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Cited by 253Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietAdipokines, Inflammation, and Metabolic Diseases

Anthropometric and adiposity indicators and risk of type 2 diabetes: systematic review and dose-response meta-analysis of cohort studies

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Jayedi, Ahmad, Soltani, Sepideh, Motlagh, Sheida Zeraat-talab, Emadi, Alireza, Shahinfar, Hosein, Moosavi, Hanieh, Shab-Bidar, Sakineh·2022·BMJ
DOI 10.1136/bmj-2021-067516PMC PMC8764578
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Abstract

Objective: To present a comprehensive review of the association between measures of body weight, waist, and fat, and different ratios of these measures, and the risk of type 2 diabetes. Design: Systematic review and dose-response meta-analysis of cohort studies. Data sources: PubMed, Scopus, and Web of Science up to 1 May 2021. Review methods: Cohort studies looking at the association between general or central adiposity and body fat content and the risk of type 2 diabetes in the general adult population were included. Two of the authors extracted the data in duplicate. Random effects dose-response meta-analyses were performed to estimate the degree of the associations. Curvilinear associations were modelled with a one stage weighted mixed effects meta-analysis. Results: 216 cohort studies with 2.3 million individuals with type 2 diabetes among 26 million participants were identified. Relative risks were 1.72 (95% confidence interval 1.65 to 1.81; n=182 studies) for an increase in body mass index of 5 units, 1.61 (1.52 to 1.70; n=78) for a 10 cm larger waist circumference, 1.63 (1.50 to 1.78; n=34) for an increase in waist-to-hip ratio of 0.1 units, 1.73 (1.51 to 1.98; n=25) for an increase in waist-to-height ratio of 0.1 units, 1.42 (1.27 to 1.58; n=9) for an increase in visceral adiposity index of 1 unit, 2.05 (1.41 to 2.98; n=6) for a 10% higher percentage body fat, 1.09 (1.05 to 1.13, n=5) for an increase in body shape index of 0.005 units, 2.55 (1.59 to 4.10, n=4) for a 10% higher body adiposity index, and 1.11 (0.98 to 1.27; n=14) for a 10 cm larger hip circumference. A strong positive linear association was found between body mass index and the risk of type 2 diabetes. Positive linear or monotonic associations were also found in all regions and ethnicities, without marked deviation from linearity at a specific cut-off value. Indices of central fatness, independent of overall adiposity, also had positive linear or monotonic associations with the risk of type 2 diabetes. Positive linear or monotonic associations were also found for total and visceral fat mass, although the number of studies was small. Conclusions: A higher body mass index was associated with a greater risk of developing type 2 diabetes. A larger waist circumference, independent of overall adiposity, was strongly and linearly associated with the risk of type 2 diabetes. Systematic review registration: PROSPERO CRD42021255338.

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  • Although the global prevalence is rising (estimates range from 11%-14% of adult population), the incidence of type 2 diabetes has stabilized or decreased in most places worldwide.

    “Although the global prevalence is rising (estimates range from 11%–14% of adult population), the incidence of type 2 diabetes has stabilized or decreased in most places worldwide.6,7”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [7]

    The Introduction (page unavailable) describes type 2 diabetes as having a rising trend over past decades, supporting the general statement that its burden is rising. It does not give an 11%–14% prevalence estimate or say that incidence has stabilized or decreased in most places worldwide; the Results examine adiposity and diabetes risk, not global incidence trends. (LLM, conf=0.84)

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Sorted by citations

Authors
Jayedi, A., Soltani, S., Motlagh, S. Z.-T., Emadi, A., Shahinfar, H., Moosavi, H., & Shab-Bidar, S.
Affiliations
  • Semnan University of Medical Sciences (IR)
  • Shahid Sadoughi University of Medical Sciences and Health Services (IR)
  • Tehran University of Medical Sciences (IR)
ORCID
Venue
BMJ
Publisher
BMJ
Published
2022-01-18
Volume
376
Pages
e067516
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj-2021-067516
PMC
PMC8764578
OpenAlex
W4206100145
Cited by
253
References
14
Citations by year
2026: 49 · 2025: 80 · 2024: 66 · 2023: 47 · 2022: 11
FWCI
7.26
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
type 2 diabetes, anthropometry, abdominal obesity, body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, visceral adiposity index, body fat percentage, body shape index, body adiposity index, hip circumference, dose-response relationship, diabetes risk factors, body weight, body fat content, adiposity indicators, dose-response curves
MeSH terms
Adipose Tissue, Adult, Aged, Anthropometry, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Obesity, Body Mass Index, Linear Models, Waist-Hip Ratio, Adiposity, Waist Circumference, Young Adult, Waist-Height Ratio

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