Endocrinology · General Practice · 3 h ago
Waist circumference may refine diabetes risk assessment in aging women
A prospective analysis of 133,620 Women’s Health Initiative participants, with validation in two independent cohorts, examined waist circumference within BMI categories and incident type 2 diabetes. Higher waist circumference generally identified greater risk within BMI strata, but risk models showed only modest discrimination.
- Higher waist circumference generally identified greater risk within BMI strata.
- Findings were directionally consistent across three cohorts.
- Risk-model discrimination was modest, with C-statistics of 0.60–0.75.
BMI does not capture central adiposity, which may add information about type 2 diabetes (T2D) risk. Researchers analyzed 133,620 Women’s Health Initiative participants without T2D at baseline, dividing them into training and test samples. They also assessed findings in the Health and Retirement Study (n=2,885) and HANDLS (n=1,037). Cox models evaluated T2D incidence across BMI and BMI-specific waist circumference (WC) categories; model discrimination was assessed using Harrell’s C-statistic.
In the WHI, adjusted hazard ratios for T2D ranged from 1.51 to 3.30 across BMI categories and from 1.40 to 4.43 across joint BMI-WC categories. Within BMI strata, higher WC generally corresponded to greater risk. Associations were directionally consistent in both external cohorts. Risk gradients were stronger at younger ages; interactions by race and ethnicity were not statistically significant. C-statistics were approximately 0.60–0.75, indicating modest discrimination.
The findings suggest WC may complement BMI when assessing adiposity-related T2D risk in women, but it is not a stand-alone prediction tool. The observational analyses do not establish that WC-based categorization improves clinical outcomes, and applicability beyond the studied populations is uncertain.
In practice
For women similar to those studied, waist circumference may add information about adiposity-related T2D risk beyond BMI: higher WC generally marked greater risk within BMI categories. It may therefore complement, but should not replace, broader metabolic risk assessment. The study does not show that WC-based risk categorization improves outcomes or establish a treatment or screening change. Its predictive discrimination was modest (C-statistics approximately 0.60–0.75), and findings may not generalize to populations outside the cohorts studied.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
The Journal of Clinical Endocrinology & Metabolism: Body Mass Index-Specific Central Adiposity and Risk of Incident Type 2 Diabetes Among Aging Women ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.