Speakers - DEWC2025

Abstract

Background/Objective

 Asians have a higher risk for type 2 diabetes (T2DM) given a waist circumference level than Western populations. The aim of this study was to investigate the relationship between the change in WC and the incidence of T2DM in Korean adults.

Methods

 We included 371,251 participants aged 20-79 years of the National Health Insurance Service from 2008 to 2019. WC change was calculated as follows : (WC at last follow-up – WC at baseline) / years. WC increase was categorized by cut-off values of 75 and 90 percentiles [men: < 1.0 / 1.0-1.7 / > 1.7 (cm/year) vs women: < 1.0 / 1.0-1.8 / > 1.8 (cm/year)]. The hazard ratio (HR) and cumulative incidence rate (CIR) were analyzed using a Cox proportional hazard model and competing-risks regression.

Result

 The age and body mass index (BMI) were 40.6 years and 24.2 kg/m2 in men and 42.5 years and 22.7 kg/m2 in women, respectively. The HR and 95% CI for developing T2DM in participants with WC increases in the 75th-90th percentile and above the 90th percentile, compared to those below the 75th percentile, were 1.28 (1.23-1.34) and 2.66 (2.53-2.78) in men, and 1.29 (1.22-1.36) and 2.83 (2.68-3.00) in women, respectively. When stratified by BMI categories, the HR (95% CI) for T2DM significantly increased with rising WC, even in normal-weight and underweight groups. The CIR for T2DM increased with an increase in WC having a graded-fashion in men and women, respectively.

Conclusion

 The increase in WC was significantly associated with a higher risk of developing T2DM in both men and women and across all age groups of Korean adults even in normal or underweight individuals. Measurement of WC and management of WC increase are needed to prevent T2DM regardless of baseline BMI status.