title: Body fat distribution and risk of diabetes among Chinese women.
abstract: OBJECTIVE
  To assess the relationship between measures of central and overall obesity and risk of diabetes.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Shanghai, China.
  
  
  METHODS
  A total of 57 130 women were screened for diabetes at enrollment for the Shanghai Women's Health Study (SWHS), a population-based cohort study of Chinese women aged 40-70 y. In this study, 345 women diagnosed with diabetes and 2760 age-matched controls (eight controls per case), randomly selected from women who tested negative for urine glucose, were included.
  
  
  RESULTS
  Risk of diabetes increased significantly with increasing levels of obesity, particularly with measures of central obesity. Compared to those in the lowest quartile, women in the highest quartile of body mass index (BMI) (>/=26.57) and waist to hip ratio (WHR) (>/=0.855) had a 2.57-fold (95% CI 1.75-3.77) and a 6.05-fold (95% CI 4.05-9.04) increased risk of diabetes, respectively. The risk of diabetes was elevated with increasing WHR at all levels of BMI, while the positive association between BMI and diabetes was observed primarily among women with a low WHR. However, test for multiplicative interaction was not statistically significant.
  
  
  CONCLUSIONS
  Our data indicated that central obesity is a stronger risk factor for diabetes than overall obesity, suggesting that WHR may be a better indicator of risk of diabetes than BMI among Chinese women.
authors.affiliation: Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Rosenthal
authors.forename: F
authors.initials: F
authors.lastname: Jin
authors.forename: X-O
authors.initials: XO
authors.lastname: Shu
authors.forename: G
authors.initials: G
authors.lastname: Yang
authors.forename: T A
authors.initials: TA
authors.lastname: Elasy
authors.forename: W-H
authors.initials: WH
authors.lastname: Chow
authors.forename: B-T
authors.initials: BT
authors.lastname: Ji
authors.forename: H-X
authors.initials: HX
authors.lastname: Xu
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.forename: Y-T
authors.initials: YT
authors.lastname: Gao
authors.forename: W
authors.initials: W
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D001824:Body Constitution; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors