Longitudinal relationship between body fat percentage and risk of type 2 diabetes in Chinese adults: Evidence from the China Health and Nutrition Survey
Siting Zhang, Hongru Jiang, Liusen Wang, Xiaofang Jia, Jiguo Zhang, Huijun Wang, Bing Zhang, Zhihong Wang, Gangqiang Ding
Abstract
Objective Body fat percentage (BF%) might be an alternative index of obesity which is the major risk factor for developing type 2 diabetes (T2D). We aim to longitudinally evaluated the relationship between BF% and risk of T2D. Methods A sample of 5,595 adults aged 18–65 who participated in two waves of China Health and Nutrition Survey (CHNS 2015 and 2018) was analyzed. Two level mixed-effects modified Poisson regression with robust estimation of variance stratified by sex was used to evaluate the risk ratios (RRs) for T2D according to quintiles of BF%, and the curves of receiver operating characteristic (ROC) were plotted to identify the optimal total and trunk BF% cut-off points for predicting an increased T2D risk. Results In males, compared with subjects in the first quintile of total BF%, those in the third (RR = 2.03, 95% CI 1.09–3.79), fourth (RR = 2.56, 95%CI 1.46–4.48), and fifth (RR = 2.16, 95%CI 1.22–3.82) quintile had higher risk of T2D after adjusting for all potential confounders ( p -trend < 0.001). For females, the RR (95% CI) was 1.92 (1.14, 3.24) in the fifth quintile ( p -trend = 0.014). Males and females with a trunk BF% >25.5 and 34.4% (≥ quintile 4), respectively, were at significantly increased risk of T2D ( p -trend = 0.001). Besides, the optimal cut-off values of total and trunk BF% were 21.9 and 25.2% for males, and 36.7 and 30.3% for females, respectively. Conclusions The incident risk of T2D significantly increased over specific level of total and trunk BF% in both Chinese males and females, and the optimal BF% cut-off values were valuable for clinical application of BF% based on sex difference, which may be a cost-effective implementation for prevention and treatment of T2D in China.