title: Changes in Waist Circumference and the Incidence of Type 2 Diabetes in Community-Dwelling Men and Women: The Suita Study.
abstract: BACKGROUND
  The association between weight gain and the incidence of type 2 diabetes is well known. The aim of our study was to investigate the relationship between change in waist circumference (WC) and type 2 diabetes incidence.
  
  
  METHODS
  The participants in the Suita Study, a population-based cohort study in an urban area of Japan, underwent a baseline survey between 1989 and 1994 (Exam 1) and were examined at follow-up every 2 years. We performed a 9.3-year cohort study of 946 men and 1327 women with no history of diabetes who underwent Exam 1 and Exam 2 (between 1997 and 1999). Participants were stratified by sex and median WC at Exam 1, and, in each stratum, participants were further classified into three categories by tertile of WC change per year between Exam 1 and Exam 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes incidence were calculated by Cox proportional hazard models. The endpoints were first diagnosis of type 2 diabetes or March 2011.
  
  
  RESULTS
  During follow-up, 287 participants developed type 2 diabetes. In both sexes with median WC or higher, participants in the highest tertile of WC change had a significantly higher risk of developing type 2 diabetes. Multivariable adjusted HRs were 1.84 (95% CI, 1.10-3.08) in men and 2.30 (95% CI, 1.31-4.04) in women. No significant association was observed among participants with WC below median.
  
  
  CONCLUSIONS
  Preventing WC gain is important in preventing type 2 diabetes in the Japanese population, especially among individuals with a relatively high WC.
authors.affiliation: Department of Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Tatsumi
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Michikazu
authors.initials: M
authors.lastname: Nakai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Aya
authors.initials: A
authors.lastname: Higashiyama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Misa
authors.initials: M
authors.lastname: Takegami
authors.forename: Yoko M
authors.initials: YM
authors.lastname: Nakao
authors.forename: Takuya
authors.initials: T
authors.lastname: Watanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014504:Urban Health / Q000706:statistics & numerical data*; D055105:Waist Circumference