title: J-shaped relationship between waist circumference and subsequent risk for Type 2 diabetes: an 8-year follow-up of relatively lean Japanese individuals.
abstract: OBJECTIVE
  This study investigated the relationship between waist circumference and the subsequent incidence of Type 2 diabetes and the association with insulin resistance and pancreatic B-cell function in relatively lean Japanese individuals.
  
  
  METHODS
  The study participants were 3992 employees (2533 men and 1459 women, aged 35-55 years) of a metal-products factory in Japan. The incidence of diabetes was determined in annual medical examinations during an 8-year follow-up. We calculated age- and sex-adjusted hazard ratios (HRs) according to the sex-specific quintile of waist circumference at baseline. Differences in baseline insulin resistance [homeostatis model assessment (HOMA)-IR] and pancreatic B-cell function (HOMA-B) were compared between participants who developed diabetes and those who did not.
  
  
  RESULTS
  During the follow-up, 218 participants developed diabetes. Age- and sex-adjusted HRs across the quintiles of waist circumference were 1.78, 1.00 (reference), 1.59, 3.11 and 3.30, respectively (P for trend, < 0.0001). The HR for the lowest quintile was significantly higher than that for the second quintile. Among participants with waist circumference of the lowest quintile, HOMA-B was lower in those who developed diabetes than in those who did not [33.1 (24.1-45.0) vs. 54.3 (37.9-74.6) median (interquartile range), P < 0.0001], but HOMA-IR did not differ between these groups.
  
  
  CONCLUSIONS
  There was a J-shaped relationship between waist circumference and subsequent risk for Type 2 diabetes in relatively lean Japanese individuals; lower pancreatic B-cell function may also increase the risk of diabetes in very lean Japanese people. Diabet. Med. 26, 753-759 (2009).
authors.affiliation: Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan. m-sakura@kanazawa-med.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Sakurai
authors.forename: K
authors.initials: K
authors.lastname: Miura
authors.forename: T
authors.initials: T
authors.lastname: Takamura
authors.forename: M
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Y
authors.initials: Y
authors.lastname: Morikawa
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Yoshita
authors.forename: T
authors.initials: T
authors.lastname: Kido
authors.forename: Y
authors.initials: Y
authors.lastname: Naruse
authors.forename: S
authors.initials: S
authors.lastname: Kaneko
authors.forename: H
authors.initials: H
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D044466:Asian People / Q000208:ethnology*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D013851:Thinness / Q000208:ethnology*; D055105:Waist Circumference / Q000208:ethnology*