BODY-FAT DISTRIBUTION AND RISK OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS IN WOMEN - THE NURSES HEALTH STUDY

Obesity is an established risk factor for non-insulin-dependent diabet es mellitus (NIDDM). Anthropometric measures of overall and central ob esity as predictors of NIDDM risk have not been as well studied, espec ially in women. Among 43,581 women enrolled in the Nurses' Health Stud y who in 1986 provided waist, hip, and weight information and who were initially free from diabetes and other major chronic diseases, NIDDM incidence was followed from 1986 to 1994. After adjustment for age, fa mily history of diabetes, smoking, exercise, and several dietary facto rs, the relative risk of NIDDM for the 90th percentile of body mass in dex (BMI) (weight (kg)/height (m)(2)) (BMI = 29.9) versus the 10th per centile (BMI = 20.1) was 11.2 (95% confidence interval (CI) 7.9-15.9). Controlling for BMI and other potentially confounding factors, the re lative risk for the 90th percentile of waist : hip ratio (WHR) (WHR = 0.86) versus the 10th percentile (WHR = 0.70) was 3.1 (95% CI 2.3-4.1) , and the relative risk for the 90th percentile of waist circumference (36.2 inches or 92 cm) versus the 10th percentile (26.2 inches or 67 cm) was 5.1 (95% CI 2.9-8.9), BMI, WHR, and waist circumference are po werful independent predictors of NIDDM in US women, Measurement of BMI and waist circumference (with or without hip circumference) are poten tially useful tools for clinicians in counseling patients regarding NI DDM risk and risk reduction.