Incidence of Bladder Cancer in Type 2 Diabetes Mellitus Patients: A Population-Based Cohort Study

Background and objectives: Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide and is associated with increased incidence of kidney cancer and bladder cancer (BC). However, studies have produced conflicting results. Therefore, we retrospectively evaluated the incidence of BC in T2DM patients using the Taiwan National Health Insurance Research Database (NHIRD). Materials and Methods: We included 31,932 patients with a diagnosis of T2DM in the study group and 63,864 age- and sex-matched patients without T2DM at a ratio of 1:2 in the control group. The primary outcome was the diagnosis of BC. Cox proportional hazards regression was used to evaluate the incidence and adjusted hazard ratio (aHR) of BC in the multivariate model. Results: After a 16-year follow-up, we found that 67 BC cases occurred in the study group and 152 BC events in the non-T2DM group without a significantly higher risk (aHR: 0.842, 95% confidence interval: 0.627–1.13). Conclusions: T2DM patients do not have a higher risk of BC.

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Effects of Aspirin or Clopidogrel on Colorectal Cancer Chemoprevention in Patients with Type 2 Diabetes Mellitus

Cancers ◽

10.3390/cancers11101468 ◽

2019 ◽

Vol 11 (10) ◽

pp. 1468 ◽

Cited By ~ 2

Author(s):

Yi-Chun Kuan ◽

Kuang-Wei Huang ◽

Cheng-Li Lin ◽

Jiing-Chyuan Luo ◽

Chia-Hung Kao

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Research Database

Background: The effect of clopidogrel, whose mechanism of action differs from that of aspirin, on CRC risk remains unknown. We investigated the effects of clopidogrel and aspirin, either as monotherapy or combined, on colorectal cancer (CRC) risk in patients with Type 2 diabetes mellitus (T2DM). Methods: We conducted a cohort study using Taiwan National Health Insurance Research Database. Four groups comprising 218,903 patients using aspirin monotherapy, 20,158 patients using clopidogrel monotherapy, 42,779 patients using dual antiplatelet therapy, and 281,840 nonuser matched controls were created using propensity score matching. Cox proportional hazards regression was used to evaluate the CRC risk during follow-up. Results: During the 13-year follow-up period, we found 9431 cases of CRC over 3,409,522 person-years. The overall incidence rates of CRC were 2.04, 3.45, 1.55, and 3.52 per 1000 person-years in the aspirin, clopidogrel, dual antiplatelet, and nonuser cohorts, respectively. The adjusted hazard ratios (aHRs) were 0.59 (95% confidence interval [CI], 0.56–0.61), 0.77 (95% CI, 0.68–0.87), and 0.37 (95% CI, 0.33–0.40) for the aspirin, clopidogrel, and dual antiplatelet cohorts, respectively. Dose- and duration-dependent chemopreventive effects were observed in the three cohorts.

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Does Use of Acupuncture Reduce the Risk of Type 2 Diabetes Mellitus in Patients With Rheumatoid Arthritis? Evidence From a Universal Coverage Health Care System

Frontiers in Medicine ◽

10.3389/fmed.2021.752556 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wei-Jen Chen ◽

Hanoch Livneh ◽

Chi-Hsien Chen ◽

Hui-Ju Huang ◽

Wen-Jiun Liu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Universal Coverage ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Control Group

Objectives: Although acupuncture is often advocated for patients with rheumatoid arthritis (RA), its efficacy for type 2 diabetes mellitus (T2DM), a common metabolic disease among RA cohorts, has not yet been established. This retrospective cohort study aimed to determine the association between acupuncture use and the development of T2DM among them.Methods: Data were collected from 1999 through 2008 for individuals aged 20–70 years in the nationwide insurance database of Taiwan. From them, we extracted 4,941 subjects within newly diagnosed RA and being T2DM free at baseline. A total of 2,237 patients had ever received acupuncture, and 2,704 patients without receiving acupuncture were designated as a control group. All of them were followed to the end of 2013 to identify T2DM incidence. The Cox proportional hazards regression model was utilized to obtain the adjusted hazard ratio (HR) for acupuncture use.Results: Compared with the RA subjects without use of acupuncture, the incidence of T2DM was lower for those who received acupuncture, with the incidence rates of 24.50 and 18.00 per 1,000 person-years (PYs), respectively. After adjusting for potential confounders, use of acupuncture was significantly related to the lower T2DM risk, with the adjusted HR of 0.73 [95% confidence interval (CI) 0.65–0.86]. Those who used acupuncture for more than five sessions had the greatest benefit in lowering the susceptibility to T2DM.Conclusion: Adding acupuncture into conventional treatment for RA was found to be related to lower risk of T2DM among RA patients. Further clinical and mechanistic studies are warranted.

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High Betaine, a Trimethylamine N-Oxide Related Metabolite, Is Prospectively Associated with Low Future Risk of Type 2 Diabetes Mellitus in the PREVEND Study

Journal of Clinical Medicine ◽

10.3390/jcm8111813 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1813 ◽

Cited By ~ 2

Author(s):

Erwin Garcia ◽

Maryse C. J. Osté ◽

Dennis W. Bennett ◽

Elias J. Jeyarajah ◽

Irina Shalaurova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Regression ◽

Proportional Hazards Regression ◽

Study Results ◽

Future Risk

Background: Gut microbiota-related metabolites, trimethylamine-N-oxide (TMAO), choline, and betaine, have been shown to be associated with cardiovascular disease (CVD) risk. Moreover, lower plasma betaine concentrations have been reported in subjects with type 2 diabetes mellitus (T2DM). However, few studies have explored the association of betaine with incident T2DM, especially in the general population. The goals of this study were to evaluate the performance of a newly developed betaine assay and to prospectively explore the potential clinical associations of betaine and future risk of T2DM in a large population-based cohort. Methods: We developed a high-throughput, nuclear magnetic resonance (NMR) spectroscopy procedure for acquiring spectra that allow for the accurate quantification of plasma/serum betaine and TMAO. Assay performance for betaine quantification was assessed and Cox proportional hazards regression was employed to evaluate the association of betaine with incident T2DM in 4336 participants in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study. Results: Betaine assay results were linear (y = 1.02X − 3.75) over a wide range of concentrations (26.0–1135 µM). The limit of blank (LOB), limit of detection (LOD) and limit of quantitation (LOQ) were 6.4, 8.9, and 13.2 µM, respectively. Coefficients of variation for intra- and inter-assay precision ranged from 1.5–4.3% and 2.5–5.5%, respectively. Deming regression analysis of results produced by NMR and liquid chromatography coupled to tandem mass spectrometry(LC-MS/MS) revealed an R2 value of 0.94 (Y = 1.08x – 1.89) and a small bias for higher values by NMR. The reference interval, in a cohort of apparently healthy adult participants (n = 501), was determined to be 23.8 to 74.7 µM (mean of 42.9 ± 12.6 µM). In the PREVEND study (n = 4336, excluding subjects with T2DM at baseline), higher betaine was associated with older age and lower body mass index, total cholesterol, triglycerides, and hsCRP. During a median follow-up of 7.3 (interquartile range (IQR), 5.9–7.7) years, 224 new T2DM cases were ascertained. Cox proportional hazards regression models revealed that the highest tertile of betaine was associated with a lower incidence of T2DM. Hazard ratio (HR) for the crude model was 0.61 (95% CI: 0.44–0.85, p = 0.004). The association remained significant even after adjusting for multiple clinical covariates and T2DM risk factors, including fasting glucose. HR for the fully-adjusted model was 0.50 (95% CI: 0.32–0.80, p = 0.003). Conclusions: The newly developed NMR-based betaine assay exhibits performance characteristics that are consistent with usage in the clinical laboratory. Betaine levels may be useful for assessing the risk of future T2DM.

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The Risk Factors of Severe Hypoglycemia in Older Patients with Dementia and Type 2 Diabetes Mellitus

Journal of Personalized Medicine ◽

10.3390/jpm12010067 ◽

2022 ◽

Vol 12 (1) ◽

pp. 67

Author(s):

Nai-Ching Chen ◽

Chien-Liang Chen ◽

Feng-Chih Shen

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Older Patients ◽

Control Group ◽

Research Database ◽

Increased Risk

Background: The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. Methods: A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered patients aged ≥65 years with a diagnosis of Alzheimer’s dementia (AD) and T2DM between 2001 and 2018 in the Chang Gung Research Database (CGRD). We extracted data included medication use, diagnoses, and biochemistry data from hospital records. Results: A total of 3877 older patients with dementia and T2DM with regular visits to the outpatient department were enrolled in this study. During the two-year follow-up period, 494 participants (12.7%) experienced hypoglycemia. Multivariable logistic multivariable regression models for hypoglycemic events showed that metformin had a protective effect (odds ratio (OR) = 0.75, p = 0.023), insulin had the highest risk (OR = 4.64, p < 0.001). Hemoglobin A1c (HbA1c) levels were not correlated with hypoglycemic events (OR = 0.95, p = 0.140). Patients with hypoglycemic episodes had a significantly higher proportion of ≥2 Charlson Comorbidity Index scores than those without hypoglycemic episodes (83.2% versus 56.4%, p < 0.001). Conclusions: Drug regimen affects hypoglycemic episodes but not HbA1c in older patients with dementia and T2DM. In addition, patients with more comorbidities experience an increased risk of hypoglycemia.

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Effects of Consuming Calcium-Rich Foods on the Incidence of Type 2 Diabetes Mellitus

Nutrients ◽

10.3390/nu11010031 ◽

2018 ◽

Vol 11 (1) ◽

pp. 31 ◽

Cited By ~ 4

Author(s):

Jimin Jeon ◽

Jiyoung Jang ◽

Kyong Park

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Large Scale ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Protective Effects ◽

Related Data ◽

Korean Adults

The effect of calcium consumption in the prevention of type 2 diabetes mellitus (T2DM) remains controversial, and depends on food calcium sources. This prospective study aimed to evaluate the association between calcium-rich food consumption and T2DM incidence among Korean adults. We analyzed the data of 8574 adults aged 40–69 years, without a history of T2DM, cardiovascular disease, and cancer at the baseline from the Korean Genome and Epidemiology Study. The consumption of calcium-rich foods was assessed using a validated semi-quantitative food frequency questionnaire. T2DM-related data were collected using biennial questionnaires, health examinations, and clinical tests. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. In the multivariate-adjusted model, yogurt intake was inversely associated with T2DM risk (HR: 0.73; 95% CI: 0.61–0.88 in the fourth quartile as compared to the first quartile). However, the intakes of other calcium-rich foods, including milk and anchovies, were not significantly associated with T2DM risk. Yogurt may provide protective effects against T2DM in Korean adults, owing to the beneficial effects of probiotics. Further prospective large-scale cohort studies should be conducted to validate these findings.

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Impact of Cardio-Renal-Metabolic Comorbidities on Cardiovascular Outcomes and Mortality in Type 2 Diabetes Mellitus

American Journal of Nephrology ◽

10.1159/000504558 ◽

2019 ◽

Vol 51 (1) ◽

pp. 74-82 ◽

Cited By ~ 1

Author(s):

David Z.I. Cherney ◽

Enrico Repetto ◽

David C. Wheeler ◽

Suzanne V. Arnold ◽

Sharon MacLachlan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Hazard Ratios ◽

Cv Disease

Background: We evaluated the incremental contribution of chronic kidney disease (CKD) to the risk of major adverse cardiovascular (CV) events (MACE), heart failure (HF), and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients and its importance relative to the presence of other cardio-renal-metabolic (CaReMe) comorbidities. Methods: Patients (≥40 years) were identified at the time of T2DM diagnosis from US (Humedica/Optum) and UK (Clinical Practice Research Datalink) databases. Patients were monitored post-diagnosis for modified MACE (myocardial infarction, stroke, ACM), HF, and ACM. Adjusted hazard ratios were obtained using Cox proportional-hazards regression to evaluate the relative risk of modified MACE, HF, and ACM due to CKD. Patients were stratified by the presence or absence of atherosclerotic CV disease (ASCVD) and age. Results: Between 2011 and 2015, of 227,224 patients identified with incident T2DM, 40,063 (17.64%) had CKD. Regardless of prior ASCVD, CKD was associated with higher risk of modified MACE, HF, and ACM; this excess hazard was more pronounced in older patients with prior ASCVD. In time-to-event analyses in the overall cohort, patients with T2DM + CKD or T2DM + CKD + hypertension + hyperlipidemia had increased risks for modified MACE, HF, and ACM versus patients with T2DM and no CaReMe comorbidities. Patients with CKD had higher risks for and shorter times to modified MACE, HF, and ACM than those without CKD. Conclusion: In T2DM patients, CKD presence was associated with higher risk of modified MACE, HF, and ACM. This may have risk-stratification implications for T2DM patients based on background CKD and highlights the potential importance of novel renoprotective strategies.

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Association Between Obesity and Microvascular Diseases in Patients With Type 2 Diabetes Mellitus

Frontiers in Endocrinology ◽

10.3389/fendo.2021.719515 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shan Gao ◽

Hongliang Zhang ◽

Chen Long ◽

Zhenhua Xing

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Ckd Progression ◽

Clinical Trial Registration ◽

Related Risk ◽

Microvascular Diseases

This study aimed to evaluate the association between obesity, evaluated by fat mass index (FMI) with the risk of microvascular diseases in patients with type 2 diabetes mellitus (T2DM) and compare the magnitude of associations of FMI, body mass index (BMI), and waist circumference (WC) with the risk of microvascular diseases. We performed a post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes study. The primary microvascular outcomes of the present study included chronic kidney disease (CKD) progression, retinopathy, and neuropathy. Cox proportional-hazards models were performed to evaluate the association of FMI with microvascular diseases. A discordant analysis was performed to compare the magnitude of associations of FMI, BMI, and WC with the risk of microvascular diseases. Our study included 10,251 T2DM participants with a median of 5 years (interquartile range, 4.2–5.7) of follow-up. A total of 6,184 participants developed CKD progression, 896 participants had retinopathy, and 3,213 participants developed neuropathy (Michigan Neuropathy Screening Instrument, >2.0). After the confounding factors were adjusted for, patients in the highest FMI quartile had a higher risk of CKD progression (HR: 1.26, 95%CI: 1.16–1.36) and neuropathy (HR: 1.93, 95% CI: 1.74–2.15), except for retinopathy (HR: 1.17, 95% CI: 0.96–1.43), than those in the lowest quartile. Discordant analyses found that FMI and WC are better in identifying individuals with obesity-related risk of neuropathy, compared with BMI; neither is better in identifying individuals with obesity-related risk of CKD progression and retinopathy. Obesity is associated with CKD progression and neuropathy in T2DM participants. Further randomized trials are needed to test whether obesity control can improve the outcomes of T2DM participants with CKD or neuropathy. FMI and WC are more useful in identifying obesity-related risk of neuropathy compared with BMI in T2DM patients.Clinical Trial Registrationhttp://www.clinicaltrials.gov, NCT00000620.

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Study of serum magnesium level in type 2 diabetes mellitus with nephropathy

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193262 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1145

Author(s):

Satya Bhushan Nayyar ◽

Hargurpal Singh Brar ◽

Sahiba Kukreja ◽

Kamaldeep Kaur

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Glycaemic Control ◽

Serum Magnesium ◽

Control Group ◽

Study Group ◽

Poor Glycaemic Control

Background: Magnesium (Mg) is the fourth most abundant cation in the human body and plays a key role in many fundamental biological processes including metabolism and DNA synthesis. Hypomagnesaemia has also been associated with poor glycemic control and albuminuria in patients with type 2 diabetes mellitus.Methods: The present study was undertaken in the Department of Medicine in SGRDIMSAR, Amritsar on 100 patients diagnosed with type 2 Diabetes Mellitus as per the latest ADA criteria. The patients were divided into 2 groups. Group A with 50 patients with type 2 diabetes mellitus with urinary albumin level >30 mg/dl (Study Group). Group B with 50 patients with type 2 diabetes mellitus with urine albumin levels <30 mg/dl (Control Group).Results: Hypomagnesemia was present in 16 patients i.e. 32% in study group and 12 patients i.e. 24% in control group (P=0.034). In study group with hypomagnesemia, 13 patients i.e. 81.25% and in control group with hypomagnesemia, 4 patients i.e. 33.33% have poor glycaemic control (P=0.033). In study group with hypomagnesemia, 14 patients i.e. 87.5% and in control group with hypomagnesemia, 5 patients i.e. 41.67% were found to have diabetic retinopathy (P=0.010).Conclusions: Hypomagnesemia was directly correlated with hypertension (P=0.004), poor glycaemic control (P=0.033), diabetic retinopathy (P=0.010) and diabetic nephropathy (P=0.034). Hypomagnesemia leads to early microvascular complications as compared to macrovascular complications. Thus, screening of serum magnesium levels in T2DM with albuminuria should alert us to look for hypertension, poor glycaemic control and retinopathy.

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Polypharmacy in Type 2 Diabetes Mellitus: Insights from an Internal Medicine Department

Medicina ◽

10.3390/medicina55080436 ◽

2019 ◽

Vol 55 (8) ◽

pp. 436 ◽

Cited By ~ 10

Author(s):

Elena-Codruța Dobrică ◽

Mihnea-Alexandru Găman ◽

Matei-Alexandru Cozma ◽

Ovidiu Bratu ◽

Anca Pantea Stoian ◽

...

Keyword(s):

Internal Medicine ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Drug Interactions ◽

Control Group ◽

Diabetic Patients ◽

Study Group ◽

Diabetes Patients

Background and Objectives: Polypharmacy heavily impacts the quality of life of patients worldwide. It is a necessary evil in many disorders, and especially in type 2 diabetes mellitus, as patients require treatment both for this condition and its related or unrelated comorbidities. Thus, we aimed to evaluate the use of polypharmacy in type 2 diabetes mellitus vs. non-diabetes patients. Materials and Methods: A cross-sectional retrospective observational study was conducted. We collected the medical records of patients hospitalized in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania, for a period of two months (01/01/2018–28/02/2018). Patients diagnosed with type 2 diabetes mellitus were included in the study group, whereas patients who were not diabetic were used as controls. Results: The study group consisted of 63 patients with type 2 diabetes mellitus (mean age 69.19 ± 9.67 years, range 46–89 years; 52.38% males). The control group included 63 non-diabetes patients (mean age 67.05 ± 14.40 years, range 42–93 years, 39.68% males). Diabetic patients had more comorbidities (10.35 ± 3.09 vs. 7.48 ± 3.59, p = 0.0001) and received more drugs (7.81 ± 2.23 vs. 5.33 ± 2.63, p = 0.0001) vs. non-diabetic counterparts. The mean number of drug-drug and food-drug interactions was higher in type 2 diabetes mellitus patients vs. controls: 8.86 ± 5.76 vs. 4.98 ± 5.04, p = 0.0003 (minor: 1.22 ± 1.42 vs. 1.27 ± 1.89; moderate: 7.08 ± 4.08 vs. 3.54 ± 3.77; major: 0.56 ± 0.74 vs. 0.37 ± 0.77) and 2.63 ± 1.08 vs. 2.19 ± 1.42 (p = 0.0457), respectively. Conclusions: Polypharmacy should be an area of serious concern also in type 2 diabetes mellitus, especially in the elderly. In our study, type 2 diabetes mellitus patients received more drugs than their non-diabetes counterparts and were exposed to more drug-drug and food-drug interactions.

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Prediction of a new body shape index and body adiposity estimator for development of type 2 diabetes mellitus: The Rural Chinese Cohort Study

British Journal Of Nutrition ◽

10.1017/s0007114517002859 ◽

2017 ◽

Vol 118 (10) ◽

pp. 771-776 ◽

Cited By ~ 10

Author(s):

Chengyi Han ◽

Yu Liu ◽

Xizhuo Sun ◽

Xinping Luo ◽

Lu Zhang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cohort Study ◽

Body Shape ◽

Proportional Hazards ◽

Shape Index ◽

Cox Proportional Hazards ◽

Body Adiposity

AbstractTo compare the ability of a body shape index (ABSI) and body adiposity estimator (BAE) to BMI, waist circumference (WC) and waist:height ratio (WHtR) for predicting development of type 2 diabetes mellitus (T2DM) in rural adult Chinese. The prospective cohort study included 11 687 eligible participants who were free of T2DM at baseline. The risk of new-onset T2DM for ABSI, BAE, BMI, WC and WHtR quintiles was estimated by Cox proportional-hazards regression at follow-up. We also compared the power of ABSI and BAE to BMI, WC and WHtR for predicting the development of T2DM. With increasing ABSI, BAE, BMI, WC and WHtR, T2DM incidence was substantially increased (Ptrend<0·0001). After adjustment for multi-covariates, risk of T2DM was increased from the second to fifth quintile as compared with first quintile for ABSI (1·27; 95 % CI 0·95, 1·69; 1·35; 95 % CI 1·00, 1·82; 1·75; 95 % CI 1·33, 2·32 and 1·87; 95 % CI 1·40, 2·49; Ptrend<0·0001); BAE (1·82; 95 % CI 1·38, 2·41; 1·93; 95 % CI 1·38, 2·68; 2·73; 95 % CI 1·94, 3·84 and 4·18; 95 % CI 2·98, 5·87; Ptrend<0·0001); BMI (1·42; 95 % CI 1·03, 1·97; 1·62; 95 % CI 1·18, 2·23; 2·59; 95 % CI 1·92, 3·50 and 3·90; 95 % CI 2·90, 5·26; Ptrend<0·0001); WC (1·53; 95 % CI 1·08, 2·17; 1·66; 95 % CI 1·18, 2·33; 2·72; 1·97, 3·76 and 4·09; 95 % CI 2·97, 5·62; Ptrend<0·0001); and WHtR (1·40; 95 % CI 0·98, 1·99; 2·06; 95 % CI 1·47, 2·88; 2·90; 95 % CI 2·10, 4·01 and 4·22; 95 % CI 3·05, 5·85; Ptrend<0·0001). ABSI, BAE, BMI, WC and WHR were effective and comparable in discriminating cases from non-cases of T2DM. Risk of T2DM was increased with elevated ABSI and BAE, but the predictive ability for T2DM did not differ than that of BMI, WC and WHtR in a rural Chinese population.

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