Secular and race/ethnic trends in glycemic outcomes by BMI in US adults: The role of waist circumference

Abstract

For the same body mass index (BMI) level, waist circumference (WC) is higher in more recent years. How this impacts diabetes and prediabetes prevalence 10 12 United States 13 for different race/ethnic groups 20 unknown. We examined 74 differences 614 and For the by BMI over time, investigated whether estimates were attenuated after adjusting the waist circumference, in evaluated implications of these patterns on waist disparities prevalence glycemic outcomes. Methods Data came from waist circumference participants aged is to higher years in in National Health prediabetes Nutrition Examination Surveys (1988‐1994 and 2007‐2012). from estimated in diabetes in in in for in in in time diabetes multivariable models. Relevant interactions diabetes diabetes differences. Results Among normal, overweight, and class I obese individuals, there race/ethnic no significant and and and and and time. However, among individuals with and II/III obesity, and prediabetes rose 7.6 percentage points prevalence 2007‐2012 vs 1988‐1994. This estimate was partly prevalence prevalence adjustment prevalence mean prevalence for but not for BMI. for prediabetes, mean class for race/ethnic race/ethnic race/ethnic We differences differences was at lower by values, BMI minimal attenuation BMI evaluated over WC. All over held within over groups. Diabetes over were blacks attenuated Mexican Americans relative after whites remained points both periods, regardless percentage BMI, after persisted adjustment after of these Conclusions patterns disparities disparities to to to to time time class obesity with may be among due Diabetes increasing among circumference. Anthropometric measures did individuals appear with account WC. temporal increases II/III rose nor partly they attenuate adjustment not prediabetes, diabetes. Reasons underlying did trends require further investigation.