Prevalence of Abdominal Obesity in Chinese Middle-Aged and Older Adults with a Normal Body Mass Index and Its Association with Type 2 Diabetes Mellitus: A Nationally Representative Cohort Study from 2011 to 2018

References

• International Diabetes Federation. IDF Diabetes Atlas . 9th. Brussels, Belgium; 2019.
   Google Scholar
• Li Y , Teng D , Shi X , et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ . 2020;369:m997. doi:10.1136/bmj.m997 32345662
   PubMed Web of Science ®Google Scholar
• World Health Organization. Global Report on Diabetes . 2016, April 21.
   Google Scholar
• Ying W , Fu W , Lee YS , Olefsky JM . The role of macrophages in obesity-associated islet inflammation and β-cell abnormalities. Nat Rev Endocrinol . 2020;16(2):81–90. doi:10.1038/s41574-019-0286-3 31836875
   PubMed Web of Science ®Google Scholar
• American Diabetes Association. Prevention or Delay of Type 2 Diabetes: standards of Medical Care in Diabetes—2020. Diabetes Care . 2020;43(Suppl Supplement 1):S32–S36. doi:10.2337/dc20-S003 31862746
   PubMed Web of Science ®Google Scholar
• Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) [in Chinese]. Chin J Endocrinol Metab . 2021;37(04):311–398.
   Google Scholar
• Wang Y , Xue H , Sun M , Zhu X , Zhao L , Yang Y . Prevention and control of obesity in China. Lancet Glob Health . 2019;7(9):e1166–e1167. doi:10.1016/S2214-109X(19)30276-1 31401995
   PubMed Web of Science ®Google Scholar
• Zhang L , Wang Z , Wang X , et al. Prevalence of abdominal obesity in china: results from a cross-sectional study of nearly half a million participants. Obesity . 2019;27(11):1898–1905. doi:10.1002/oby.22620 31549787
   PubMed Web of Science ®Google Scholar
• Ashwell M , Gunn P , Gibson S . Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev . 2012;13(3):275–286. doi:10.1111/j.1467-789X.2011.00952.x 22106927
   PubMed Web of Science ®Google Scholar
• Ashwell M , Lejeune S , McPherson K . Ratio of waist circumference to height may be better indicator of need for weight management. BMJ . 1996;312(7027):377. doi:10.1136/bmj.312.7027.377
   PubMed Web of Science ®Google Scholar
• Lee CMY , Huxley RR , Wildman RP , Woodward M . Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol . 2008;61(7):646–653. doi:10.1016/j.jclinepi.2007.08.012 18359190
   PubMed Web of Science ®Google Scholar
• Patel SA , Ali MK , Alam D , et al. Obesity and its Relation With Diabetes and Hypertension: a Cross-Sectional Study Across 4 Geographical Regions. Glob Heart . 2016;11(1):71–79.e4. doi:10.1016/j.gheart.2016.01.003 27102024
   PubMed Web of Science ®Google Scholar
• Tyrovolas S , Koyanagi A , Garin N , et al. Diabetes mellitus and its association with central obesity and disability among older adults: a global perspective. Exp Gerontol . 2015;64:70–77. doi:10.1016/j.exger.2015.02.010 25688991
   PubMed Web of Science ®Google Scholar
• Wang T , Zhang R , Ma X , et al. Causal Association of Overall Obesity and Abdominal Obesity with Type 2 Diabetes: a Mendelian Randomization Analysis. Obesity . 2018;26(5):934–942. doi:10.1002/oby.22167 29630776
   PubMed Web of Science ®Google Scholar
• Flegal KM , Shepherd JA , Looker AC , et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. Am J Clin Nutr . 2009;89(2):500–508. doi:10.3945/ajcn.2008.26847 19116329
   PubMed Web of Science ®Google Scholar
• Zhao Y , Hu Y , Smith JP , Strauss J , Yang G . Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol . 2014;43(1):61–68. doi:10.1093/ije/dys203 23243115
   PubMed Web of Science ®Google Scholar
• WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet . 2004;363(9403):157–163. doi:10.1016/S0140-6736(03)15268-3 14726171
   PubMed Web of Science ®Google Scholar
• Caleyachetty R , Barber TM , Mohammed NI , et al. Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study. Lancet Diabetes Endocrinol . 2021;9(7):419–426. doi:10.1016/S2213-8587(21)00088-7 33989535
   PubMed Web of Science ®Google Scholar
• He W , Li Q , Yang M , et al. Lower BMI cutoffs to define overweight and obesity in China. Obesity . 2015;23(3):684–691. doi:10.1002/oby.20995 25645003
   PubMed Web of Science ®Google Scholar
• Zhou B-F . Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci . 2002;15(1):83–96.12046553
   PubMed Web of Science ®Google Scholar
• Chen C , Lu FC . The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci . 2004;17:Suppl:1–36.
   Google Scholar
• Pan X-F , Wang L , Pan A . Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol . 2021;9(6):373–392. doi:10.1016/S2213-8587(21)00045-0 34022156
   PubMed Web of Science ®Google Scholar
• Chen X , Crimmins E , Hu PP , et al. Venous Blood-Based Biomarkers in the China Health and Retirement Longitudinal Study: rationale, Design, and Results From the 2015 Wave. Am J Epidemiol . 2019;188(11):1871–1877. doi:10.1093/aje/kwz170 31364691
   PubMed Web of Science ®Google Scholar
• American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care . 2020;43(Suppl 1):S14–S31. doi:10.2337/dc20-S002 31862745
   PubMed Web of Science ®Google Scholar
• Song P , Li X , Bu Y , et al. Temporal trends in normal weight central obesity and its associations with cardiometabolic risk among Chinese adults. Sci Rep . 2019;9(1):5411. doi:10.1038/s41598-019-41986-5 30931996
   PubMed Web of Science ®Google Scholar
• Kim HY , Kim JK , Shin GG , Han JA , Kim JW . Association between Abdominal Obesity and Cardiovascular Risk Factors in Adults with Normal Body Mass Index: based on the Sixth Korea National Health and Nutrition Examination Survey. J Obes Metab Syndr . 2019;28(4):262–270. doi:10.7570/jomes.2019.28.4.262 31909369
   PubMed Web of Science ®Google Scholar
• Shirasawa T , Ochiai H , Yoshimoto T , et al. Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study. J Health Popul Nutr . 2019;38(1):46. doi:10.1186/s41043-019-0201-5 31849344
   PubMed Web of Science ®Google Scholar
• Gastaldelli A , Cusi K , Pettiti M , et al. Relationship between hepatic/visceral fat and hepatic insulin resistance in nondiabetic and type 2 diabetic subjects. Gastroenterology . 2007;133(2):496–506. doi:10.1053/j.gastro.2007.04.068 17681171
   PubMed Web of Science ®Google Scholar
• Tchernof A , Després J-P . Pathophysiology of human visceral obesity: an update. Physiol Rev . 2013;93(1):359–404. doi:10.1152/physrev.00033.2011 23303913
   PubMed Web of Science ®Google Scholar
• Kahn SE , Hull RL , Utzschneider KM . Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature . 2006;444(7121):840–846. doi:10.1038/nature05482 17167471
   PubMed Web of Science ®Google Scholar
• Wang Y , Rimm EB , Stampfer MJ , Willett WC , Hu FB . Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr . 2005;81(3):555–563. doi:10.1093/ajcn/81.3.555 15755822
   PubMed Web of Science ®Google Scholar
• Neeland IJ , Ross R , Després J-P , et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol . 2019;7(9):715–725. doi:10.1016/S2213-8587(19)30084-1 31301983
   PubMed Web of Science ®Google Scholar
• Katsiki N , Mikhailidis DP , Banach M . Leptin, cardiovascular diseases and type 2 diabetes mellitus. Acta Pharmacol Sin . 2018;39(7):1176–1188. doi:10.1038/aps.2018.40 29877321
   PubMed Web of Science ®Google Scholar
• López-Jaramillo P , Gómez-Arbeláez D , López-López J , et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Horm Mol Biol Clin Investig . 2014;18(1):37–45. doi:10.1515/hmbci-2013-0053
   PubMedGoogle Scholar
• Faulds MH , Zhao C , Dahlman-Wright K , Gustafsson J-Å . The diversity of sex steroid action: regulation of metabolism by estrogen signaling. J Endocrinol . 2012;212(1):3–12. doi:10.1530/JOE-11-0044 21511884
   PubMed Web of Science ®Google Scholar