on the medical history questionnaire by self-reported leisure-time activities during the past 3 months. We defined T2D as fasting glucose ≥126 mg/dl, insulin use, or physician-diagnosis during follow-up medical examinations. Cox regression was used to quantify the association between running and T2D after adjusting for baseline age, sex, examination year, body mass index, smoking status, heavy alcohol drinking, abnormal electrocardiogram, hypertension, hypercholesterolemia, and levels of other physical activities. Results: During an average follow-up of 6.5 years, 1,015 adults developed T2D. Approximately 30% of adults participated in leisure-time running. Runners had a 29% lower risk of developing T2D compared with non-runners. The hazard ratios (95% confidence intervals) of T2D were 0.97 (0.74-1.27), 0.66 (0.49-0.89), 0.62 (0.45-0.85), 0.78 (0.58-1.03), and 0.57 (0.42-0.79) across quintiles (Q) of running time (minutes/week); 0.99 (0.76-1.30), 0.60 (0.44-0.82), 0.72 (0.55-0.94), 0.65 (0.47-0.90), and 0.63 (0.47-0.86) across Q of running distance (miles/week); 1.08 (0.83-1.40), 0.67 (0.50-0.90), 0.70 (0.53-0.93), 0.61 (0.45-0.83), and 0.53 (0.36-0.76) across Q of running frequency (times/week); 0.95 (0.73-1.24), 0.70 (0.52-0.94), 0.62 (0.45-0.84), 0.73 (0.55-0.97), and 0.58 (0.42-0.80) across Q of total amount of running (MET-minutes/week); and 0.95 (0.71-1.28), 0.76 (0.59-0.99), 0.59 (0.42-0.83), 0.66 (0.51-0.85), and 0.62 (0.43-0.90) across Q of running speed (mph), respectively, compared with no running after adjusting for confounders including levels of other physical activities. Conclusions: Participating in leisure-time running is associated with markedly lower risk of developing T2D in adults. Except for those in the very lowest Q for running doses, even relatively low running doses (starting with Q 2) were associated with marked reductions in T2D risk over time, supporting the prescription of running to reduce T2D.

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Profiles of Polyphenol Intake and Type 2 Diabetes Risk in 60,586 Women Followed for 20 Years: Results from the E3N Cohort Study

Nutrients ◽

10.3390/nu12071934 ◽

2020 ◽

Vol 12 (7) ◽

pp. 1934

Author(s):

Nasser Laouali ◽

Takiy Berrandou ◽

Joseph A. Rothwell ◽

Sanam Shah ◽

Douae El Fatouhi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Fruits And Vegetables ◽

Cox Regression ◽

Joint Effect ◽

Varied Diet ◽

Polyphenol Intake ◽

The Individual ◽

Daily Intakes

Most studies on dietary polyphenol intake and type 2 diabetes (T2D) risk have focused on total or specific subclasses of polyphenols. Since polyphenols are often consumed simultaneously, the joint effect of an intake of multiple subclasses should be explored. We aimed to identify profiles of the dietary polyphenol subclasses intake associated with T2D. A total of 60,586 women from the Etude Epidémiologique auprès de femmes de l’Education Nationale (E3N) cohort study were followed for 20 years between 1993 and 2014. T2D cases were identified and validated. The individual energy-adjusted daily intakes of 15 subclasses of polyphenols were estimated at baseline using a food frequency questionnaire and the PhenolExplorer database. We used Bayesian profile regression to perform the clustering of the covariates by identifying exposure profiles of polyphenol intakes and, simultaneously, link these to T2D risk by using multivariable Cox regression models. We validated 2740 incident T2D cases during follow-up, and identified 15 distinct clusters with different intake profiles and T2D risk. When compared to the largest cluster (n = 6298 women), higher risks of T2D were observed in three of those clusters, which were composed of women with low or medium intakes of anthocyanins, dihydroflavonols, catechins, flavonols, hydroxybenzoic acids, lignans, and stilbenes. One cluster (n = 4243), characterized by higher intakes of these polyphenol subclasses, exhibited lower T2D risk when compared to the reference cluster. These results highlight the importance of a varied diet of polyphenol-rich foods such as nuts, fruits, and vegetables to prevent T2D risk.

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The Relationship between AKI and CKD in Patients with Type 2 Diabetes: An Observational Cohort Study

Journal of the American Society of Nephrology ◽

10.1681/asn.2020030323 ◽

2020 ◽

Vol 32 (1) ◽

pp. 138-150 ◽

Cited By ~ 2

Author(s):

Simona Hapca ◽

Moneeza K. Siddiqui ◽

Ryan S.Y. Kwan ◽

Michelle Lim ◽

Shona Matthew ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Observational Studies ◽

Observational Cohort Study ◽

Patients With Diabetes ◽

Observational Cohort ◽

The Relationship ◽

Egfr Slope

BackgroundThere are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population.MethodsIn this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline.ResultsWe followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD.ConclusionsPatients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.

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Snoring frequency and risk of type 2 diabetes mellitus: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-042469 ◽

2021 ◽

Vol 11 (5) ◽

pp. e042469

Author(s):

Ningbin Dai ◽

Qianwen Shi ◽

Yujie Hua ◽

Yu Guo ◽

Zheng Bian ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cohort Study ◽

Interaction Effect ◽

Chinese Population ◽

Cox Regression ◽

Baseline Survey ◽

Increased Risk

ObjectiveTo evaluate the association between snoring frequency and type 2 diabetes mellitus (T2DM) according to age and gender in Chinese population.DesignA cohort study was performed in Suzhou site of the China Kadoorie Biobank. Residents who didn’t suffer from T2DM at baseline survey (2004–2008) and in half a year after baseline were enrolled in this study and followed cause-specific morbidity until 31 December 2013. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. Cox regression models were used to estimate HRs and 95% CIs for the snoring and T2DM association.SettingWuzhong district, Suzhou, China.ParticipantsA total of 49 453 participants (men: 41.8%; mean age: 51.14±10.28 years) were enrolled in this study.Outcome measuresT2DM cases were defined as International Classification of Diseases 10th Revision code of E11 and were identified through disease registries and health insurance databases.ResultsDuring a media of 7.18 years follow-up, 1120 T2DM cases were identified. Higher T2DM incidence was observed in participants with frequent and occasional snoring compared with those without (4.80 and 2.87 vs 2.39 per 1000 person-years). The multivariable-adjusted model found snoring was independently associated with T2DM (HR 1.28, 95% CI 1.20 to 1.38), both in men (HR 1.25, 95% CI 1.10 to 1.41) and women (HR 1.28, 95% CI 1.17 to 1.39). Moreover, a significant multiplicative interaction effect between snoring and age was detected on T2DM risk (p=0.015).ConclusionsSnoring was independently associated with an increased risk of T2DM in Chinese population, both in men and women. Meanwhile, there was an interaction effect between snoring and age on T2DM risk.

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Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0067055 ◽

2013 ◽

Vol 8 (6) ◽

pp. e67055 ◽

Cited By ~ 48

Author(s):

Tine Roman de Mettelinge ◽

Dirk Cambier ◽

Patrick Calders ◽

Nele Van Den Noortgate ◽

Kim Delbaere

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Older Adults ◽

Type 2 Diabetes Mellitus ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Falls In Older Adults ◽

The Relationship

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Estimated glucose disposal rate and risk of stroke and mortality in type 2 diabetes: a nationwide cohort study

Cardiovascular Diabetology ◽

10.1186/s12933-021-01394-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Alexander Zabala ◽

Vladimer Darsalia ◽

Marcus Lind ◽

Ann-Marie Svensson ◽

Stefan Franzén ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Cohort Study ◽

Cox Regression ◽

Glucose Disposal ◽

Risk Of Death ◽

Increased Risk ◽

Estimated Glucose Disposal Rate ◽

Glucose Disposal Rate

Abstract Background and aims Insulin resistance contributes to the development of type 2 diabetes (T2D) and is also a cardiovascular risk factor. The aim of this study was to investigate the potential association between insulin resistance measured by estimated glucose disposal rate (eGDR) and risk of stroke and mortality thereof in people with T2D. Materials and methods Nationwide population based observational cohort study that included all T2D patients from the Swedish national diabetes registry between 2004 and 2016 with full data on eGDR and categorised as following: < 4, 4–6, 6–8, and ≥ 8 mg/kg/min. We calculated crude incidence rates and 95% confidence intervals (CIs) and used multiple Cox regression to estimate hazard ratios (HRs) to assess the association between the risk of stroke and death, according to the eGDR categories in which the lowest category < 4 (i.e., highest grade of insulin resistance), served as a reference. The relative importance attributed of each factor in the eGDR formula was measured by the R2 (± SE) values calculating the explainable log-likelihoods in the Cox regression. Results A total of 104 697 T2D individuals, 44.5% women, mean age of 63 years, were included. During a median follow up-time of 5.6 years, 4201 strokes occurred (4.0%). After multivariate adjustment the HRs (95% CI) for stroke in patients with eGDR categories between 4–6, 6–8 and > 8 were: 0.77 (0.69–0.87), 0.68 (0.58–0.80) and 0.60 (0.48–0.76), compared to the reference < 4. Corresponding numbers for the risk of death were: 0.82 (0.70–0.94), 0.75 (0.64–0.88) and 0.68 (0.53–0.89). The attributed relative risk R2 (± SE) for each variable in the eGDR formula and stroke was for: hypertension (0.045 ± 0.0024), HbA1c (0.013 ± 0.0014), and waist (0.006 ± 0.0009), respectively. Conclusion A low eGDR (a measure of insulin resistance) is associated with an increased risk of stroke and death in individuals with T2D. The relative attributed risk was most important for hypertension.

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