title: Independent and combined associations of abdominal obesity and seated resting heart rate with type 2 diabetes among older Chinese: the Guangzhou Biobank Cohort Study.
abstract: BACKGROUND
  Central obesity and poor physical fitness predict the development of type 2 diabetes and cardiovascular mortality among Caucasian populations. We studied the independent and combined effect of abdominal obesity and seated resting heart rate used as an indicator of physical fitness, on the presence of type 2 diabetes among 30 519 older residents of Guangzhou, Southern China.
  
  
  METHODS
  Participants were stratified into four groups, based on the Asian criteria for abdominal obesity (≥90/≥ 80 cm in men/women) and the 75% cut-off point for seated resting heart rate (≥83 beats per min). The association with type 2 diabetes was assessed using multivariable logistic regression.
  
  
  RESULTS
  A total of 3777 (12.7%) volunteers were diagnosed with type 2 diabetes, which was independently associated with seated resting heart rate and, in particular, increasing levels of abdominal obesity (p < 0.001). An odds ratio of 3.93 (95% confidence interval = 3.48-4.43) was identified for type 2 diabetes in participants who were obese with a seated resting heart rate ≥ 83 beats per min after adjusting for potential confounders.
  
  
  CONCLUSIONS
  Higher seated resting heart rate, a marker of poor physical fitness, independently doubles the risk of type 2 diabetes. The strength of this association is further increased when abdominal obesity is considered.
authors.affiliation: Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Bríain
authors.initials: B
authors.lastname: ó Hartaigh
authors.forename: Chao Qiang
authors.initials: CQ
authors.lastname: Jiang
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bosch
authors.forename: Wei Sen
authors.initials: WS
authors.lastname: Zhang
authors.forename: Kar Keung
authors.initials: KK
authors.lastname: Cheng
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.forename: G Neil
authors.initials: GN
authors.lastname: Thomas
mesh_terms: D000368:Aged; D044466:Asian People; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000503:physiopathology; D010809:Physical Fitness; D011446:Prospective Studies