Central obesity predicts the worsening of glycemia in southern Chinese

Aims: The association between obesity and type 2 diabetes has been found to be consistent across different ethnic populations. Our aim was to study th e contribution of obesity to the development of type 2 diabetes in a non-ob ese Chinese population with a high prevalence of diabetes (9.8% in 1995-199 6). Methods: Six-hundred and forty-four non-diabetic subjects were recruited fr om the Hong Kong Cardiovascular Risk Factor Prevalence Study (1995-1996). T his was a community-based population study which involved the use of a 75 g oral glucose tolerance test and 1985 World Health Organization diagnostic criteria. Their glycemic status was reassessed at 2 y. Results: In subjects with impaired glucose tolerance (n=322), the annual pr ogression rate to diabetes (4.8%; 95% CI 2.5-7.1%), was 8-fold that in cont rol subjects (0.6%; 95% CI 0.0-1.4%; P<0.001). Baseline waist-hip ratio (WH R; OR per unit increase = 1.05; 95% CI 1.02-1.07, P=0.0003) and post-load 2 h plasma glucose (OR per unit increase = 2.02; 95% CI 1.76-2.34, P<0.0001) were significantly associated with glycemic status at 2 y in stepwise poly tomous logistic regression analysis. Subjects with high baseline waist circ umference or WHR (greater than or equal to median) were more likely to have worsening of glucose tolerance at 2y than those with low waist circumferen ce (<median; conversion to diabetes, OR 3.8, P=0.001) or WHR (<median; conv ersion to diabetes, OR 2.8, P=0.019). Conclusion: Abdominal obesity, readily assessed by the measurement of WHR o r waist circumference, was for the first time shown prospectively to be ind ependently associated with the deterioration of glucose tolerance in a Chin ese population.